Duplicate Discounts: Big Pharma Shows True Colors

Surprise! It turns out the drug industry was never really interested in 340B program integrity after all.

Big Pharma has made a lot of noise over the last few years about supplying 340B pricing to contract pharmacies in exchange for claims data. It was sold as a method to improve program integrity and catch “duplicate discounts” – when a drug company provides both a reduced 340B price and a rebate on the same medicine.

The prevalence of duplicate discounts has never been quantified, but manufacturers have used them as a justification for unwarranted meddling in the 340B program. Starting in 2020, some drug companies began requiring hospitals that work with community pharmacies to supply claims data to a Big Pharma-created platform called 340B ESP as a condition to receive 340B pricing. “Data uploaded by 340B covered entities will be used exclusively to identify and resolve duplicate Medicaid and commercial rebates,” says the scheme on its FAQ page.

But recently, drug makers have begun dropping claims data requirements and are simply denying government-mandated discounts to 340B hospitals that use multiple pharmacies. It seems the sky has stopped falling on the issue of program integrity. And that puts the lie to Big Pharma’s 340B ESP ruse. The claims data clearly never mattered in the first place.

Sixteen companies have revised and enhanced their 340B restrictions, in many cases tightening the noose regardless of whether safety-net hospitals turn over claims data or not. They are: Pfizer, J&J, Amgen, Abbvie, GSK, Novartis, Bayer, Novo Nordisk, Exilis, Bausch, Boehringer Ingelheim, Astra Zeneca, Merck, UCB, Bristol Meyers Squibb and EMD.

It’s more proof that Big Pharma will stop at nothing to kill the 340B program – including creating a bogus system to track data that didn’t matter to manufacturers to begin with.

Further shame for a shameless industry.