University of Maryland Medical Center, Baltimore, MD, USA.
University of Maryland School of Pharmacy, Baltimore, MD, USA.
Res Social Adm Pharm. 2019 Jan;15(1):114-116. doi: 10.1016/j.sapharm.2018.03.065. Epub 2018 Mar 27.
The 340B Drug Pricing Program was intended to stretch federal resources by providing significant discounts to covered entities providing care to underserved populations. Program implementation and evidence of expanding services to higher income patients has brought more scrutiny and calls for elimination of the program. While additional review and reform may be warranted, profitability from 340B discounts enables covered entities to provide additional services that may not be feasible in absence of the program. This case report demonstrates one institution's use of 340B discounts to financially justify providing bedside medication delivery services for patients at the time of discharge from an inpatient admission. A simple financial model was developed using hospital data and inputs from available literature to estimate gross profit and earnings before interest, taxes, depreciation, and amortization (EBITDA) with and without 340B discounts. Without the 340B drug price discounts, the service would operate at a financial loss, and further investigation must be done to determine whether other clinical or economic benefits would warrant discharge medication delivery at the institution.
340B 药品定价计划旨在通过向为服务不足人群提供护理的参保实体提供大幅折扣来扩大联邦资源。该计划的实施以及向高收入患者扩大服务的证据引起了更多的审查和取消该计划的呼声。虽然可能需要进一步审查和改革，但 340B 折扣的盈利能力使参保实体能够提供额外的服务，如果没有该计划，这些服务可能是不可行的。本案例报告展示了一家机构利用 340B 折扣来证明在患者从住院治疗出院时提供床边用药配送服务的合理性。使用医院数据和现有文献中的投入，开发了一个简单的财务模型，以估算有和没有 340B 折扣的毛利润和息税折旧摊销前利润（EBITDA）。如果没有 340B 药品价格折扣，该服务将出现财务亏损，必须进一步调查，以确定是否有其他临床或经济效益证明在该机构提供出院用药配送是合理的。
