Two national health analysts have criticized the federal 340B drug discount program, describing it as "wasteful" and ineffective in serving its intended low-income patients. The Pioneer Institute announced on X that Real Clear Health features William S. Smith and Robert Popovian discussing this issue.
According to an op-ed by Smith and Popovian, there is an ongoing problem of "duplicate discounts" under the 340B program. Manufacturers are required to provide discounts through both the 340B program and Medicaid rebates for the same drug, a practice prohibited by federal law. Despite audits showing frequent noncompliance, enforcement remains limited. The authors suggest that this issue could worsen with the introduction of federal price controls under the Inflation Reduction Act, potentially leading to deeper discounts. They also note that the Health Resources and Services Administration (HRSA) has not effectively addressed the problem.
"The 340B program is, in general, a wasteful program that does not serve the low-income populations it was intended to serve," Smith and Popovian wrote in their op-ed at Real Clear Health. They added that this issue could be addressed by the incoming administration and should be on the list of programs examined by the newly introduced Department of Government Efficiency.
Smith is a senior fellow and director of the Pioneer Life Sciences Initiative with extensive experience in government and corporate roles, including work with Republican House leadership, the White House, Massachusetts governors, Pfizer, and as a consultant to pharmaceutical companies. He holds a PhD in political science from Catholic University.
Popovian is a senior visiting health policy fellow at Pioneer Institute and founder of Conquest Advisors. He previously served as vice president of U.S. government relations at Pfizer and is an expert in biopharmaceuticals and health policy. He holds a doctorate in pharmacy and a master’s degree in pharmaceutical economics and policy from USC.
The Pioneer Institute is a Massachusetts-based research organization focused on education, healthcare, transportation, and economic policy. It produces research through outside experts and provides resources for legislators and government staff without accepting government grants or university affiliations.