PHP63 - Availability of Pharmacies Participating in the 340B Drug Pricing Program, 2016

Abstract

Little is known about the availability of pharmacies that participate in 340B program. Our objectives are to estimate the availability of 340B pharmacies and to examine the community characteristics associated with 340B pharmacy availability. Cross-sectional analysis of data from the National Council for Prescription Drug Programs (2015), the Health Resources and Services Administration (2016), and the American Community Survey (2011-2015). We estimated the number of 340B pharmacies per capita for all communities in the US. We used logistic regressions to examine community characteristics associated with the availability of 340B pharmacies. In 2016, one in four community pharmacies in the US participated in the 340B program (n=16,397). While chain and independent pharmacies account for 58.7% of 340B pharmacies, only 14.4% of independent pharmacies participated in the program. The number of 340B pharmacies per 1,000 peoples (per-capita) was 5.2; this ranged considerably between and within counties. MUAs (20.3% vs 18.9%; P<0.01), communities with higher prevalence of public insured (Q1:15.5% vs. Q5:22.2%; P<0.01), and poverty (Q1:14.5% vs. Q5:21.5%; P<0.01) have higher availability of at least one 340B pharmacy. Communities with the highest uninsured rates have lower availability of 340B pharmacies than all other communities (Q1-Q4 average: 14.5% vs. Q5: 21.5%; P<0.01). After adjustment for confounding covariates among urban communities with at least one pharmacy, being a MUA (OR:1.13 [CI 1.05-1.20]; P<0.01) and higher poverty (Q1 vs Q5 OR:1.39 [CI 1.23-1.57]; P<0.01) is positively associated with 340B availability. Community prevalence of no insurance is negatively associated with 340B pharmacy availability(Q1 vs Q5 OR:0.79 [CI 0.68-0.92]; P<0.01). One in five communities in the US have a 340B pharmacy. Community availability of 340B pharmacies is more common in poor communities. Despite the program’s aim of improving access to healthcare and medications for uninsured patients, communities with higher proportion of uninsured residents are lacking 340B pharmacies.