Dear Addy: 340B Programs

Dear Addy,
The specialty pharmacy that I have to use through my insurer doesn’t carry my preferred brand of factor so I have to go through the prior authorization process to get my factor. My hemophilia treatment center (HTC) does not have a 340B program but I know of another HTC that does and they carry my brand of factor. When I contacted this other HTC, they told me that I had to be a patient at that HTC in order to get my factor through their 340B program. Is this really true?
Signed,
Amelia, Hemophilia B
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Dear Amelia,
The simple answer is yes, it is true. This is required by law. In order to use an HTC’s, or any eligible entity’s 340B program, you must be a “qualified patient.” Basically, a qualified patient must have a relationship with a 340B-eligible entity (an HTC, for example). The entity in question must maintain records of the patient’s care, and the patient must receive healthcare services from a provider employed or contracted by the entity. There really is no wiggle room in the law, but changes are on the horizon to potential expand the definition of a qualified patient. We will keep you posted!
Sincerely,
Addy
 

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HFA frequently receives questions from the bleeding disorders community related to advocacy issues. The questions often impact the entire community. In an effort to reach the largest audience possible with our responses to these widely applicable questions, HFA developed “Dear Addy.” Questions submitted to this column are edited in order to protect privacy and should be considered educational only, not individual guidance.