Missouri has long been a leader among states in setting common-sense, consumer-centric public policies. Our state was home to the first state university west of the Mississippi, opened in1841. The Pony Express’ first trip originated in Missouri. We hosted the first Olympic Games in America. And we were the first state to begin construction on an interstate highway.
Missouri has been leading the nation in passing laws to protect our citizens against the sky-high cost of health care, especially when it comes to prescription drugs for working-class and rural Missourians. Most recently, we were one of the first states to adopt legislation to protect a little-known but highly effective federal law known as the 340B drug pricing program.
Enacted in 1992, 340B requires drug companies to sell their products at a discount when they are purchased by safety-net hospitals, rural health clinics (RHCs), and Federally Qualified Health Centers (FQHCs) that serve large numbers of patients with low incomes who often cannot afford the care they need. In exchange for those discounts, participating drug companies were guaranteed entry into the lucrative Medicare and Medicaid prescription drug programs. Uniquely, 340B does not take any taxpayer dollars to pay for care. Instead, the funds come out of drug company profits. For over 30 years, 340B has done its job, helping patients and keeping safety-net hospitals, RHCs and FQHCs open to continue serving small communities across our state. All the while, drug companies continued to get more and more wealthy.
Healthcare providers in Missouri use the savings they earn from the discounts to pay for care – including but not limited to drugs – that patients need but cannot afford. The savings also pay for such vital but money-losing services as trauma and burn care, obstetrics, treatment of opioid dependency, and care for people with HIV/AIDS. 340B dollars also help our hospitals, RHCs, and FQHCs recruit and retain new doctors and nurses, a key part of preserving our health care system.
Without 340B, the wave of rural hospital, clinic, and health center closures we have already seen would be worse. More providers would be forced to close—either that or taxpayers would be left to cover that health care while drug company profits would grow even more. That makes no sense. It’s also wrong.
It may be shocking, but not surprising, that the pharmaceutical industry is trying to gut 340B to increase their profits even more. These attacks are occurring in Washington DC and Jefferson City. Missouri is one of a group of mostly red states to pass legislation protecting 340B from these attacks. Drug companies have gone to the courts to sue states like ours to overturn those laws. Just last year, drugmakers sued the state of Arkansas over their law protecting 340B and were denied their review to overturn the law by the United States Supreme Court. In Congress, Senate Majority Leader Thune has been a steadfast advocate for Missourians, consistently standing up for policies that protect access to affordable health care and safeguarding programs like 340B. His leadership in the Senate has been instrumental in pushing back against pharma’s efforts to weaken the program, ensuring that Missouri rural hospitals, clinics, FQHCs, and patients continue to benefit from the cost savings it provides.
However, with their multi-million dollar lobbying and legal campaigns failing, the drug industry has turned to the age-old tactic of misleading consumers about drug pricing. By spreading falsehoods, they hope to tarnish 340B’s reputation and protect their profits all while defenders of the program are outmanned, outgunned, and outspent.
It’s vitally important that we Missourians do not fall for these tricks when the health of our residents and communities is on the line. 340B is a highly effective program that has lowered drug prices and kept rural hospitals, health centers, and clinics operating at a time when many of their compadres have had to close up shop, leaving rural communities without a source of care.
Missouri has protected the 340B program and must keep up that fight. The best way to achieve that victory is to make sure our fellow Missourians understand what the program is, who it benefits, and the pure profit motive of those trying to destroy it, piece by piece.
Executive Director of the Missouri Rural Health Association (MRHA). At MRHA, we are elevating the voices of rural Missourians to improve health and wellbeing by providing leadership on rural priorities through advocacy, partnerships, and education.
