Protect 340B and Eliminate White Bagging

Legislation prohibiting insurers and pharmacy benefit managers (PBMs) from discriminating against providers and patients participating in the federal 340B program is advancing through the Missouri legislature.

The House overwhelmingly amended Senate Bill 187 to protect 340B and prohibit white bagging practices. That bill now returns to the Senate where we want the amendment to survive the Senate votes and/or conference negotiations that come next.

The insurance lobby is working in the Senate to oppose our efforts. Opposing 340B and engaging in white bagging harms patients, communities and the hospitals that support them.

Here’s why it’s important:

• The 340B program is designed to protect certain clinics and hospitals from drug price increases and to ensure access to needed drugs for those who are unable to afford them. The cost of this program is borne by the pharmaceutical manufacturers.
• Insurers, PBMs and manufacturers are undermining the 340B program by reimbursing providers at a lower rate because they participate in the program, thereby limiting a patient’s freedom to go to a 340B-participating provider. This is a direct threat to the viability of Missouri hospitals and the health of patients that rely on the 340B program to receive treatment regardless of their ability to pay.
• The House amendment prohibits insurers and PBMs from compelling hospitals to engage in white bagging. White bagging is when a health insurer requires a medication to be provided by its preferred specialty pharmacy instead of the provider’s pharmacy.
• White bagging is costly and dangerous for patients because the drugs are dispensed and shipped outside the normal medication safety system. This is particularly risky for patients with multiple sclerosis, cerebral palsy, cancer, rheumatoid arthritis and several other conditions. White bagging involves insurers, rather than doctors, deciding what is in the best interest of the patient.