Health care advocates are supporting legislation to protect access to a federal discount drug program considered critical to community health centers and programs that serve rural and underserved patients.

Groups including the Maine Pharmacy Association, the Maine Primary Care Association — which represents the clinics — and the Maine Hospital Association said on Wednesday that the bill would prevent pharmaceutical companies from restricting access to discounted drugs through what’s known as the 340B program.

But a representative from the pharmaceutical industry criticized the bill, arguing it would open the door to more abuse by hospitals that are exploiting the program.

Maine would join a growing number of states passing laws to prevent drug makers from limiting access to the discounted drugs. While 340B is a federal program, states have authority to set rules around its implementation.

The program mandates that drug companies sell certain outpatient drugs at discounted rates to safety net programs, which reinvest those savings into services and charity care.

The bill’s proponents say that the pharmaceutical industry and pharmacy benefit managers — the industry’s middle men — are exploiting loopholes in order to restrict access and divert funds from the discounts back to the pharmaceutical industry.

Lori Dwyer, president and CEO of Penobscot Community Health Care, a clinic in Bangor, said the 340B program is essential to the clinic being able to survive. She said drug companies are using loopholes in the program to make it harder to access the discounted drugs and causing losses in the industry, including $5 million at Penobscot Community Health Care.

“It’s foundational to our programming and to our financial sustainability,” Dwyer said in an interview with the Press Herald. “The program is one of the really critical components to our stability, and it had been for decades, until recently.”

The community health care clinics offer free or deeply discounted services and serve populations that may not otherwise be able to access health care. The 20 community clinics — called federally qualified health centers — serve about one in six patients in Maine.

Dwyer said one example of a loophole being exploited is that the pharmaceutical industry will require that drugs in the discount program can only be purchased at one designated pharmacy serving a relatively large geographic area.

“We can only contract with one local pharmacy, but we draw patients from all over the place. We can’t ask our patients to drive so far out of their way,” Dwyer said. The cost to the patient is the same if they buy it from a different pharmacy, Dwyer said, but the health clinics lose funding when patients fill prescriptions at pharmacies that are not designated to be part of the program.

Details of the bill have not yet been printed and released. But numerous states have passed or introduced legislation prohibiting drug manufacturers from restricting 340B drug access in various ways.

The pharmaceutical industry is calling on lawmakers to reject the bill, saying it would lead to greater abuse by hospitals that are exploiting the program to make big profits without benefiting the patients it is intended to help.

ABUSE OR ESSENTIAL NEED?

Stami Turk, director of public affairs at the Pharmaceutical Research and Manufacturers of America industry group, said in a written statement that “wealthy hospitals work with (pharmacy benefit managers) and other middle men to exploit the 340B program.”

Hospitals are “buying medicines at steep discounts and charging massive markups, imposing higher costs on patients, employers and taxpayers,” Turk said. “And despite claims by the hospital industry, there is no transparency or accountability in the program to verify it’s benefiting the people it should.”

Turk said that “investigations by the media and state lawmakers continue uncovering rampant abuse of the 340B program by large hospitals, yet the hospital industry wants to expand it.”

But an official at MaineHealth, the parent organization of Maine Medical Center in Portland and the largest health care network in Maine, said the 340B program is essential to low-income patients through a reduced-price medication program the hospital network operates.

“Funding from the 340B Drug Pricing Program is critical to our ability to provide this life-saving service and we urge the Legislature to take the necessary steps to protect this program,” said Brett Barrieau, program manager for MaineHealth’s Access to Care program.

The bill is currently at the state Revisor’s Office so it hasn’t yet been officially introduced. It is not expected to cost the state money, as it is a regulatory bill.

Rep. Jack Ducharme, R-Madison, one of the bill’s co-sponsors, said it’s a bipartisan idea that he believes will help protect a program that is important for rural residents.

“This doesn’t cost the state any money and it’s the right thing to do for the people of Maine,” Ducharme said.