Access to Affordable Life-Saving Medications
This executive order, issued by President Donald J. Trump and signed July 24, 2020, directs federal agencies to take steps to improve access to two life-saving medications—insulin and injectable epinephrine—for Americans who struggle to afford them. The core idea is to enable Federally Qualified Health Centers (FQHCs) to dispense these drugs to low-income, uninsured, or high-cost-sharing patients at prices tied to what the FQHC pays under the 340B Drug Pricing Program, plus a minimal administration fee. The order emphasizes that current high list prices for insulin and epinephrine contribute to access barriers and notes that while competition is helping epinephrine prices come down, some kits remain very expensive. It also makes clear that any actions depend on applicable law and funding, and it does not create new legal rights. In practical terms, the order would condition certain federal grants to FQHCs on adopting practices that make insulin and injectable epinephrine available to eligible individuals at the discounted 340B price (plus a small admin fee). It targets the uninsured or those with high cost-sharing or high deductibles, aiming to pass through discount pricing at the point of sale through FQHCs.
Key Points
- 1Purpose and problem identified: Insulin and injectable epinephrine can be unaffordable for many Americans, despite some insurance coverage, and high prices for these drugs create barriers to life-saving treatment.
- 2Mechanism to improve access: Future grants under section 330(e) of the Public Health Service Act would be conditioned on FQHCs establishing practices to sell insulin and injectable epinephrine at the discounted 340B price paid by the FQHC, plus a minimal administration fee, to eligible individuals.
- 3Target populations: Individuals with high cost sharing for either drug, those with high deductibles, or those who are uninsured.
- 4Scope of drugs: The policy focuses specifically on insulin and injectable epinephrine.
- 5Legal and fiscal caveats: Implemented “to the extent permitted by law” and subject to appropriations; the order does not create enforceable rights or benefits and relies on existing authorities and funding.