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Biotransformation, also known as drug metabolism, is a vital physiological process that chemically alters drugs, facilitating their elimination from the body and terminating their action. This process involves two main phases: phase I and phase II reactions. Phase I reactions, including oxidation, reduction, and hydrolysis, introduce or unmask polar functional groups on the drug molecule, thereby increasing its water solubility. By enhancing water solubility, the drug becomes more hydrophilic...
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Once the process of glomerular filtration is completed, blood carrying unfiltered drug molecules traverses through efferent arterioles and makes its way into the peritubular capillaries in the proximal tubule. A variety of carriers play a pivotal role in actively secreting drugs from these peritubular capillaries into the tubular fluid. The organic anion transporter transfers acidic drugs, against an electrochemical gradient, from the peritubular capillaries into the renal tubule cells and...
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Mapeo del flujo de fondos 340B a través de farmacias por contrato

Anthony M DiGiorgio1,2, Parisa Jahangirizadeh3, Deborah Williams4

  • 1The University of California, San Francisco, CA, USA.

Inquiry : a journal of medical care organization, provision and financing
|December 24, 2025
PubMed
Resumen
Este resumen es generado por máquina.

El Programa de Precios de Medicamentos 340B

Palabras clave:
340BPolítica Sanitariafarmacia por contratoentidades cubiertasprecios de medicamentosgestores de beneficios farmacéuticosadministradores externos

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Área de la Ciencia:

  • Economía de la Salud
  • Política Farmacéutica
  • Gestión de la Atención Médica

Sus antecedentes:

  • El Programa de Precios de Medicamentos 340B (340B) tiene como objetivo reducir los costos de los medicamentos para los proveedores de la red de seguridad.
  • La expansión del programa y el uso de farmacias por contrato han generado preocupaciones sobre su impacto y funcionamiento actuales.

Objetivo del estudio:

  • Analizar el flujo de fondos dentro del programa 340B contemporáneo.
  • Identificar las desviaciones de beneficios y los desajustes con la intención original del programa, centrándose en las farmacias por contrato y los PBM.

Principales métodos:

  • Mapeo detallado de las transacciones financieras dentro del ecosistema 340B.
  • Análisis de los incentivos de beneficios y los flujos de fondos que involucran a entidades cubiertas, farmacias por contrato, TPA y PBM.

Principales resultados:

  • Las entidades cubiertas generan beneficios significativos de los medicamentos 340B, sin mandato de reinversión en poblaciones desatendidas.
  • Las farmacias por contrato y los TPA aumentan la complejidad y los riesgos de desvío y descuentos duplicados.
  • Las cadenas de farmacias PBM integradas verticalmente capturan ingresos sustanciales.

Conclusiones:

  • El programa 340B actual presenta desajustes entre los incentivos de beneficios y los objetivos de atención al paciente.
  • Se necesitan reformas legislativas y administrativas para reenfocar el programa 340B en sus beneficiarios previstos: pacientes de bajos ingresos y vulnerables.