The federal 340B Drug Pricing Program was created in 1992 with the intent to expand access to care for patients with the most need through free or low-cost medications, health care, preventive services, transportation, and more. The program does this by providing rural hospitals and certain health clinics a path to buy prescription medications at a significant discount. In turn, the hospitals and clinics are supposed to use the money saved to help care for more low-income and uninsured patients.
At its core, the program holds lifesaving power. However, well-documented abuses, coupled with limited transparency and oversight, have left the program increasingly misaligned with its original purpose.
Massive health systems, like Bon Secours in Virginia, supposed non-profits like the AIDS Healthcare Foundation, bad actors within community health centers, and even for-profit corporations, have been able to exploit the 340B program, turning it into a revenue-generating scheme that doesn’t benefit patients at all.
At the federal level, patient advocates, community-based organizations, provider associations, health care experts, and even congressional representatives have repeatedly called for reform.
In 2024, the Community Access National Network (CANN) launched “340B: What About Me?” to highlight how bad actors use 340B to raise executive salaries while refusing to offer low-cost or free care to vulnerable patients. In 2025, the Community Oncology Alliance released their “COA Prescription for Health Care Reform” which offers solutions to overhaul 340B and return it to its core mission. Later that same year, Representatives Carter (R-GA) and Harshbarger (R-TN) introduced legislation to establish “critical oversight and transparency of the 340B program while providing clear, practical, and achievable solutions to help ensure the 340B program can be a force for good in the nation’s health care safety net.”
In California specifically, Dr. Ifeoma Udoh, a public health scientist and Executive Vice President for Policy Advocacy and Science for the Black Women’s Health Imperative, stated that “we all lose if the program stays in its current form or is expanded without measurable transparency and accountability metrics.” A sentiment echoed by Dr. Diane Nugent, a hematologist with the Center for Inherited Blood Disorders (CIBD), which is an Orange County-based safety net clinic serving patients with rare, chronic inherited blood disorders.
To ensure the 340B program is sustainable and able to help true safety-net entities well into the future, there must be actions taken at the federal level. State-by-state actions – which can offer insights into the amount of money collected by hospitals, clinics, contract pharmacies, and third-party middlemen – won’t solve the program’s systemic issues running rampant throughout the country.
By improving oversight and accountability at the federal level, we can restore integrity to the program and ensure vulnerable Americans in every single state directly benefit from the 340B program.
Join consumer advocates, industry analysts, academic researchers, journalists, patient advocacy organizations, community pharmacists, and patients in calling for a future rooted in reform — one where savings are transparently tracked and directed back into the communities and patient populations the program was designed to serve.
