Worcester Business Journal

wbjournal.com | April 18, 2022 | Worcester Business Journal 21 Cost-saving drug program needs transparency V I E W P O I N T E D I T O R I A L M assachusetts's policymakers have a history of fighting to end discrimination in health care and empower patients across our state to access the medicines and care they need. As elected officials continue these efforts, they should look no further than the second-most costly drug pricing program in America behind only Medicare Part D. Outdated, unregulated, and growing exponentially, the 340B Drug Pricing Program has steered off its original path to help vulnerable patients access their care in Massachusetts and around the country. It's time Massachusetts Attor- ney General Maura Healey and other elected leaders take notice and bring transparency and accountability. Congress created the 340B Drug Pricing Program in the 1990s to help stretch limited resources to allow Medicaid and unin- sured patients to access life-saving health care. Hospitals and clinics qualify for 340B by serving a predetermined percentage of those patients. ose qualifying hospitals and clinics can purchase their prescription drugs at significantly discounted prices from drug manufacturers. ese savings are meant to offer a critical safety net to help Massachusetts patients access their care. But for the 1.5 million Massachusettsans who depend on the 340B program to help cover the cost of their care, the question remains: is 340B actually providing afford- able access to necessary treatments, or is it allowing those eligible hospitals to pocket those drug discounts? e data reveals this safety net is failing patients in Massachusetts. Today, no serious legal or regulatory oversight exists to require hospitals and clinics to pass savings on to patients or report transparently on those efforts. is gap has allowed what some have referred to as bad actor hospitals, clinics, pharmacy benefit managers, and health insurers to take advantage of the program. In fact, evidence shows 340B hospitals in states including Massachusetts provide significantly lower levels of charity care compared to the average hospital (1.04% as compared to 2.03%). e same report found 340B hospitals were almost twice as profit- able as the average hospital. Mass. regulators and lawmakers should bring greater oversight and transparency to 340B and modernize this outdated program. Massachusetts representatives like Congressman Jim McGovern (D-Worcester) have already proven themselves to be champions for protecting and ex- panding patient access to affordable care and addressing 340B loopholes is a crucial aspect of that effort. e work to improve 340B begins with pulling back the curtain on how exactly participating hospitals in Massachusetts are passing their 340B savings to their patients. Absent any transparency or reporting requirements, the 340B program will continue to put profit over people. Brian Nyquist is the executive director of Texas nonprofit Infusion Access Foundation, which provides support to patients at 65 infusion centers throughout Massachusetts. BY BRIAN NYQUIST Special to WBJ The above Editorial is the opinion of the WBJ Editorial Board. The Viewpoint column, the A Thousand Words cartoon, and the Word from the Web commentary represent the opinions of their authors and do not necessarily reflect the views of WBJ or its staff. WBJ welcomes letters to the editor and commentary submissions. Send them to bkane@wbjournal.com. A T H O U SA N D WO R D S B Y R A M Ó N L . S A N D O V A L Time to re-embrace the immigrant workforce Brian Nyquist D espite an unease caused by problems like inflation, the U.S. and Central Massachusetts economic engines are surging right now. e national GDP grew 6% in 2021, the most since 1984. In Greater Worcester, unemployment dropped 0.6 percentage points in February to 4.4%, which is close to pre-COVID levels and actually slightly above state and national averages. is engine needs fuel to keep up this pace, and right now the main fuel needed is people. Employers in every sector are hurting for workers. e retirements of the aging Baby Boomer gener- ation accelerated in the pandemic, and the need to provide child care and elder care are preventing otherwise able-bodied Americans from fully partic- ipating in the workforce. With a decline in the birth rates and an increase in the death rate during the pandemic, the U.S. population growth rate was 0.1% in 2021, the lowest level since the U.S. Census started keeping track. And the one reliable source of working-age adults has essentially been shut off for the past five years: immigration. e legal immigration system was dismantled under former President Donald Trump, and the current fighting between Democrats and Republicans in Washington, D.C. over how to rebuild it under President Joe Biden has resulted in a lag of new younger people being allowed to come work in the country. e net international migration in 2021 was the lowest level in decades, according to the U.S. Census Bureau, with the 168,000 work visas issued being 59% lower than the number issued in 2019. David Jordan, president of the Worcester nonprofit Seven Hills Foundation, which has 4,600 employees spread over locations in Massachusetts and Rhode Is- land, says the workforce shortage has reached a crisis point in the health and human services industry. No doubt this crisis is permeating to many other indus- tries as well. While Washington, D.C. struggles over the big picture of immigration reform, Jordan has proposed a relatively quick fix to Congressman Jim McGovern (D-Worcester) and U.S. Labor Secretary Marty Walsh to help alleviate this crisis. Under Jordan's proposal, the existing H2-B visa program would be expanded to allow health and human services workers to enter the U.S. for up to 36 months, allowing them to work for a licensed non- profit during that time, and aer which they would return to their home countries or apply for another legal immigration status. By broadening the pro- gram, thousands of potential workers from Europe, Africa, or other areas of the globe could support care for the growing elderly and/or disabled populations. Beyond Jordan's tweak to address this one issue, it is time to look broadly at the comprehensive ways immigrants can support and shape the national and Central Massachusetts economy and business community. e flow of immigrants into the market should have never slowed; but regardless of what happened in the past, it is time to move forward with an embrace of those who make this business community stronger. W W

• Cover