![](media/image1.jpeg){width="4.047916666666667in"
height="1.4236111111111112in"}

February 6, 2001

# Pharmacy Issues

he Office of Pharmacy Affairs of the Health Resources and Services
Administration (HRSA) administers the Section 340B drug discount
program. Under its auspices, certain federally funded grantees have
access to low-cost pharmaceutical drugs. Frank Dodge, Deputy Director of
the Office of Pharmacy Affairs, and his colleagues discussed issues of
drug accessibility in a conference call with CAP grantees on February 6,
2001.

HRSA's Drug Pricing Program, authorized under Section 340B of the Public
Health Service Act, requires drug manufacturers participating in
Medicaid to provide formula-based discounts or rebates for 16 specified
HHS programs and safety net hospitals and clinics. Since its inception
in 1992, the program has cut drug costs for participants approximately
23 percent by \$1.5 billion. The Prime Vendor program, developed under
another Section 340B provision, should allow even greater savings for
its participating customers through combined buying power. These savings
are used by health centers and other participating health care providers
to expand access to prescription drugs and other services for uninsured
and underinsured people.

Other HRSA programs that facilitate the acquisition of low-cost
pharmaceutical drugs for health care providers were discussed:

Disproportionate Share Hospitals

Disproportionate Share Hospitals (DSH) may also buy discounted
outpatient drugs under Section 602 of the Veterans Health Care Act, as
long as they receive 11.75% or more of their revenue through Medicare
reimbursement and participate in a state and/or local government health
care program. For more information on the links between DSH and the
discount drug program, visit the Office of Pharmacy Affairs website and
click on "DSH". The website also provides information on how to become a
DSH.

Prime Vendor Program

Patients at community health centers, HIV/AIDS treatment and drug
assistance programs, safety net hospitals and clinics, and many other
health care providers serving low-income individuals can gain access to
lower cost prescription drugs under an agreement with Bergen Brunswig
Drug Company (BBDC) as the prime vendor for HRSA's Office of Drug
Pricing. As prime vendor, BBDC negotiates lower prices with
pharmaceutical companies based on the extensive nationwide buying power
of 12,000 entities eligible to participate in HRSA\'s prime vendor
program.

BBDC consolidates drug sales and delivery, and negotiates the best price
on drugs for the network of health providers participating in the Prime
Vendor program. Other benefits to participating health care providers
include lower distribution costs, reduced turnaround times for delivery
of critical drugs and decreased inventory costs. In addition, the BBDC
will offer help to participating sites to more efficiently utilize the
drug manufacturers' Indigent Drug Program, provide technical assistance
in pharmacy management services to the network of health providers in
the prime vendor program, gauge patient satisfaction, automate business
transactions for health care providers and package drugs in quantities
patients need.

Contracted Pharmacy Services

The Office of Pharmacy Affairs has developed contracted pharmacy
services guidelines. These guidelines are designed to facilitate program
implementation for covered entities that wish to utilize contracted
pharmacy services to dispense section 340B outpatient drugs but do not
have access to an \"in-house\" pharmacy.

Other programs of interest to CAP grantees include:

Volunteers in Health Care (VIH)

VIH is a nationwide, non-profit program established in 1997 as a
resource for health care providers interested in organizing or expanding
volunteer- led health and dental services for the uninsured in their
communities. VIH offers call-in technical assistance, networking and
educational experiences, and seed grants.

VIH seeks to:

-   Identify organizations across the United States that systematically
    use clinical volunteers

-   Provide technical assistance and small grants to such organizations

-   Link organizations with each other, creating a communication and
    resource network and helping to share lessons learned

-   Shine a light on the achievements, dilemmas, and scopes of these
    organizations' efforts to care for the uninsured

-   Inform public policy

    VIH also supports RxAssist, an on-line tool created to assist health
    care providers in locating sources of free pharmaceuticals for their
    uninsured patients. Their website includes a searchable database
    with information on accessing more than 100 manufacturer's programs
    and offers step-by-step forms with directions on how to apply.

Public Hospital Pharmacy Coalition

The Public Hospital Pharmacy Coalition (PHPC) is an organization of more
than 100 safety net hospitals and health systems located throughout the
U.S. The Coalition was formed to increase the affordability and
accessibility of pharmaceutical care for the nation\'s poor and
underserved populations.

PHPC monitors, educates and serves as an advocate on federal legislative
and regulatory issues related to drug pricing and other pharmacy matters
affecting safety net providers. PHPC members participate in the Public
Health Service\'s 340B drug discount program. The Coalition is dedicated
to protecting the 340B program and creating new opportunities for
members to save on pharmaceuticals.

For additional information:

Office of Pharmacy Affairs:

Toll Free Number for Technical Assistance: **1-866-PHARMTA**

For Policy Issues and Questions: **1-800-628-6297**

Website: http://www.hrsa.gov/odpp/

*(Includes information on DSH, 340B, Prime Vendor, and the BPHC Clinical
Pharmacy Demonstration Projects)*

Volunteers In Health Care/Rx Assist:

Phone Number: **1-877-844-8442**

Websites: www.volunteersinhealthcare.org

www.rxassist.org

Public Hospital Pharmacy Coalition

Phone Number: **202/624-7346**

Website: www.phpc-rx.org

SPEAKERS ON THIS CALL:

-   Frank Dodge: Deputy Director, Office of Pharmacy Affairs, HRSA

-   Bill Matthews: Prime Vendor Program, HRSA

-   Janet Walton: Volunteers in Health

-   Kathryn Richardson: Indigent Drug Program

-   Ted Slafsky: Public Pharmacy Hospital Coalition

-   Bill Von Oehsen: Public Pharmacy Hospital Coalition

DISEASE MANAGEMENT CALL PARTICIPANTS:

