Tom Wilbur

𝐓𝐡𝐞 𝐌𝐨𝐬𝐭 𝐈𝐦𝐩𝐨𝐫𝐭𝐚𝐧𝐭 340𝐁 𝐩𝐚𝐩𝐞𝐫 𝐘𝐨𝐮'𝐥𝐥 𝐄𝐯𝐞𝐫 𝐑𝐞𝐚𝐝 If you care about #340B policy, use the long weekend to read this outstanding new paper: "Stretching Scarce Authorizing Legislation as Far as Possible: A Legislative History of the 340B Drug Pricing Program." Sayeh Nikpay @saynikpay and her colleagues went back to the early 1990's to reconstruct the program's origins. Their research draws on interviews with 18 key participants and 175 primary source documents spanning 1990–1992. Their conclusion is difficult to ignore: 340B was originally designed as a narrow policy solution to address an unintended consequence of Medicaid’s best-price provision and to support core safety-net providers. But the paper makes a compelling case that today’s program extends far beyond Congress’s original intent. Whether you support or oppose the current structure of 340B, this paper is essential reading for anyone who wants to understand how we got here. Read it here: drugch.nl/4dVSiTD One especially fascinating detail: The disproportionate share hospital (DSH) eligibility threshold of 11.75% was chosen to qualify two specific hospitals and secure bipartisan support from Senator Hatch and Representative Bliley. In other words, the threshold was not grounded in any broader scientific or policy rationale. Amazing.