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This article is the latest in IQVIA's series of yearly reports on the size and growth of the 340B drug discount program. In 2022, 340B sales exceeded $100B in whole acquisition cost in dollars for the first time despite contract pharmacy restrictions imposed by manufacturers. Looking ahead, 340B growth is likely to be influenced by continued developments in contract pharmacy restrictions and related court cases, the impact of the Inflation Reduction Act, recent changes in pricing strategies in the insulin market, and the expansion of the 340B patient definition.

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Bon Secours Mercy Health, a major nonprofit health system, used the poverty of Richmond Community Hospital’s patients to tap into a lucrative federal drug program.

A decades-old federal program that offered big drug discounts to a small number of hospitals to help low-income patients now benefits some of the most successful nonprofit health systems in the U.S.

With the 340B program marking its 30th anniversary in November, we must ask: who is benefiting from this drug pricing program? Is it truly supporting low-income communities as it was intended to?

For vulnerable patients across America, getting the 340B Drug Pricing Program right could be the difference between receiving lifesaving care or not. If it was working how Congress intended when it was created three decades ago, the 340B program would help vulnerable communities access their medications. Amid skyrocketing inflation rates that have left Americans all over the country pinching pennies, now is the time to step up to support these communities and their patients.

With the unparalleled effects of the COVID-19 pandemic, it makes sense that health care is a top concern for Americans. The virus has wreaked havoc in all corners of the nation. People young and old have all experienced disruption to their livelihoods, but the pandemic has disproportionately impacted underserved communities, making safety-net programs even more critical to addressing health inequities. At the same time, many of these safety-net hospitals that should be champions of vulnerable patients through charity care are instead actually providing less care than even their for-profit counterparts — a clear sign that something is terribly wrong.

The Alliance for Integrity and Reform of 340B (AIR340B) released a new report by Xcenda, titled “340B and Health Equity: A Missed Opportunity in Medically Underserved Areas,” which found a dismal 38% of 340B disproportionate share hospitals (DSH) are located in medically underserved areas (MUAs) as defined by the Health Resources and Services Administration, despite their mission of “serving a significantly disproportionate number of low-income patients.”

Complex health care regulation is always a work in progress. Consider the Affordable Care Act (ACA), which has helped millions of Americans access health insurance. Since 2010, when the act was signed into law, Washington has constantly worked to improve the ACA, and the law has often come under the microscope of lawmakers and even the Supreme Court.