Local population characteristics and access equity of 340B contract pharmacies

The 340B Drug Pricing Program allows certain US medical entities with vulnerable patient populations to receive large discounts on outpatient prescriptions and use those savings at the entity's discretion. Since reforms in 2010, the number of pharmacies with whom 340B entities contract grew massively. This article explores the locations of 340B contract pharmacies and corresponding local populations within Texas. We measured and tested for statistical differences in population characteristics between 340B and non-340B pharmacies and the association with other local amenities. We focused on measures of pharmacy accessibility, local population social vulnerability, and local access to other crucial amenities, measures of population well-being previously not investigated in this debate. We found that 340B and non-340B pharmacies are located in fairly similar local populations, but 340B pharmacies are located in statistically significantly less-vulnerable populations than the facilities with which they contract. We found that comparisons of pharmacy accessibility measures are complicated by sensitivity to data sources. Our results suggest that the contract pharmacy program within Texas may target less-vulnerable populations through the shift from covered entity pharmacies to outside pharmacies. Impacts on the target patient population at the covered entity require further research to measure.