Hospitals say the Government Accountability Office used faulty methodology when it found that hospitals that serve high numbers of low-income patients abuse a federal drug discount by overprescribing medications. HHS raised similar concerns about the findings.
Hospitals that serve a disproportionate share of uninsured and low-income patients have access to discounted prices on outpatient drugs through the 340B Drug Pricing Program, administered by the Health Resources and Services Administration. Drugmakers have argued that the program is being exploited by hospitals for financial reasons and should be pared back.
A GAO report released last week found that in 2008 and 2012, per-beneficiary Part B drug spending, including oncology drug spending, was substantially higher at hospitals using the 340B discount than at other hospitals. For example, in 2012, average per-beneficiary spending at 340B hospitals was $144, compared with about $60 at hospitals not in the program.
“This indicates that, on average, beneficiaries at 340B disproportionate-share hospitals were either prescribed more drugs or more expensive drugs than beneficiaries at the other hospitals in GAO's analysis,” the watchdog agency said.
Hospital groups questioned how GAO came up with its results. They argued that the report didn't take into account that 340B hospitals may see sicker patients than other hospitals, and they said the GAO may have unfairly ignored other reasons for the higher spending, including that patients in non-340B hospitals more frequently receive drugs outside of hospitals.
“We're surprised not only by the lack of evidence and data for GAO's conclusions and recommendations, but also by its suggestion that physicians in our nation's essential hospitals would ignore patient needs to enrich hospitals,” Dr. Bruce Siegel, CEO of America's Essential Hospitals, said in a written statement.
Tom Nickels, a senior vice president at the American Hospital Association, agreed. “Simply put, the GAO report misses the mark,” he said.
A 340B hospital group called 340B Health said the GAO's study “only examined average difference in per-beneficiary spending by hospital type, and did not examine any patient differences in terms of outcomes or quality.”