The 340B program was established more than 30 years ago as part of the Public Health Service Act to help safety-net providers improve access to affordable medicines and healthcare services for low-income and other vulnerable patients. Through the program, biopharmaceutical companies offer discounts on outpatient medications to 340B eligible covered entities, which include safety-net hospitals and federal grantees like Community Health Centers (CHCs), rural health clinics, and other providers treating underserved communities.
There has been ongoing debate over the program’s impact and the current level of transparency and accountability. Some stakeholders like the program as it is. Among those who want to see change, some believe the program needs more specific directives to create clarity in its administration and express the need for greater transparency to ensure the program effectively supports safety-net providers and communities.
Over the years, the rapid growth of contract pharmacies within the 340B program has added to these challenges. In 2010, there were fewer than 1,500 contract pharmacies. Today, that number has grown to approximately 34,000, with 75% of them owned by major corporations such as CVS, Walgreens, Walmart, OptumRx, and Express Scripts. This expansion has raised concerns about whether the program is still meeting its original mission. Critics argue that the dominance of large corporate pharmacies and their role in the program may divert resources away from the vulnerable patients the program was designed to help.
Previous Legislation and Calls for Reform
Previous legislation, the 340B Access Act (H.R. 8574) was introduced in the 118th Congress to address PBM reform, focusing on increasing transparency, oversight, and accountability within the system. While the legislation failed to advance, it highlights the growing, bipartisan agreement on the need to restore the program to its intended purpose, ensuring that it serves vulnerable patients and underserved communities effectively.
CCPA Believes these are the Key Policy Priorities for the 340B Program
- Ensuring 340B discounts are serving vulnerable patients: Requiring hospitals and pharmacies to ensure patients see benefits from 340B funds.
- Prioritizing safety net providers and patient access: Ensuring grantees can continue their valuable mission while incentivizing 340B entities to maintain facilities close to underserved patients.
- Improving transparency and accountability and protecting the 340B program from abuse: Protecting the program from abuse by entities, like PBMs, who seem to have been unfairly profiting from the program for years. New transparency measures should prevent misuse and ensure equal accountability for all covered entities and partners in the program.
Advocacy and Action
The 340B program is a complex policy issue that continues to evolve as advocates and lawmakers shine a light on it. The Chronic Care Policy Alliance (CCPA) remains actively involved in this discussion, supporting efforts that realign the 340B program with its foundational goals. By enhancing transparency, modernizing practices, and ensuring patients benefit, we can protect low-income and at-risk patient access and ensure the program achieves its intended purpose.
With new legislation expected in 2025 to address these challenges, it’s more important than ever to advocate for policies that strengthen the 340B program for the patients and communities it serves. We encourage stakeholders and community members to engage with Congress on this critical issue.
CCPA will continue to share updates and insights on our blog and social media.