The 340B program is a lifesaver. Congress should protect it from Big Pharma

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The 340B program is a lifesaver. Congress should protect it from Big Pharma

by Michael Weinstein

July 07, 2023 12:00 AM

The pharmaceutical industry’s relentless, astronomically expensive campaign to smear the 340B Drug Pricing Program — one of the world’s most important humanitarian programs — knows no bounds. Our healthcare safety net is under attack.

Since its creation in 1992, the 340B program has provided financial assistance to nonprofit hospitals and clinics serving vulnerable communities. Millions can’t afford the cost of healthcare. But that’s where 340B steps in, enabling healthcare nonprofit organizations to stretch already scarce federal resources as far as possible, providing underserved patients with lifesaving services.

Unfortunately, Big Pharma doesn’t seem to be in the business of caring about those patients, with drugmakers currently determined to restrict 340B pharmacy sales. Since 2020, at least 21 drug companies have restricted the number of contract pharmacies where 340B nonprofit groups can fill patient prescriptions, failing to live up to their statutory obligations (to which drugmakers agreed).

Big Pharma’s lust for profit will not be satisfied until drugmakers have destroyed this humanitarian program. Drug companies cannot win the 340B argument on its merits, so they seek to confuse consumers by throwing around words such as “price transparency” to undermine the program.

But transparency is already the status quo. The 340B program provides nonprofit groups with discounted drug prices to enhance their services. Exactly 100% of that money comes from drug companies’ inflated prices. The sole beneficiary of 340B’s destruction is the pharmaceutical industry, which is exclusively bottom-line-oriented. Between July 2021 and July 2022, for example, there were more than 1,200 drugs with which price increases exceeded the annual inflation rate. The average price increase was nearly 32% — in a single year.

Nonprofit groups, including 340B participants, cannot have profits. Unlike drugmakers that inflate prices to generate salaries in the tens of millions of dollars, nonprofit groups are required to spend all of their money on actual services that are closely monitored by a wide range of government agencies. My organization, AIDS Healthcare Foundation, or AHF, is a relevant case study. AHF supports the federal government’s Ending the HIV Epidemic program through our various 340B discounts. Despite the billions of dollars that the federal government pours into Ending the HIV Epidemic, there are still many gaps in care. The 340B program fills those gaps by increasing access for those who need it most.

Only a comprehensive approach from public education, social marketing, prevention, testing, treatment, social support to food and housing can we end the HIV epidemic. As the largest HIV care provider in the country, AHF has relied on 340B to expand geographically and programmatically.

But we recognize that we aren’t alone in this fight, or at least we shouldn’t be. When it comes to innovation and important medical breakthroughs, the pharmaceutical industry has a pivotal role to play, as long as the 340B program remains intact. But drug companies fail to live up to their societal responsibility time and time again.

Those who believe in the healthcare safety net must hold Big Pharma accountable, pushing back against the industry’s misleading claims. While drugmakers continue to issue “paid-to-order” academic analyses, it is incumbent on the 340B program’s supporters to set the record straight and speak truth to corporate power.


Let’s be clear: 340B is a lifesaver for thousands of hospitals and covered entities that would not survive or thrive without it. Millions of people’s lives are at stake. The program also costs the taxpayer nothing, with drug discounts coming exclusively from drug company profits. The opponents of 340B are simply self-interested profiteers — there is no other explanation.

Now is the time for America’s healthcare champions to stand up and support the 340B Drug Pricing Program. On this issue, a Big Pharma win is everyone else’s loss.

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Michael Weinstein is the president of AIDS Healthcare Foundation, the largest global AIDS organization.


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