As pharmacy deserts proliferate across the U.S., particularly in rural areas, Greenville, S.C.-based Prisma Health is utilizing the 340B program to help fill the gap.
Jennifer Bair, PharmD, chief pharmacy officer at Prisma Health, told Becker’s that the health system — with locations in South Carolina and Tennessee — has used savings from the 340B Drug Pricing Program to help build a retail pharmacy presence in rural areas where commercial providers have pulled out and where patients have limited access to medications.
Dr. Bair said in one rural community, patient feedback led to action on the part of the health system.
“We heard a lot of feedback from the community that they needed access 24/7, so we responded to the needs of that community and opened that pharmacy 24/7, and that hospital is a 340B-covered entity,” she said.
Operating a 24-hour pharmacy in a low volume area would not be financially viable in and of itself, she added.
“We don’t fill enough prescriptions overnight, really, to justify the cost of the pharmacist, right? We use the 340B funds to supplement the salary there,” Dr. Bair said.
The 340B program, created in 1992, was initially designed to allow safety-net hospitals and healthcare providers purchase drugs at lower prices. However, in recent years the program has come under scrutiny amid rising tensions between hospitals and drug manufacturers over how 340B program savings are used, with some manufacturers accusing providers of abusing the system.
President Donald Trump signed an executive order April 15 that reinforces a policy from his first term that reduced Medicare reimbursement rates for drugs purchased through the 340B program. The aim is to lower patient cost sharing and bring more accountability to drug pricing, according to the White House.
Supporters of the order argue the changes would help lower drug costs for Medicare and improve financial accountability within the system. Critics, however, warn the cuts could undermine the 340B program’s ability to support safety-net hospitals, particularly those serving low-income and uninsured patients.
While watching policy changes unfold, Dr. Bair emphasized that Prisma Health is focused on honoring the program’s original mission, which is to bridge access gaps that would otherwise not be sustainable.
Internally, Prisma Health has developed a steering committee to oversee 340B operations and ensure transparency in how savings are being used to protect the viability of the program.
“I understand where the manufacturers are coming from when they see bad actors and question whether the funds are being used appropriately,” she said. “But we have to protect the original intent of the program. One of the things we’re doing is making sure we can track the impact and tell the story. We need to be able to explain why this program matters to us and what services would be affected if 340B went away.”
