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The case for drug discounts


It is truly disappointing to see Howard Dean carrying the water for the pharmaceutical industry in his Aug. 6 op-ed, “How drug discounts are being manipulated.” His position on the vital 340B drug discount program is both misleading and at odds with his own track record of supporting universal health care.

Sadly, Dr. Dean has chosen to fall in with drug companies that wish to derail the 340B program because it eats into profits.

He is clearly not on the side of safety-net health care providers like Detroit’s Henry Ford Hospital, where I treat patients with cancer. We provide more than $200 million in uncompensated care annually. We take pride in the fact that our doctors are blind to a patient’s economic circumstances. That’s thanks in large part to 340B savings.

Congress created the 340B program in 1992 with bipartisan support to allow health providers that serve large numbers of low-income patients to receive discounted medications from drug companies. In turn, these safety-net hospitals use their savings to maintain and enhance the services they provide to their vulnerable patient populations, including supplying low-cost or no-cost medicines to the community. The program also helps fund diabetes, HIV/AIDS, cancer, dental and primary-care clinics.

Contrary to Dr. Dean’s assertion based on a pharmaceutical industry-funded report, the contract pharmacy program is not being abused by hospitals. Each private pharmacy that Henry Ford Hospital contracts with offers discounts to eligible patients on a sliding scale. We currently have 500 patients receiving free medicines in this way — totaling more than $500,000 in giveaways. The system makes drugs easier to obtain closer to home, and it keeps our patients healthier and out of the emergency room.

In fact, 82 percent of 340B health care providers have no relationships with outside pharmacies whatsoever. Lone private pharmacies often have multiple relationships with the clinics of a single provider and these relationships are all counted as “contract arrangements” by the government. Only about 14,000 pharmacies have such deals.

The good doctor professes support for universal healthcare but his position against the 340B drug discount program doesn’t add up. If Big Pharma is successful gutting it, safety-net hospitals will be forced to cut back medication discounts and vital clinical services for the underserved in Detroit and millions of other needy patients across America.

Robert Chapman, MD, director, Josephine

Ford Cancer Institute at the Henry Ford Health

System in Detroit