+------------------+---------------------------------------------------+
| ###### Name      | ###### Organization                               |
+------------------+---------------------------------------------------+
| Abby Sears       | Oregon                                            |
+------------------+---------------------------------------------------+
| Amir Abrams      | LA CAP                                            |
+------------------+---------------------------------------------------+
| Audrey Smolkin   | HRSA Philadelphia, PA                             |
+------------------+---------------------------------------------------+
| Aurelia          | Aaron E. Henry Community Health Center, MS        |
| Jones-Taylor     |                                                   |
+------------------+---------------------------------------------------+
| Barbara Eyman    | Powell Goldstein                                  |
+------------------+---------------------------------------------------+
| Beryl Cochran    | HRSA Seattle                                      |
+------------------+---------------------------------------------------+
| Bob Harris       | Harlan County KY CAP                              |
+------------------+---------------------------------------------------+
| Brenda Theus     | CAP PD, Memphis                                   |
+------------------+---------------------------------------------------+
| Cynthia Walker   | CHOICE Regional Health Network Olympia, WA        |
+------------------+---------------------------------------------------+
| Dave Fant        | WV CAP                                            |
+------------------+---------------------------------------------------+
| Debbie L. Nuss   | Community Health Council KS CAP                   |
+------------------+---------------------------------------------------+
| Dennis Williams  | NC CAP                                            |
+------------------+---------------------------------------------------+
| Edgar Brisbon    | PA CAP                                            |
+------------------+---------------------------------------------------+
| Irma Honda       | HRSA San Francisco                                |
+------------------+---------------------------------------------------+
| Jackie Lifer     | Lawyer                                            |
+------------------+---------------------------------------------------+
| James Burnosky   | RWJ: Communities in Charge                        |
+------------------+---------------------------------------------------+
| Jason Ladmer     | KS CAP                                            |
+------------------+---------------------------------------------------+
| Jay McGath       | HRSA                                              |
+------------------+---------------------------------------------------+
| Jennifer Dalton  | Ingham, MI                                        |
+------------------+---------------------------------------------------+
| JoAnne Jorgenson | Inova Health System                               |
+------------------+---------------------------------------------------+
| Joanne Omi       | NYC CAP                                           |
+------------------+---------------------------------------------------+
| John Prochaska   | Chicago                                           |
+------------------+---------------------------------------------------+
| Joseph Cooper    | Milwaukee CAP                                     |
+------------------+---------------------------------------------------+
| Judy Szalapski   | MN CAP                                            |
+------------------+---------------------------------------------------+
| Julia Tillman    | Central CAP                                       |
+------------------+---------------------------------------------------+
| Kay Freeman      | CareNet Partners: Tallahassee, FL                 |
+------------------+---------------------------------------------------+
| Kristen West     | CHOICE Regional Health Network Olympia, WA        |
+------------------+---------------------------------------------------+
| Lela Keyes       | Aaron E. Henry Community Health Center, MS        |
+------------------+---------------------------------------------------+
| Len Stewart      | MA CAP                                            |
+------------------+---------------------------------------------------+
| Linda Cundiff    | Somerville, MA                                    |
+------------------+---------------------------------------------------+
| Liz DiCarlo      | MA CAP                                            |
+------------------+---------------------------------------------------+
| Liz Whitley      | Denver Health                                     |
+------------------+---------------------------------------------------+
| Luanne Nyberg    | Hennepin County Medical Center                    |
+------------------+---------------------------------------------------+
| Lynn             | Inova Health System                               |
| Evans-Riester    |                                                   |
+------------------+---------------------------------------------------+
| MAC contractors  | Management Assistance Corporation                 |
+------------------+---------------------------------------------------+
| Marika Bertolini | CHOICE Regional Health Network Olympia, WA        |
+------------------+---------------------------------------------------+
| Mark B. Wilcox   | Health Federation of Philly                       |
+------------------+---------------------------------------------------+
| Mary Helen Mays  | El Paso CAP                                       |
+------------------+---------------------------------------------------+
| Michael Head     | Cincinnati                                        |
+------------------+---------------------------------------------------+
| Mike DeLucca     | FL CAP                                            |
+------------------+---------------------------------------------------+
| Paula Lucey      | Milwaukee CAP                                     |
+------------------+---------------------------------------------------+
| Phebe King       | Maine Health                                      |
+------------------+---------------------------------------------------+
| Richard Liniger  | San Fran HRSA                                     |
+------------------+---------------------------------------------------+
| Ruth Woolum      | SKYCAP-Hazard                                     |
+------------------+---------------------------------------------------+
| Seema Verna      | Indianapolis, IN                                  |
+------------------+---------------------------------------------------+
| Stacy Kelly      | Austin CAP                                        |
+------------------+---------------------------------------------------+
| Steve Dorage     | HRSA Atlanta                                      |
+------------------+---------------------------------------------------+
| Tammy Eberly     | Tiahoga CAP                                       |
+------------------+---------------------------------------------------+
| Tammy Stoltz     | PCAP Pima Community Access Program                |
+------------------+---------------------------------------------------+
| Ted Hanley       | Galveston CAP                                     |
+------------------+---------------------------------------------------+
| Tom Irons        | NC CAP                                            |
+------------------+---------------------------------------------------+
| Tom Lewis        | MD CAP                                            |
+------------------+---------------------------------------------------+
| Tracey Bush      | New Orleans CAP                                   |
+------------------+---------------------------------------------------+
| Zandra Glenn     | Leon County CAP                                   |
+------------------+---------------------------------------------------+
| Synthesis        | Synthesis Professional Services                   |
| Writers          |                                                   |
+------------------+---------------------------------------------------+

Summary Developed By: Synthesis Professional Services, Inc.