Drug pricing program improved prostate cancer treatment adherence

Socially vulnerable patients more likely to stick with oral medications at hospitals participating in 340B program

5:00 PM

Author | Nicole Fawcett

Spilled pills next to a stethoscope and pile of cash
Credit: Getty Images

Prostate cancer patients receiving care at hospitals that are part of a special drug pricing program were more likely to stick to their prescription drug therapy than patients at other hospitals, according to a study from researchers at the University of Michigan’s Rogel Cancer Center and Institute for Healthcare Policy and Innovation.

The 340B Drug Pricing Program is a federal program that requires the pharmaceutical industry to provide a discount on the cost of drugs to participating hospitals and other health care sites who serve a disproportionate number of Medicare and Medicaid patients. The program was started to enable hospitals to stretch scarce resources, reach more patients and provide more comprehensive services. What the hospitals save on drug prices, they are expected to invest in services that help disadvantaged patients in their community.

“In the field of advanced prostate cancer, there’s been a paradigm shift to using newer targeted oral treatments. But these drugs are expensive, and cost can limit access to these drugs, particularly among those who are socioeconomically disadvantaged. We wanted to see if the 340B program could help mitigate this disparity,” said study first author Kassem Faraj, M.D., a urologic oncology fellow at Michigan Medicine.

The team looked back at a 20% sample of Medicare beneficiaries diagnosed with advanced prostate cancer who were treated with these targeted therapies at a hospital based program. They identified 2,237 men treated at 340B participating hospitals and 1,100 treated at non-participating hospitals.

They then looked at a social vulnerability index, a zip code based measure that characterizes socioeconomic, racial and household characteristics. They found that patients from areas with greater social vulnerability were less likely to use the oral drugs. There was no difference in use between 340B and non-340B hospitals.

However, patients receiving treatment at 340B hospitals were more likely to continue treatment. The researchers saw that in non-340B hospitals, as social vulnerability increased, adherence dropped. But in 340B hospitals, adherence remained flat regardless of social vulnerability. Results were published in Cancer.

“There are many reasons why adherence to these drugs can drop. We suspect that 340B hospitals potentially have some resources or mechanisms that are helping these vulnerable patients maintain adherence,” Faraj said. This could include medication management programs or financial help for out-of-pocket drug costs.

“While 340B participation didn’t increase the number of patients using this therapy, it was associated with better treatment adherence among socially vulnerable patients,” Faraj said.

Additional authors: Samuel R. Kaufman, Mary Oerline, Lindsey Herrel, Avinash Maganty, Megan E.V. Caram, Vahakn B. Shahinian, Brent K. Hollenbeck

Funding: National Cancer Institute grants T32 CA 180984, R01 CA275993, R01 CA 269367.

Disclosure: Michigan Medicine participates in the 340B program. Learn more about how the hospital provides community support.

Citation: “The 340B Program and oral specialty drugs for advanced prostate cancer,”Cancer. DOI: 10.1002/cncr.35262

Sign up for Health Lab newsletters today. Get medical tips from top experts and learn about new scientific discoveries every week by subscribing to Health Lab’s two newsletters, Health & Wellness and Research & Innovation.

Sign up for the Health Lab Podcast: Add us on SpotifyApple Podcasts or wherever you get you listen to your favorite shows.

 


More Articles About: Cancer: Cancer Types Prostate Cancer Cancer Treatment Cancer Research Hormonal Therapy for Cancer Health Care Delivery, Policy and Economics Health Care Quality Urology Prostate Conditions
Health Lab word mark overlaying blue cells
Health Lab

Explore a variety of healthcare news & stories by visiting the Health Lab home page for more articles.

Media Contact Public Relations

Department of Communication at Michigan Medicine

[email protected]

734-764-2220

Related
man at table writing down in living room
Health Lab
Free online tool helps prostate cancer patients save on out-of-pocket drug costs
A free online tool could potentially save some prostate cancer patients more than $9,000 in out-of-pocket drug costs, a Michigan Medicine study finds.
Stay Informed

Want top health & research news weekly? Sign up for Health Lab’s newsletters today!

Subscribe
Featured News & Stories weight scale black white in exam room close up
Health Lab
Adding obesity experts to primary care clinics improves patients’ weight loss outcomes
A weight navigation program for primary care patients with obesity led to more use of proven weight management strategies and more weight loss
zoom screens with 7 different backgrounds and doctor silhouettes outlined in each
Health Lab
The doctor is in…. but what’s behind them?
A study reveals that what a doctor has behind them during a telehealth visit can make a difference in how the patient feels about them and their care.
Cancer Aware
Palliative Care vs Hospice Care
On this episode of Cancer Aware, we are talking with Maria Silveira who is a palliative care specialist at Michigan Medicine and the Ann Arbor Veterans Affairs. She has over 20 years of experience working in the hospital and in clinic, taking care of patients with serious illness, supporting them and their families through what is often the toughest time of their lives. She helps train the next generation of palliative care and hospice physicians and nurse practitioners, and she does research in symptom management.
cancer cell blue yellow
Health Lab
Widening inequality seen where cancer clinical trials are available
The availability of clinical trials of new treatments for cancer varies greatly by geography, and a new study shows more socially vulnerable areas have far fewer.
stained glass green blue purple orange pink
Health Lab
Massive study identifies new biomarkers for renal cancer subtypes, improving diagnosis and—eventually—treatment
A study led by University of Michigan Health Rogel Cancer Center researchers identifies novel biomarkers in renal cell carcinomas.
gloves surgery blue yellow
Health Lab
More oversight of donated tissue products urgently needed, say experts and Michigan policymakers
A JAMA viewpoint outlines the tragic story of Shandra Eisenga, a patient who received spine surgery for back pain only to inexplicably contract tuberculosis.