This week we are joined by Dr. John Carlo, CEO of Prism Health North Texas. Prism Health is a Ryan White Clinic, which are grantees of the Health Resources and Services Administration (HRSA) Ryan White HIV/AIDS program. They provide care to patients at risk of or living with HIV/AIDS and are one of 16 types of 340B covered entities. John discusses 340B’s role in Prism Health’s ability to care for patients, how Ryan White Clinics work together with 340B hospitals, how they are serving patients during the pandemic, and the latest innovations in HIV care. Before the interview, we share important updates related to drug company denials of 340B discounts to covered entities that partner with community pharmacies.

How 340B Savings Help Ryan White Clinics Serve Patients 

Prism Health’s primary focus is on providing care and effective treatment for uninsured or underinsured patients at risk of or living with HIV/AIDS. As a Ryan White Clinic, Prism Health receives federal funding through the HRSA Ryan White HIV/AIDS program. John shares that this funding is not sufficient to cover the increasing number of people who need access to services. HIV medications are expensive, and the 340B program enables clinics to purchase more medications for uninsured and underinsured patients. The 340B savings also enable Prism Health to provide wraparound services including transportation access, case management, and behavioral health services. 

Ryan White Clinics and 340B Hospitals Working Together 

John describes Ryan White Clinics as part of a “medical neighborhood” for underserved patients along with 340B hospitals and other covered entities. Ryan White Clinics partner with 340B hospitals to ensure their patients have access to tertiary care, specialty care, diagnostics, and imaging, which are resources Ryan White Clinics do not have. In turn, 340B hospitals will refer patients who come to the hospital with HIV-related medical complications to Ryan White Clinics to maintain primary care services after they are discharged. 

Drug Manufacturers’ Denial Of 340B Discounts and the Impact on HIV/AIDS Patients

John shares that drug manufacturer denials of 340B discounts to covered entities when drugs are dispensed at community pharmacies have a detrimental effect on care delivery for patients. The manufacturers have threatened to stop providing the discounts to Prism Health, which relies on community pharmacy partnerships because many of its patients are not local and live in rural areas. John explains how this decision from drug manufacturers risks access to prescription drugs for uninsured and underinsured patients and harms patient care. 

The Effects of the COVID-19 Pandemic on HIV Care 

Due to the pandemic, fewer patients are going to Prism Health to receive care and access needed medications. This can lead to a higher risk of patients contracting HIV and patients living with HIV experiencing disease progression or transmitting the disease to others. John discusses how Prism Health’s case management team takes several steps to provide outreach to patients who are missing appointments and prescription pickups, including having mobile teams go into neighborhoods and working with partners in housing and homelessness. The additional time and resources spent to accomplish this is another example of why 340B savings are needed to augment government grant funding. 

Preventing HIV And the Future OF HIV/AIDS Care 

Prism Health also works with patients who are at risk of HIV through pre-exposure prophylaxis (PrEP). Under the Ryan White Act, grant funds only can be used to provide care for someone living with HIV, so 340B is critical for supporting access to PrEP. John shares that Prism Health has used 340B savings to launch a program that provides PrEP to patients with sexually transmitted diseases, because these patients are at higher risk for HIV. John says ending the HIV/AIDS epidemic this decade is possible but will take substantial commitment, resources, and funding to support HIV/AIDS prevention and continued care for patients living with the disease.

Check out all our episodes on the 340B Insight podcast website. You also can stay updated on all 340B Health news and information by visiting our homepage. If you have any questions you would like us to cover in this podcast, email us at [email protected].

Resources 

1. HHS Response to Eli Lilly Motion for Preliminary Injunction Regarding Administrative Dispute Resolution  
2. Statement on Court Dismissal of 340B Community Pharmacy Lawsuit 
3. Majority of U.S. House Backs Efforts to Protect 340B from Unlawful Drug Company Actions 
4. Prism Health North Texas 
5. 340B Coalition Winter Conference