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Background <p>Since&#xa0;2020, US drug manufacturers have restricted the use of the 340B Drug Pricing Program, leading to unexpected increases in medication costs for individuals with type 2 diabetes engaged in care in community health centers.</p> Objective <p>To explore&#xa0;experiences of individuals with diabetes regarding medication access in the era of 340B Drug Pricing Program restrictions.</p> Design <p>Qualitative study using&#xa0;direct content analysis grounded in Andersen’s Behavioral Model of Health Services Use.</p> Participants <p>Uninsured and underinsured adults who speak English or Spanish and are receiving care for type 2 diabetes in a health center setting.</p> Approach <p>Semi-structured interviews, transcribed and analyzed using the constant comparative method by a bilingual and multiprofessional coding team.</p> Key Results <p>We achieved thematic saturation after 25 interviews conducted July–August 2024. Individuals described multilayered barriers to medication access during a time of 340B Drug Pricing Program restrictions. Three themes emerged: (1) participants perceived they navigate medication access alone, (2) loved ones (family, peers) shaped participants’ approach to medications and lifestyle changes for diabetes treatment, and (3) language and culture of pharmacy staff are enablers of medication access. Findings build on the Andersen model by demonstrating how pharmacy policies and practice impact all four of the model’s domains.</p> Conclusions <p>In the era of 340B Drug Pricing Program restrictions, individuals with diabetes perceive that navigation resources are needed to facilitate access to medications. Pharmacy programs that target family and community units may better resonate with individuals with diabetes than those that target individual patients. Cultural and structural competence among pharmacy staff are important drivers of individuals’ choice of pharmacy.</p>

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Navigating Access to Medications for Diabetes Mellitus in the Era of 340B Drug Pricing Program Restrictions: A Bilingual Qualitative Study of Patients’ Perspectives

  • 期刊论文

  • 发表日期：

    2025年8月27日

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  • Sarah S. Lalani,
  • Veena Kapadia,
  • Kasia J. Lipska,
  • Chelsea McKevitt,
  • Abmaridel Montosa,
  • Mario Ochoa-Prieto,
  • Mellisa Pensa,
  • Benjamin J. Oldfield

摘要

Background

Since 2020, US drug manufacturers have restricted the use of the 340B Drug Pricing Program, leading to unexpected increases in medication costs for individuals with type 2 diabetes engaged in care in community health centers.

Objective

To explore experiences of individuals with diabetes regarding medication access in the era of 340B Drug Pricing Program restrictions.

Design

Qualitative study using direct content analysis grounded in Andersen’s Behavioral Model of Health Services Use.

Participants

Uninsured and underinsured adults who speak English or Spanish and are receiving care for type 2 diabetes in a health center setting.

Approach

Semi-structured interviews, transcribed and analyzed using the constant comparative method by a bilingual and multiprofessional coding team.

Key Results

We achieved thematic saturation after 25 interviews conducted July–August 2024. Individuals described multilayered barriers to medication access during a time of 340B Drug Pricing Program restrictions. Three themes emerged: (1) participants perceived they navigate medication access alone, (2) loved ones (family, peers) shaped participants’ approach to medications and lifestyle changes for diabetes treatment, and (3) language and culture of pharmacy staff are enablers of medication access. Findings build on the Andersen model by demonstrating how pharmacy policies and practice impact all four of the model’s domains.

Conclusions

In the era of 340B Drug Pricing Program restrictions, individuals with diabetes perceive that navigation resources are needed to facilitate access to medications. Pharmacy programs that target family and community units may better resonate with individuals with diabetes than those that target individual patients. Cultural and structural competence among pharmacy staff are important drivers of individuals’ choice of pharmacy.