RWC-340B Study: Value of Ryan White Providers and Impacts Associated with Resource Reduction

How Ryan White clinics use the 340B Drug Pricing Program

For over 30 years, HRSA Ryan White HIV/AIDS Program (RWHAP) grantees have served people living with HIV/AIDS (PLWHA) in the US. The program supports 50% of all PLWHA in the US by providing access to care, treatment, support services, and essential prescription drugs used for
antiretroviral therapy (ART).

RWHAP grantees and subgrantees participating in the federal 340B Drug Pricing Program receive discounts on outpatient prescription drugs.

The Ryan White clinics use the savings to expand services to clients, including clinical care and non-clinical case management and social services.

From Savings to Services

340B savings on prescription drugs allow Ryan White clinics to stretch their limited financial resources to provide additional services for patients, such as:

  • Funding free or low-cost primary HIV/AIDS medical care
  • Health insurance coverage counseling and co-pay assistance
  • Support services
    – Medical transportation
    – Respite care for caregivers
    – Non-medical case management
    – Housing assistance
    – Food assistance

Please be advised that the data presented on this page has been updated to incorporate the most recently available data. We extend our appreciation to Mr. Christopher Broom for his contributions and sourcing of the revised data.

340B Savings Challenges

The staggering 18.4% increase in medical care costs due to inflation from 2015 to 2021 occurred while Ryan White funding remained stagnant. Notably, the Ryan White HIV/AIDS Program (RWHAP) used 340B savings to offset these rising costs and provided care to an additional 43,040 individuals living with HIV/AIDS (PLWHA). This underscores the importance of the 340B program to RWHAP.

Over the last few years, the 340B Program has been at the center of drug pricing reform conversations. Recent proposals have actively sought to reduce 340B savings at covered entities, including changes in Medicaid pharmacy benefit design that could shift savings away from Ryan White programs.

1 out of 2
50% of all people living with HIV/AIDS in the US receive medical care through the RWHAP

340B Program Oversight

HRSA is responsible for administering the 340B Program and overseeing compliance with the 340B statute. To that end, HRSA performs program
integrity checks and audits covered entities. Program participants are required to attest to their compliance each year.

Key trends limiting 340B

Some state Medicaid programs have restricted the program by reducing the reimbursement to safety-net providers or not covering 340B drugs dispensed by 340B contract pharmacies.

RWHAP Statistics
  • 78.3% of clients are retained in care
  • 81.9% of clients have health coverage
  • 31.5% Medicaid
  • 10.5% Medicare
  • 10.0% Employer

Percent of RWHAP clients receiving HIV care that are virally suppressed, exceeding national average 62.7% of PLWHA.

30 Years of the Ryan White Care Act

On August 18, 2020, HRSA celebrated the 30th Anniversary of the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. The Ryan
White HIV/AIDS Program plays a critical role in the Trump administration’s “Ending the HIV Epidemic: A Plan for America” initiative. This goal of this 10-year plan is to reduce new HIV infections to less than 3,000 annually by 2030.

Client Demographics

  • 73.7% from racial/ethnic minorities
  • 59.2% live at or below the federal poverty level
  • 72.2% cis male, 26.5% cis female, 1.9% transgender
  • 48.7% 50 years and older

Undetectable = Untransmittable

Patients who are virally suppressed cannot transmit the virus to an HIV-negative sexual partner. 89.7% of RWHAP clients are virally suppressed, and the percentage has increased each year.

Percent of RWHAP Clients Virally Suppressed, Compared to National Average of Viral Suppression in 2017

2021 RWHAP Clients

*Note: 2021 RWHAP client-level data showed 89.7% of RWHAP clients are virally suppressed compared with 63.1% of all PLWHA in 2017.

RWHAP HIV Care, Treatment, and Support Services

  • PrEP for at-risk people
  • Risk management counseling
  • Prescription drug access and adherence counseling
  • Medical and nonmedical case management
  • Medical nutrition therapy
  • Medical transportation
  • Mental health services
  • Health education
  • Outpatient ambulatory health services
  • Referrals for support services
  • Insurance coverage assistance
  • Legal assistance
  • Childcare
  • Emergency financial assistance

HRSA: US Health Resources & Services Administration, PLWHA: Persons Living With HIV/AIDS; PrEP: Pre-Exposure Prophylaxis for HIV; RWHAP: Ryan White HIV/AIDS Program.
Avalere Health, LLC completed the research reported in this fact sheet. Avalere does not expressly or implicitly endorse RWC or any third party’s products or services, and the deliverables provided by Avalere to RWC were neutral in nature.

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