Elizabeth Linderbaum is NACHC’s Deputy Director of Regulatory Affairs.
This post is part of NACHC’s 340B Blog Series. The 340B Drug Pricing Program is an essential source of support for Community Health Centers, allowing them to stretch increasingly scarce federal resources and reinvest in patient care. Learn more about 340B and read other blogs in the series.
Nestled in the western part of South Carolina called the Lakelands region, Carolina Health Centers has 12 medical offices where they serve 28,000 patients across 7 counties, totaling to approximately 130,000 patient visits per year. Founded in 1977, Carolina Health Centers participates in the 340B program, a federal bipartisan drug pricing program.
The intent of the 340B program is for certain safety-net health care providers to receive specific medications at a discount to allow them to stretch their already scarce resources. The program enables Community Health Centers like Carolina Health Centers to reinvest 340B savings into existing services or offer new services that positively impact patient care and access to health care services.
Pharmacies located in patient communities are crucial
Given their large and mostly rural service area, Carolina Health Centers uses contract pharmacies to increase their patients’ access to affordable medications in their own communities. While they own two pharmacies, all of their medical sites are 35 to 40 minutes away from those in-house pharmacies. This makes contract pharmacies – a pharmacy the health center contracts with to provide medication– located in their patients’ communities crucial. 340B savings can help health centers enter into agreements with contract pharmacies.
Not only do local pharmacies expand patient access to discounted medications but they help alleviate potential transportation barriers for patients. Some contract pharmacies also offer extended weekend hours, giving patients another opportunity to get their prescriptions in case the health centers’ in-house pharmacies aren’t open when they need a prescription.
Savings from 340B support a free home delivery program and courier service for medications
Carolina Health Centers uses 340B savings to offer services that meet the unique needs of their patients and bring the care directly to them. During the pandemic, they began a free home delivery program for patients that live in a 10-square mile radius of their health center. This allowed patients who did not feel comfortable going into the pharmacy, or could not get to the pharmacy, to still get their prescriptions or over the counter medications. Carolina Health Centers continues to offer this service, which delivers an average of 1,000 prescriptions per month and as high as 40 deliveries per day.
Another way they have innovatively helped extend pharmaceutical access for their patients is through their courier service. This health center-owned courier service delivers medications to Carolina Health Centers’ medical office locations at least once per day, helping connect their patients with low incomes and patients who face barriers to going to the pharmacy in-person with their medications. Over 25,000 prescriptions per year are delivered using this program. Without 340B savings, maintaining these services that expand access to patients would be in jeopardy of being rolled back or discontinued.
Migratory farm worker clinic supported in part by 340B savings
Carolina Health Centers also sees the direct impact 340B savings has on enhancing health equity for their patients. Given their geographic location, migratory farm workers make up a significant amount of their patient population. During peak growing season, Carolina Health Centers runs a migratory farm worker clinic every Saturday; during off-peak months, it operates every other Saturday. They offer not only medical care, but dental, pharmacy services, integrated behavioral health, health education, wellness screenings, and interpreters to migratory farm workers and their families.
Recent pharmaceutical manufacturer restrictions have threatened health centers’ ability to offer valuable services and programs that help their patients. For Carolina Health Centers, that means programs like their migratory farm worker clinic. While some funding for these pop-up clinics comes from federal grants, their 340B savings account for a large portion of these services. These 340B savings also help fund massive vaccine clinics set up at specific farms so that workers do not have to worry about traveling far distances to stay up to date on their vaccines. While Carolina Health Centers has been able to sustain this program, its viability could be in jeopardy if manufacturers continue to impose restrictions.
The 340B program and its savings has enabled Carolina Health Centers to meet their patients wherever they are in western South Carolina. Their health center, along with others across the country, rely on 340B savings to expand services depending on community needs. Let’s continue to protect this crucial program and protect health care access!
Thank you to Dominic Mellette, PharmD, Chief Pharmacy Officer, for talking with us about Carolina Health Centers.
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I am a retired CHC employee now living in South Alabama in an area that is both rural and urban with transportation that ONLY services the county so even though there are the Walgreens and CVS’s that doesn’t help the thousands of families who do not have access to the 340 medicine system which would greatly benefit this mostly sging population. The increasing cost of medicine is making it almost impossible to pay for medicine. What can be done to attract the big box pharmacy’s invest in and participate in the 340 pharmacy assistance program?
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