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Hospitals and community health centers urge state protection for 340B access; pharma warns of unintended costs
Summary
A bipartisan group of hospitals and federally qualified health centers told the Senate committee that manufacturer restrictions on contract pharmacies are cutting critical savings; the pharmaceutical industry warned the bill would lock in a broken system that raises employer costs.
The committee heard sharply divergent testimony on Senate Bill 253, which would prohibit pharmaceutical manufacturers from denying 340B pricing to covered entities when drugs are dispensed through contract pharmacies.
What the bill would do: SB 253 would make it an unfair trade practice under state law for a manufacturer to restrict access to 340B drug pricing when a covered entity (hospital, federally qualified health center or Ryan White provider) uses contract pharmacies to dispense medicines to eligible patients.
Supporters’ case: Hospitals (Dartmouth Health, Lamprey Health and Coös County Family Health Services among others) and community health centers said manufacturers have recently limited where drugs eligible for 340B pricing can be dispensed, reducing the savings safety‑net providers rely on to fund care coordination, medication assistance and specialty programs for low‑income patients. Health providers said 340B proceeds fund nurse‑managed programs, HIV care, hemophilia treatments, transportation, and other services that otherwise would be difficult to sustain.
Industry concerns: Pharmaceutical Research and Manufacturers of America (PhRMA) warned the committee that contract‑pharmacy practices have been exploited by middlemen and PBMs, that program growth has been dramatic since 2010 and that states should not lock subregulatory guidance into law. PhRMA cited analyses saying some contracted profits have flowed to PBMs and their affiliates and argued the state could increase employer costs by reducing manufacturer rebates.
Where the parties disagree: Providers argued the bill is needed to preserve patient access for rural hospitals and clinics; pharma argued the system has been distorted and urged federal fixes instead of state law.
Committee action and next steps: The committee did not vote on the bill. Senators asked for more data and suggested the state could consider transparency or reporting requirements to show how 340B funds are used in New Hampshire. Supporters recommended a state‑level report or community‑benefit disclosure to increase transparency.
