{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T05:18:56Z","timestamp":1767676736060,"version":"build-2065373602"},"reference-count":40,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T00:00:00Z","timestamp":1708646400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["CA180984","CA269367","CA275993"],"award-info":[{"award-number":["CA180984","CA269367","CA275993"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2024,6,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Expensive oral specialty drugs for advanced prostate cancer can be associated with treatment disparities. The 340B program allows hospitals to purchase medications at discounts, generating savings that can improve care of the socioeconomically disadvantaged. This study assessed the effect of hospital 340B participation on advanced prostate cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The authors performed a retrospective cohort study of Medicare beneficiaries with advanced prostate cancer from 2012 to 2019. The primary outcome was use of an oral specialty drug. Secondary outcomes included monthly out\u2010of\u2010pocket costs and treatment adherence. We evaluated the effects of 1) hospital 340B participation, 2) a regional measure vulnerability, the social vulnerability index (SVI), and 3) the interaction between hospital 340B participation and SVI on outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 2237 and 1100 men who received care at 340B and non\u2010340B hospitals. There was no difference in specialty drug use between 340B and non\u2010340B hospitals, whereas specialty drug use decreased with increased SVI (odds ratio, 0.95, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.038). However, the interaction between hospital 340B participation and SVI on specialty drug use was not significant. Neither 340B participation, SVI, or their interaction were associated with out\u2010of\u2010pocket costs. Although hospital 340B participation and SVI were not associated with treatment adherence, their interaction was significant (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.020). This demonstrated that 340B was associated with better adherence among socially vulnerable men.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The 340B program was not associated with specialty drug use in men with advanced prostate cancer. However, among those who were started on therapy, 340B was associated with increased treatment adherence in more socially vulnerable men.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.35262","type":"journal-article","created":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T21:04:37Z","timestamp":1708722277000},"page":"2160-2168","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The 340B Program and oral specialty drugs for advanced prostate cancer"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2130-0446","authenticated-orcid":false,"given":"Kassem S.","family":"Faraj","sequence":"first","affiliation":[{"name":"Dow Division of Health Services Research Department of Urology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel R.","family":"Kaufman","sequence":"additional","affiliation":[{"name":"Dow Division of Health Services Research Department of Urology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Oerline","sequence":"additional","affiliation":[{"name":"Dow Division of Health Services Research Department of Urology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0221-0784","authenticated-orcid":false,"given":"Lindsey A.","family":"Herrel","sequence":"additional","affiliation":[{"name":"Dow Division of Health Services Research Department of Urology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6436-6667","authenticated-orcid":false,"given":"Avinash","family":"Maganty","sequence":"additional","affiliation":[{"name":"Dow Division of Health Services Research Department of Urology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1597-5428","authenticated-orcid":false,"given":"Megan E. V.","family":"Caram","sequence":"additional","affiliation":[{"name":"VA Health Services Research and Development Center for Clinical Management Research VA Ann Arbor Healthcare System  Ann Arbor Michigan USA"},{"name":"Division of Hematology\/Oncology Department of Internal Medicine University of Michigan  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vahakn B.","family":"Shahinian","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Internal Medicine University of Michigan  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brent K.","family":"Hollenbeck","sequence":"additional","affiliation":[{"name":"Dow Division of Health Services Research Department of Urology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,2,23]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"American Cancer Society.Key Statistics for Prostate Cancer. 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