What is the impact of the 340B program on drug access, healthcare quality, and finances among low-income and/or uninsured patients?

Abstract

The 340B Program is a pharmaceutical subsidization program enacted in 1992 aimed towards allowing safety-net hospitals and clinics to better stretch their limited resources to serve uninsured and/or low-income patients. With its rapid growth, the 340B program has faced scrutiny in regards to its levels of efficacy and integrity. This report aims to analyze academic literature related to instances of 340B enactment across the United States and evaluate the extent to which it has accomplished its original objectives in three main areas: drug access, financial effects, and healthcare quality. We conducted a comprehensive literature review utilizing Google Scholar primarily to explore these three aspects in the context of the 340B Program.

In regards to the results, they suggest that while the program has succeeded in reducing drug costs and improving healthcare outcomes in some instances, there are significant concerns regarding its misuse. Certain hospitals have been found to utilize the program to bolster their own profits rather than to improve the quality of care for vulnerable populations. The program has allowed some hospitals to sustain critical services and enhance patient care, yet evidence also shows that it has led to increased drug spending and reinvestment into hospitals in more affluent areas. Similarly, the impact on healthcare quality is varied, with some studies showing improvements in services provided by 340B hospitals, while others indicate no significant difference in care quality compared to non-340B hospitals. These findings highlight both the benefits and shortcomings of the 340B program, raising important questions about its current level of integrity in implementation and the need for potential reforms to ensure participating entities are truly utilizing the program for its original intentions.