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The 340B Drug Pricing Program and Management of Advanced Prostate Cancer.

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  • 1Dow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.

Cancer Medicine
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Summary

The 340B program did not increase targeted therapy use for advanced prostate cancer in socioeconomically disadvantaged men. Despite lower initiation rates among vulnerable populations, 340B penetration did not bridge this gap.

Keywords:
androgen receptor antagonistshealth policyhealthcare disparitiesprostatic neoplasmssocial vulnerability

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Area of Science:

  • Oncology
  • Health Economics
  • Health Disparities

Background:

  • Oral targeted therapies are standard for advanced prostate cancer.
  • High cost can be a barrier, especially for economically disadvantaged patients.
  • The 340B program offers potential savings to mitigate treatment access barriers.

Purpose of the Study:

  • To investigate the association between 340B program penetration and targeted therapy initiation in advanced prostate cancer.
  • To assess if 340B program penetration mitigates socioeconomic disparities in treatment access.

Main Methods:

  • Retrospective study of Medicare fee-for-service beneficiaries (2012-2019).
  • Examined patient-level initiation of targeted therapy.
  • Analyzed 340B penetration by hospital referral region and socioeconomic disadvantage using the Social Vulnerability Index (SVI).
  • Used Cox models to assess relationships and interaction effects.

Main Results:

  • No significant association was found between 340B penetration and targeted therapy use.
  • Socioeconomically disadvantaged men (higher SVI) were less likely to initiate treatment.
  • Increased 340B penetration did not reduce the disparity in treatment initiation based on SVI.

Conclusions:

  • Regional 340B penetration did not influence the uptake of targeted therapies for advanced prostate cancer.
  • The 340B program did not alleviate socioeconomic disparities in accessing these vital treatments.