Department of Pharmacy, Houston Methodist, 7550 Greenbriar Dr., Houston, TX, 77030, USA.
Powers Pyles Sutter & Verville PC, 1501 M Street NW, Seventh Floor, Washington, D.C, 20005, USA.
Res Social Adm Pharm. 2021 Nov;17(11):1887-1892. doi: 10.1016/j.sapharm.2021.03.010. Epub 2021 Mar 20.
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.
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.
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.
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.
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.
对于那些在配药方面存在障碍的患者来说，在其治疗场所获得药物获取服务的机会意味着他们能否获得所开药物治疗以及是否会中断治疗。医院通常提供不受支付方报销的药物获取服务；然而，这些服务难以持续。340B 药品定价计划允许参保实体通过为某些门诊药物提供折扣定价来节省资金，然后可以利用这些资金提供更全面的服务，包括药物获取服务。
与未参与 340B 计划的医院相比，描述参与 340B 药品定价计划的医院所提供的药物获取服务。
2019 年 3 月至 2019 年 5 月，从全国非联邦急症护理医院的药剂主任中收集了主要问卷答复数据。使用美国医院协会数据查看器收集了 1531 家医院的人口统计学信息。如果医院有 199 张床位或更少，没有独特的医疗保险提供者 ID，是联邦所有、位于美国大陆以外或是非急症护理医院且服务于特定患者群体，则将其排除在外。本研究利用比例分层抽样策略向 340B 和非 340B 医院发放电子问卷，以评估药物获取服务的数量和类型。对 500 家随机抽取的医院进行了问卷调查，并通过 Qualtrics 软件中的记录答复收集数据。
与非 340B 医院相比，340B 医院提供的药物获取服务数量明显更高（6.20 比 3.91，p=0.0001），这是根据医院规模和所有权类型的差异进行调整后的结果。在所评估的九种药物获取服务中，报告提供该服务的 340B 医院比例均高于非 340B 医院。在所评估的九个项目中有六个存在统计学差异。
与同等规模的非 340B 医院相比，340B 医院平均提供了更多的药物获取服务，这表明参与 340B 药品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项目。
