• Jeah Jung, Wendy Y Xu, and Yamini Kalidindi.
• Department of Health Policy and Administration, College of Health and Human Development, The Pennsylvania State University, University Park, PA.
• Health Serv Res. 2018 Oct 1; 53 (5): 3528-3548.

ObjectiveTo examine the impact of the 340B drug discount program on the site of cancer drug administration and cancer care spending in Medicare.Data Sources/Study Setting2010-2013 Medicare claims data for a random sample of Medicare Fee-for-Service beneficiaries with cancer.Study DesignWe identified the 340B effect using variation in the availability of 340B hospitals across markets. We considered beneficiaries from markets that newly gained a 340B hospital during the study period (new 340B markets) as the treatment group. Beneficiaries in markets with no 340B hospital were the control group. We used a difference-in-differences approach with market fixed effects.Data CollectionSecondary data analysis.Principal FindingsThe probability of a patient receiving cancer drug administration in hospital outpatient departments (HOPDs) versus physician offices increased 7.8 percentage points more in new 340B markets than in markets with no 340B hospital. Per-patient spending on other cancer care increased $1,162 more in new 340B markets than in markets with no 340B hospital.ConclusionsThe 340B program shifted the site of cancer drug administration to HOPDs and increased spending on other cancer care. As the program expands, continuing assessment of its impact on service utilization and spending would be needed.© Health Research and Educational Trust.

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