Bipartisan Coalition of Attorneys General Protect Access to Low-Cost Prescription Drugs at Health Centers

Protecting access to low-cost prescription drugs received a boost this week from a bipartisan coalition of attorneys general representing nearly 30 states. The group is urging the U.S. Department of Health and Human Services (HHS) to hold accountable drug manufacturers that are unlawfully refusing to provide discounts to federally qualified health centers, hospitals, and other providers that serve vulnerable patient populations through the 340B Drug Pricing Program.  As we’ve mentioned in the past (see previous blog post), the 340B program that is critical for health centers’ ability to make medications and services affordable for patients has been under attack by pharmaceutical manufacturers over the course of the past few months. The actions by drugmakers include refusing to allow certain 340B drugs to be shipped to contract pharmacies, conditioning access to 340B drugs among health centers by demanding extensive data — measures that ultimately deprive health centers of 340B savings and make it harder for patients to buy life-saving affordable medicines.

To defend health centers, 29 state attorneys general sent a bipartisan letter to U.S. Health and Human Services (HHS) Secretary Alex Azar and Health Resources and Services Administration (HRSA) Administrator Tom Engels urging them “to address drug manufacturers’ unlawful refusal to provide critical drug discounts to covered entities, such as community health centers, under the 340B Drug Pricing Program.”

The letter was led by Connecticut Attorney General William Tong and California Attorney General Xavier Becerra, who is President-elect Joe Biden’s nominee to be the next Secretary of the Department of Health and Human Services. Other signers include State Attorneys General of Kansas, Nebraska, Colorado, Delaware, Hawaii, Illinois, Iowa, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Dakota, Vermont, Virginia, Washington, Wisconsin, and the District of Columbia.

The letter also adds that “…HHS has the authority to issue civil monetary penalties, and to issue guidance articulating the statutory responsibilities of drug manufacturers. The illegal actions of drug manufacturers during this time of urgent need compel HHS to utilize its authority to maintain and support the purpose and execution of the 340B Drug Pricing Program.”

This bipartisan, multistate action could not have come at a more critical time for health centers. Across the country, millions of lives are at stake and health center operations and budgets face possible devastation in the midst of the devastating pandemic. NACHC has spoken out against these tactics and filed a lawsuit back in October in response. The suit seeks to compel the Department of Health and Human Services (HHS) to promulgate administrative dispute resolution (“ADR”) regulations and implement a process to adjudicate and remedy the 340B violations by drugmakers.

Meanwhile, the impact of the drugmakers’ actions on health centers and patients is gaining notice. In a New York Times story published today Sue Veer, the president and chief executive of Carolina Health Centers, in South Carolina, described how cutting off access to contract pharmacies reduces “the savings that my health centers can retain and then invest back into primary care, things like behavioral health and substance abuse programs,” or programs for people who have H.I.V.”

Attorney General William Tong of Connecticut, also summed it up this way to Times reporter Sheryl Gay Stolberg: “It really stuns me that companies do not seem to understand that people need access to health care and prescription drugs, literally, to live.”