Oncology News Central (ONC)“Eye-Opening” Drug Pricing Analysis Has Big Oncology Implications, Says COA Director

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Recent analysis reveals significant involvement of pharmacy benefit managers (PBMs) in the 340B Drug Pricing Program, raising concerns about fund diversion and potential impacts on patient care. The study, conducted by Avalere for the Community Oncology Alliance (COA), highlights the extensive participation of PBMs and their affiliated for-profit corporations in 340B contract pharmacies, particularly through mail-order and specialty pharmacy arrangements.

Key Points:

• 69% of 340B contract pharmacies are associated with a PBM through vertical integration or contractual arrangements
• Specialty and mail-order pharmacies account for 29% of all contract pharmacy arrangements, despite representing only 1% of contract pharmacies
• The analysis challenges the argument that contract pharmacies primarily serve rural areas
• Implications for oncology include potential delays in drug delivery, treatment denials, and increased administrative burden for practices
• COA advocates for increased transparency and accountability in the 340B program
• Potential reforms may focus on limiting PBM involvement in contract pharmacies and improving oversight
• The growing intersection between 340B and PBMs is drawing bipartisan attention for reform efforts

“Congress never contemplated that this would be a program that would be a moneymaker for for-profit corporations. It was specifically a program that entitled a finite, relatively small number of safety net hospitals to stretch scarce resources.”
– Ted Okon, MBA, COA Executive Director

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