In 1992, the government established a federal drug discount program that required the pharmaceutical industry to provide discounted drugs for public and non-profit hospitals and clinics that serve high numbers of the poor. It's called 340B and MetroHealth relies on it to give lifesaving medicine to patients for little or no cost.

"Such as cancer therapy for cancer patients, it can provide a diabetic patient with insulin, it can provide blood pressure medication to high blood pressure patients, whatever medication that is needed," says Dr. Benjamin Li, Director of MetroHealth's Cancer Center.

The Health Resources and Services Administration, or HRSA, is seeking to change the 340B guidelines by limiting hospital and patient eligibility. Advocates say it's due to pharmaceutical industry greed.

"The motivation to limit this is to increase profit for the pharmaceuticals, it's not to the benefit of the taxpayers or the citizens. There's a 2 percent increase in profit just by having this program shut down," Dr. Li said.

Critics contend the program has gone astray, savings aren't being passed along and for-profit hospitals and private practices lose their competitive edge because they pay full price.

However, one major concern is Congress is winding down and no one has seen the details of the proposed changes.

"It's issues like this that end up sneaking up on the public and then they wonder why they didn't have a say in it. They have a say now and I would strongly encourage them to use that voice," Klingler said.

340B Matters is a grassroots coalition that started four months ago trying to prevent HRSA from gutting the program and demand HRSA reveal the details of the proposed reforms. If the program is cut, the burden may fall on everyone.

"Outpatient drug costs are going no where but up and unfortunately programs like this that have worked so well for so long being looked at for going away can be a huge detriment to the folks who do have insurance because they're going to be the ones who will have to pay for it," said 340B Matters spokesman Hans Klingler.

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