The study, carried out by the North Carolina state treasurer and the state health plan, looked at the cost of cancer drugs bought through the federal 340B drug pricing program. The program, meant to assist uninsured and low-income patients, requires pharmaceutical manufacturers participating in Medicaid to sell outpatient drugs at a discount to nonprofit hospitals and other eligible entities. There are no legal requirements for hospitals to share cost savings with patients or reinvest them in the community.
The study found hospitals collected 1.7 to 3.7 times the acquisition cost of six common cancer drugs. State health plan members were charged $21,512 for pembrolizumab, compared to the estimated cost of $7,895.
Markups varied by system, with the average markup being more than four times higher than the average sale price.
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