Assistant Professor, Department of Neurological Surgery, UCSF; Affiliated Faculty, Institute for Health Policy Studies, UCSF; Director of Spinal Neurotrauma, ZSFG; Senior Affiliated Scholar, Mercatus Center
Disappointing to hear someone from HRSA state that a flawed drug discount program is a “pillar of US healthcare…” More than doctors and nurses, huh?
Nationally Recognized Expert in Health Care and Life Sciences, Educator, Regulatory Consultant, Patient Access Advocate, Independent Director, and Retired Sidley Austin Partner
#HRSA’s Presentation at the 340B Coalition Conference: Insightful, Deeply Disappointing The 340B Coalition’s Summer Conference kicked off today. Jordan Grossman, the Deputy Administrator at the Health Resources and Services Administration (HRSAgov), HHS presented. It was equal parts interesting and deeply disappointing. The presentation started with a bit of a thud, when the announcement was made—repeatedly—that he would not be taking questions. It was indicative of a defensive tone that wound its way through the presentation. More about that later. For a big chunk of the presentation, Grossman was all in in support of the 340B community’s view that 340B revenues are used for the benefit of patients. • He began with a full throttled statement that the agency’s own vast array of programs “simply could not exist without 340B program”. • Next, he called 340B the “irreplaceable pillar” of the #healthcare system. • HRSA is “concerned” about the “pillar” in light of the current environment (which sounded like a veiled reference to the #contractpharmacy policies). • From there, he said over and over again “we know that” 340B CEs use revenues to support dozens of specified “beneficial” programs. There was no call for more of the revenues to be used by #coveredentities to provide lower cost access to #prescription #drugs—zip, none, zed. Although I resist Adam Fein’s conclusion that HRSA has succumbed to “regulatory capture”—where an agency becomes focused on advancing the positions of regulated stakeholders, rather than providing oversight—it was hard not to think exactly that during this section of the presentation. Grossman’s presentation here had the flavor of a political stump speech. Having expressed support for 340B CEs, Grossman turned to decrying the fact that, despite HRSA’s support of CEs, the agency “has been subject to a wide range of legal challenges in recent years… [that] have come … from covered entities and from manufacturers”. The subtext was pretty clear, though unstated—we support CEs, stop suing us. Grossman completely sidestepped any substantive references to the federal court cases, the state laws declaring those policies illegal, and the various #legislative proposals that have been advanced. Rather blandly, he stated that HRSA’s recent budget proposal reflected HRSA’s policy positions: 1) covered entities should be obligated to report how much they have in #340B revenues and how they use them; 2) Congress should codify contract #pharmacies, with what conditions it thinks appropriate (i.e., #Congress fix this because we are done); and 3) Congress should give #HRSA regulatory authority (i.e., insulate us from these lawsuits by giving us clear authority to act). Most telling is what HRSA DIDN’T address. The words compliance, diversion, and duplicate discounts were never used. Not a one. Not once. #lifesciences #drugpricing #Protect340B #Defend340B
Nationally Recognized Expert in Health Care and Life Sciences, Educator, Regulatory Consultant, Patient Access Advocate, Independent Director, and Retired Sidley Austin Partner
2wTouché! And thanks for the repost.