Background

For patients that face barriers to filling their prescriptions, the availability of medication access services at their site of care can mean the difference between receiving prescribed drug therapy, and undue interruptions in care. Hospitals often provide medication access services that are not reimbursed by payers; however, they can be challenging to sustain. The 340B Drug Pricing Program allows covered entities to generate savings through discounted pricing for certain outpatient medications, which can then be used to provide more comprehensive services, including medication access services.

Objective

To characterize medication access services provided at hospitals that participate in the 340B Drug Pricing Program compared to hospitals that do not participate in the 340B Program.

Methods

Primary questionnaire response data was collected from a national sample of Directors of Pharmacy at non-federal acute care hospitals from March 2019 to May 2019. American Hospital Association Data Viewer was used to collect demographic information on 1,531 hospitals. Hospitals were excluded if they had 199 beds or fewer, did not have a unique Medicare provider ID, were federally owned, were located outside the continental U.S., or were non-acute care hospitals that served niche patient populations. This study utilized a proportional stratified sampling strategy to administer an electronic questionnaire to 340B and non-340B hospitals to assess the number and type of medication access service offerings. A final randomized sample of 500 hospitals were administered the questionnaire, and data was collected through recorded responses in Qualtrics software.

Results

340B hospitals provided a significantly higher average number of medication access services compared to non-340B hospitals (6.20 vs. 3.91, p = 0.0001), adjusted for differences in hospital size and ownership type. For all nine medication access services that were assessed, a higher percentage of 340B hospitals reported providing the service compared to non-340B hospitals. This difference was statistically significant for six out of nine programs assessed.

Conclusions

340B hospitals provided more medication access services, on average, than comparably sized non-340B hospitals, suggesting that hospitals participating in the 340B Drug Pricing Program may be better positioned to create and administer programs that support medication access services.

中文翻译：

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340B 和非 340B 医院药物获取服务的比较

背景

对于在配药方面面临障碍的患者，在他们的护理地点是否提供药物获取服务可能意味着接受处方药物治疗与护理不当中断之间的差异。医院通常提供不由付款人报销的药物获取服务；然而，它们可能难以维持。340B 药物定价计划允许受保实体通过某些门诊药物的折扣定价来节省开支，然后可用于提供更全面的服务，包括药物获取服务。

客观的

比较参与 340B 药物定价计划的医院与不参与 340B 计划的医院提供的药物获取服务的特征。

方法

主要问卷答复数据是从 2019 年 3 月至 2019 年 5 月非联邦急诊医院药房主任的全国样本中收集的。美国医院协会数据查看器用于收集 1,531 家医院的人口统计信息。如果医院有 199 张或更少床位、没有唯一的医疗保险提供者 ID、为联邦政府所有、位于美国大陆以外，或者是为特定患者群体提供服务的非急症护理医院，则被排除在外。本研究采用比例分层抽样策略对 340B 和非 340B 医院进行电子问卷调查，以评估药物获取服务的数量和类型。对 500 家医院的最终随机样本进行了问卷调查，

结果

与非 340B 医院相比，340B 医院提供的药物获取服务的平均数量明显更高（6.20 对 3.91，p = 0.0001），根据医院规模和所有权类型的差异进行调整。对于所有接受评估的九项药物获取服务，与非 340B 医院相比，340B 医院报告提供服务的百分比更高。对于评估的九个程序中的六个，这种差异具有统计学意义。

结论

平均而言，340B 医院提供的药物获取服务比同等规模的非 340B 医院多，这表明参与 340B 药物定价计划的医院可能更有能力创建和管理支持药物获取服务的计划。