340B PATIENTS Act is Against what BlackDoctor.org (BDO) Believes In – Oppose it
Join BlackDoctor.org (BDO) as we sound the alarm to oppose the 340B PATIENTS Act, which – if passed – could cement in law one of the most misused features of the 340B program — contract pharmacies. This 340B PATIENTS Act does not put patients first, and does not include the necessary transparency language or patient protections that are warranted.
Time and time again BlackDoctor.org is observing this same transparency issue, and it’s not getting fixed fast enough or with consistency. We must pause and ask ourselves why are we allowing contract pharmacies to profit from 340B?
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The 340B program was created to help hospitals and health centers purchase discounted medicines to aid underserved patients. Over time, this mission has been hijacked by contract pharmacy arrangements that allow the hospitals and health systems themselves to profit – instead of patients. This broken 340B system needs a closer eye.
Contract pharmacies — often mail-order or retail chains working on behalf of hospitals — have become the dominant force in the 340B program. While their footprint has expanded, the benefits to low-income and uninsured patients have not. Instead, these arrangements generate massive profits for hospitals and middlemen. The average profit margin on 340B drugs dispensed through contract pharmacies is now 72%. In 2023 alone, 340B entities and their contract pharmacies generated more than $64 billion in profits from discounted drugs.
None of these gains are required to be shared with patients. Contract pharmacies can purchase a drug for pennies on the dollar — often 57% under list price — then charge patients full freight. Meanwhile, communities like ours continue to struggle with high out-of-pocket costs and access gaps.
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The inequity is systemic. Research shows that contract pharmacy expansion has favored wealthier, commercially insured neighborhoods while retreating from low-income, Black communities. Between 2011 and 2019, the share of 340B pharmacies declined in the poorest zip codes — even as they grew in affluent areas.
We need real reform, not a giveaway for hospitals and middlemen. The recent Senate HELP Committee report, led by Senator Bill Cassidy, offers a better path forward: enforce transparency, ensure patients benefit directly from 340B savings, and hold bad actors accountable. The 340B PATIENTS Act does none of this — it simply codifies the status quo.
