AbbVie has filed a lawsuit against the U.S. government, seeking clearer guidance on which patients qualify for a drug discount program.
Under the 340B Program, pharmaceutical companies are required to provide medicines at significantly reduced prices to eligible healthcare providers that serve low-income populations.
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AbbVie is seeking a clearer, updated definition of patient eligibility from the government, arguing that current guidelines contain loopholes. The company says these gaps allow hospitals and clinics to claim drug discounts for patients with minimal or unrelated contact, and in some cases, even request multiple discounts for the same prescription.
AbbVie argued that existing loopholes have turned a program originally designed as a “safety-net” into a discretionary revenue source for hospitals.
The company is pushing for a rule under the 340B Program that would limit discounts to cases where the healthcare provider is directly managing the patient’s condition and has conducted a comprehensive medical visit within the past 12 months.
This move represents the latest escalation in a long-running dispute between drugmakers and healthcare providers over the multi-billion-dollar 340B program.
A series of lawsuits some successful and others not have argued that certain state laws conflict with the federal framework governing the program. Drugmakers have also long contended that the widespread use of contract pharmacies under 340B reduces transparency and increases the risk that some medications are discounted in situations where they should not be.
