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Iowa senator's bill adds to growing scrutiny for drug discounts in hospitals

Sen. Chuck Grassley, R-Iowa, a longtime critic of a program that requires drug companies to give discounts to nonprofit hospitals, proposed a bill March 1 that would require the facilities to disclose how much they save and what they do with the money.

Grassley's bill comes as the so-called 340B program comes under growing scrutiny in Congress, including hearings in the House Energy and Commerce Committee as soon as later this month. The Senate Health, Education, Labor and Pensions Committee is also expected to hold hearings on the program this spring, according to a committee spokeswoman.

Another bill, introduced Jan. 16 by Sen. Bill Cassidy, R-La., would prevent more hospitals from getting the discount for two years while new hospital reporting requirements are created.

Critics such as the Pharmaceutical Research and Manufacturers of America, or PhRMA, previously cited a number of reports from the General Accounting Office and the U.S. Department of Health and Human Services' Office of Inspector General that criticize hospitals for not passing the discounts on to patients in the form of lower drug prices. Hospitals, however, said the savings are still used for social purposes, such as for low-income HIV/AIDS patients, diabetes treatment and dental clinics.

Grassley's bill would also require hospitals to disclose the difference between the discounted price of a drug and how much they charged insurers for the same drug. Hospitals have been accused of charging insurers the nondiscounted price for drugs and pocketing the difference.

"By understanding the difference in those amounts, Congress will be able to assess whether the program is working as intended," Grassley's release said.

A coalition of more than 1,300 hospitals in the 340B program said the bill "focuses on only one narrow data point of the 340B drug pricing program. The group, 340B Health, said in an emailed statement: "The information the legislation seeks would paint an incomplete and inaccurate picture of how 340B enables hospitals to meet the purpose of the program — to 'stretch scarce federal resources as far as possible, reaching more eligible patients and providing more comprehensive services.'"