Why US states struggle to deliver savings

US state and federal investigations have shown 340B is often exploited for profit, yet some states have passed laws attempting to protect these practices from oversight.

According to trade group Pharmaceutical Research and Manufacturers of America (PhRMA), they have repeatedly found evidence that large hospital systems participating in 340B charge more for services or prescription drugs than non-340B hospitals.

For-profit third-party administrators and pharmacies that contract with hospitals are also making huge amounts off the program. Only in the USA do entities that do not make brand medicines - like prescription benefit managers (PBMs), insurers and the 340B program - receive half of every dollar spent on them.