Title: Karmen Hanson, MA
1 Karmen Hanson, MA Senior Policy
Specialist National Conference of State
Legislatures
340B Drug Purchasing Options for States
Overview of State Rx 340B Legislation August 5,
2005
- Over 600 bills in all 50 states.
- What's new and different?
- Future for states and 340B?
22005 Rx Legislation Overview
- As of late June, over 600 bills in 50 states
- Approx. 33 states PASSED legislation (a few
vetoes) - Approx. 350 bills in both 2003 2004
- Some familiar topics Medicaid, SPAPs, Rx
importation, bulk purchasing, and 340B - New topics MMA, clinical trials, Rx monitoring,
access to brand name Rx, and liability
protection
32005 Rx Legislation Examples
42005 Rx Law Examples
- As of early July, laws include
- 340B, access to brand name Rx, bulk purchasing,
Rx clearinghouses, Rx discounts, Rx importation,
labels, manuf. liability, mail order, marketing,
Medicaid, MMA, PBM, PDL, pricing, Rx
recycling/reuse, subsidies, clinical trails and
wholesalers - 340B still gets attention
5States 340B Growing!
6States get creative with 340B
- States may
- fund services
- encourage or expand use
- systematically evaluate options
- provide loans to FQHCs for pharmacies
- 2005 Law Examples CO (vetoed), ME, NY, UT
- Bills CA, HI, MA, MN, NM, RI
- 2004 Law Examples NM, VT
- Bills CO, CT, KY, MD, MN, VA
- 2003, etc
7State Activities Encouraging 340B
82005 340B Laws
- ME LD 1324 Establishes the Pharmacy Cost
Management Council to develop measures to
control the cost of Rx and . research
purchasing and coordination of benefits related
to maximizing use of federal programs (Medicare,
340B)... - NY A 7298 Implements the 340 B pharmacy savings
program. Prohibits state from reimbursing 340B
covered entities or contracted pharmacies at
Medicaid price for drugs that are for 340B
outpatients. Payment must be for 340B price plus
reasonable administrative cost. - UT HB 33 Creates a five-year pilot program for
disease and pharmaceutical management of bleeding
disorders permits enrollees in the pilot program
to participate in 340B and reporting of costs to
state.
92005 340B Legislation
- CA AB 76 Would pursue "all opportunities for the
state to achieve savings through the federal 340B
program including individuals receiving
prescription drugs through state programs. It
would ensure that hospitals, clinics, and other
eligible entities participate in the program.
(passed Assm. 6/2/05) - CA AB 77 Would allow pilot project for
contracting for inmate health care to use 340B
and reduce health care costs. (passed Assm.
6/2/05) - CO HB 1152 Would require state to maximize Rx
discounts through the utilization of 340B in
order to receive the maximum state budget
savings. (VETOED by gov. 6/1/05) - HI HB 1058/SB 868 Would appropriate funds to the
DOH for FQHCs and the Medicine Bank to provide
pharmacy services and supplies to low-income
patients. (Did not pass by end of session)
102005 340B Legislation cont.
- MA H 2700 Would require all programs, clinics,
hospitals and other health-related centers and
entities that are eligible under Section 340B to
participate in the federal prescription drug
price discount program, unless they demonstrate
greater savings through other purchasing. (In
committee) - MN HF 1422 Would require Hemophilia drugs to be
obtained from a 340B approved health facility.
(Passed both chambers, but did not pass
conference committee) - NM SB 11 Would expand pharmacy services in
primary care clinics. (Did not pass by end of
session) - RI S 806 Would create a coordinated
pharmaceutical contracting system or multi-state
Rx program on behalf of all individuals served or
covered by state programs and expanded use of
340B discounted pricing. (In committee)
11Other 340B laws/actions NM
- 2002- SJM 35 (Memorial) Requests . (to)
"identify all avenues to maximize prescription
drug discounts that may be achieved by using the
federal 340B program. - 2003- SB 338, now Chapter 315 Requires
Medicaid to identify entities that are eligible
to participate in 340B. Range of General Fund
Savings 500,000-1.5M. - 2004- HB 88 Ensures that all eligible entities
participate in the federal drug pricing program
under Section 340B of the federal Public Health
Service Act. Allows entities receiving greater
discounts to opt out.
12More Laws ME and CT- 2003
- Maine Requires the Department of Human Services
to study and report to the Joint Standing
Committee on Health and Human Services the
benefits that could be recognized by the state
through prescription drug discount programs
available under Section 340B of the federal
Public Health Services Act used to provide
prescription drugs in Maine. - Connecticut Provides loans to FQHCs for the cost
of establishing a pharmacy facility or a
partnership with a community pharmacy to serve as
a centralized prescription drug distributor for
FQHCs that have established affordable
pharmaceutical drug programs for their patients.
The Commissioner of Social Services would assist
any FQHC that is applying for a loan by providing
non-individual identifying information concerning
potential participants in the affordable
pharmaceutical drug program.
13More LawsAR, MD and TX- 2001
- Arkansas HB 2498 of 2001 authorizes expanded use,
creation or designation of FQHCs to get
"substantially discounted prescription drug
prices." - Maryland HB 6 of 2001 requires the state to study
the feasibility of purchasing prescription drugs
through FQHCs. - Texas HB 915 of creates the Interagency Council
on Pharmaceuticals Bulk Purchasing, which must
investigate options for using the 340B program
...for better purchasing power, including ...
using rebate programs, hospital disproportionate
share purchasing, and health department and FQHC
purchasing." - Texas SB 347 of authorizes TX to provide
prescription drug services to the prison
population through the 340B program. Establishes
a contract with two university hospital pharmacy
systems that are qualified providers within the
340B program.
14States Rx Future ?
- Future of state assistance plans?
- Medicare Part D? Changes coming!
- AWP ? ASP Price changes for 340B?
- States are still in this to stay.
- Information
- Pharmacy Services Support Center http//pssc.apha
net.org/ - www.ncsl.org/programs/health/drug340B.htm