Jeffrey Last, a Senior Policy Advisor in the United States Senate, has called for reforms to ensure that the 340B Drug Discount Program benefits patient care rather than for-profit intermediaries. His statement was made during a livestream hosted by the American Enterprise Institute on YouTube.
"We are pushing for reform of 340B," said Last. "Some of the examples that we've seen, especially in the report. how much of the 340B benefit — which I'll say is that spread between the reimbursement of that drug and the actual cost of the drug — is actually going towards for-profit contract pharmacies and third-party administrators. and not going to those entities to provide care for patients."
The 340B Drug Pricing Program, established in 1992, allows certain healthcare providers to purchase outpatient drugs at reduced prices. These savings are intended to support care for low-income and uninsured patients. The program is managed by the Health Resources and Services Administration.
According to the U.S. Government Accountability Office (GAO), covered entities purchased approximately $6.1 billion in 340B drugs in 2018. Despite the program's scale, the GAO reported limited information on how those savings were applied by providers and recommended enhanced oversight to ensure the program meets its intended purpose.
A study published in Health Affairs found that many 340B contract pharmacy arrangements in 2019 involved for-profit pharmacies retaining a significant share of the profit margin between drug acquisition and reimbursement. The research indicated that these profits often did not flow back to safety-net providers, leading authors to conclude that current arrangements may reduce the program’s effectiveness in serving vulnerable patients.
Last has served as a Senior Policy Advisor in the United States Senate since March 2025. He has experience in federal healthcare policy, including previous advisory roles within the U.S. Department of Health and Human Services. Based in Washington, D.C., he focuses on legislative health policy.
