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BITTER MEDICINE | Columns | The Journal Gazette

The COVID-19 pandemic rages on, half a million Hoosiers are out of work, and Indianapolis-based Eli Lilly has chosen this moment in history to end the company’s participation in the 340B Drug Pricing Program that provides affordable prescription drugs to low-income residents.

What was Lilly thinking? It’s hard to tell – the company didn’t respond to multiple requests for interviews.

But the medical professionals who are trying desperately to keep the poorest people in the country healthy say the company is attempting to recoup some of its profits from independent pharmacies, which sometimes offer their own discounts. They accuse drug manufacturers threatening to exit the 340B program of courting potential disaster.

The 340B program allows health centers to buy prescription drugs at discounted prices, at a time when the country’s health care system is struggling to provide basic care for patients with chronic conditions who need vital outpatient treatment.

The threatened end of 340B most severely affects community “safety net” health centers, including Fort Wayne’s Neighborhood Health Clinics Inc., which provide primary health care to vulnerable people regardless of their ability to pay.

Many area hospitals may also lose their access to affordable drugs. Tami Brigle, public relations manager at Parkview Health, said 340B programs are in place to serve low-income patients at Parkview Regional Medical Center, Parkview Randallia, Parkview Behavioral Health Center, and at Parkview hospitals in LaGrange and Wabash.

Neighborhood Health Clinics President and CEO Angie Zaegel worries that the effective end of 340B support from Lilly and other manufacturers will make it impossible for the center to provide affordable prescription drugs to low-income northeast Indiana residents.

She said Neighborhood Health Clinics keep careful records of the drugs they prescribe, and their sources.

“We’re a much smaller fish,” Zaegel said. “We’re a qualified health center. This is the only way we’re able to provide our patients with affordable medicines to keep them healthy. We’re closely monitoring this, and trying to understand the overall impact, which we see as a threat to the 340B program. We rely on contracted pharmacy relationships. I’m not sure how we’ll help our patients get access to affordable drugs.”

“Angie is not alone,” said Drew Thomas, finance and operations manager for the Indiana Primary Health Care Association. “We represent 36 primary health centers in Indiana that treat 600,000 Hoosiers, and a vast majority of these clinics have 340B programs.”

Created by Congress in 1992, and representing less than 3% of total U.S. drug sales, the 340B program allows basic health care centers to stretch the federal funding they receive, and provide care to more people.

Hospitals and health clinics such as Neighborhood Health Clinics use their savings to fund specialty clinics that treat patients with specific conditions like diabetes.

The 340B program has also been an important tool for stretching federal grants to help combat the opioid epidemic, which has ravaged urban and rural communities alike.

Pharmacies first

Lilly’s move is not the first time the hammer has dropped on 340B.

In 2018, the