340b Pharmacy Geographic Variation and Associated Socioeconomic Status

Abstract

340b Drug Discount program was originated in 1992 believing only 90 DSH hospitals who treat low income patients might qualify and with the simple mandate of ‘stretching scare federal resources.’ This research project evaluated the HRSA covered entity database testing hypotheses that the 340b program is growing disproportionately into higher SES neighborhoods over time. The data was categorized into three distinct time periods and each location entering the program was mapped over time from 1992 – Oct 2019. Using the most conservative and time relevant of three SES thresholds, SES variables were dichotomized into low and high SES. This research showed the 340b program, post ACA has grown in just 9 years from 6k entities to include over 64 k locations and is growing by an average of 850 new entities a month. Now over 4/5ths of all 340b entities are located in higher income areas. Ongoing rapid growth of 340b entities predominantly in High SES neighborhoods needs further discussion and research. (supplemental file: Tableau GIS map of 340b entities entering 340b program over time – 1992-Oct 2019)