Employers and lawmakers press for 340B transparency, warn program expansion may mask true costs

Several members and witnesses called attention to the 340B drug pricing program during the subcommittee hearing, arguing that expansion of contract pharmacy arrangements and broader hospital participation have made it harder to see whether discounts reach intended patients.

Rep. Buddy Carter and other members said the program is growing rapidly and that hospital systems are using contract pharmacies and affiliated networks in ways that obscure how discounts translate to patient or community benefit. “If you're masking the cost because of the profits that you're making on the 340B...I can't help you,” Rep. Carter said, urging clearer patient definitions and reporting.

Elizabeth Mitchell, speaking for large self‑insured employers, said purchasers see evidence that 340B expansion can increase commercial market costs and supported stronger transparency. “We fully support more transparency to get a better handle on what's happening and why and really identify strategies for savings,” she said.

Richard Pollock of the American Hospital Association responded that 340B funds pay for community programs including home health and behavioral health where services are scarce, but he said hospitals were willing to engage on ways to make use of program funds more transparent.

Lawmakers from both parties indicated interest in legislative fixes that would preserve 340B benefits for safety‑net providers while limiting market distortions—suggesting options such as tighter patient‑eligibility definitions, mandatory reporting on how savings are used, and targeted limits on contract pharmacy relationships. The subcommittee did not draft or vote on any 340B legislation at the hearing.