340B’s lack of guardrails criticized by PhRMA

24 June 2026

A new Milbank Quarterly paper ends the debate: The 340B was never intended to be a hospital markup program that drives up costs for patients, employers and taxpayers, according to US trade group Pharmaceutical Research Manufacturers of America (PhRMA)

This matters because Congress created 340B as a narrow safety-net program focused on federally funded clinics and public hospitals that served low-income and uninsured patients, not as an unlimited, virtually unchecked revenue stream for large hospital systems.

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