The Intersection of 340B and Cancer Care

As policymakers consider changes to the 340B program, there is increasing interest in whether and how the drug discounts potentially affect the delivery of cancer care.

Just as oncology influences the 340B program’s scope and growth, this study found that the 340B program influences the delivery of cancer care in the US. The financial incentives associated with 340B directly impact what a cancer patient pays for their care – the higher the cost of the drug used, the greater the amount cancer patients pay in cost sharing like deductibles and coinsurance. The incentives that the 340B program creates for hospitals to use costlier medications adds to the costs borne by cancer patients. And the findings from this study and others indicate that the 340B status of a hospital does not necessarily translate to greater amounts of charity care. While 340B hospitals may use the financial benefits of the program in other ways that benefit patients, lack of transparency makes this difficult to confirm.

340B financial incentives have also contributed to the consolidation of cancer care within the hospital setting. Today, urban academic medical centers are the primary beneficiaries of 340B drug margins from cancer treatments and are also more likely to establish or acquire new cancer care sites. While urban teaching hospitals may offer innovative treatments and high-quality care, this consolidation could have negative implications for some patients.

As policymakers consider changes to the 340B program, these issues will need to be addressed to ensure that cancer care is not unfairly impacted, and cancer patients are not burdened with additional out-of-pocket costs.