T-R FILE PHOTO “Some patients of Marshalltown Primary Health Care might lose the reduced prices they are getting on prescription drugs. Pharmaceutical companies are seeking restrictions on a federal program which provides the discounts.”

Some patients at Primary Health Care in Marshalltown are facing the possibility of an increase in the cost of their prescription drugs.

Pharmaceutical companies are fighting back against the federal 340B program, which requires drug manufacturers participating in Medicaid to offer discounts on prescriptions to medical institutions.

Primary Health Care is one such institution.

“As a federally qualified health center, we are able to buy drugs for patients and provide those medicines to patients at the same cost we bought them,” Primary Health Care CEO Kelly Huntsman said. “We also charge them for a fill fee, but that fee does not cover the cost of filling. We are passing savings to our patients, which is really the purpose of 340B.”

One example of a discount Huntsman used was for insulin.

“We can buy insulin for $10. Without 340B, that insulin costs $400,” she said.

This summer some pharmaceutical companies began notifying 340B participants of future limitations on drug distributions.

“We were notified July 1 by one manufacturer that certain medications were not going to be included starting Oct. 1,” Huntsman said. “Then it escalated from there to include all medications.”

Some drug manufacturers are requesting information Huntsman is not comfortable with providing.

“We have to provide patient information to a third party on all prescriptions so they can verify there are no duplicate discounts,” she said. “From our perspective, we are concerned about HIPAA. We are concerned about providing patient information. If we do not provide it, the manufacturer will no longer ship medications to us.”

Huntsman said they are good stewards of the program and are happy to follow guidelines the program has.

“But I do not feel like this is helping meet the objective,” she said. “The next step for us is how to stay in front of the six manufacturers who issued notice they would stop shipping if we don’t provide data. We need to stay ahead and navigate for the patients who are impacted.”

Most of the Primary Health Care patients who participate in the 340B program are concerned how they will navigate increased prescription costs and get their medications.

“Some are afraid,” Huntsman said. “Will they have the money they need for their medications?”

To help reassure them, Huntsman said Primary Health Care has been telling them they are finding ways to get them their prescriptions.

In an effort to stop the pharmaceutical companies from taking these steps, Huntsman said she has been in contact with U.S. Sens. Chuck Grassley (R-Iowa) and Joni Ernst (R-Iowa) and U.S. Rep. Abby Finkenauer (D-Iowa), who have been receptive to the concerns.

Jason Noble, the senior adviser for communications for Finkenauer, said the Congresswoman strongly supports the 340B program which keeps drug prices low for low-income patients and improves the quality of health care.

“What’s happening here is pretty simple: the pharmaceutical companies’ actions violate the law governing 340B and threaten to undermine the program,” Noble said. “Congresswoman Finkenauer has joined numerous oversight efforts calling on the industry to stop this behavior and directing the U.S. Department of Health and Human Services to enforce the law and address existing violations.”

In addition, Finkenauer has joined U.S. Rep Cindy Axne (D-Mich.) in asking Alex Azar, the HHS Secretary, to rescind executive actions which would undermine 340B at community health centers.

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Contact Lana Bradstream at 641-753-6611 or

lbradstream@timesrepublican.com.