'Conjectural statement' could cause confusion about 340B program

To the editor:

I was surprised and disappointed to see the conjectural statement by Jeffery C. Ward, MD, printed in the Aug. 25 cover story titled “Growth of 340B program triggers ‘battle over big money.”

He refers to “anecdotal accounts” of Disproportionate Share Hospitals sending “all of their indigent care elsewhere for therapy” in a practice that he admits “hasn’t been rampant.”

Is this non-supported supposition even worthy of appearing in print? I would respectfully request that Dr. Ward retract the statement, which can only induce confusion regarding a program that helps so many underserved citizens.

Robert Chapman, MD
Director, Josephine Ford Cancer Institute
Henry Ford Health System, Detroit
rchapma@hfhs.org

I appreciate the opportunity Dr. Chapman has given me to clarify my statements.

I, too, am in a 340B institution and see the good works that it can do.

Perhaps “anecdotal” was not specific enough. I did not mean it to be interpreted as “hearsay.”

As the ASCO 340B workgroup began its deliberations, we interviewed a number of physician leaders in and out of 340B institutions across the country and were apprised of what we believe to be fairly isolated abuses.

Included in expressed concerns were hospitals that qualify for 340B through Medicaid traffic through their ER and inpatient facilities, but routinely send indigent oncology care to the county hospital. In at least one circumstance, we corroborated this through interviews with multiple physicians, press releases and court filings.

To turn a blind eye to these abuses, however isolated they may be, discredits and threatens a necessary program. Better to reform the 340B program utilizing the principles laid out in ASCO’s policy statement and prune any infested branches before somebody decides to cut down the whole tree.

Jeffery C. Ward, MD
Medical oncologist
Swedish Cancer Institute Edmonds
Edmonds, Wash.