Jessica Dobrinsky, Policy Analyst at the Cardinal Institute for West Virginia Policy, said that the 340B Drug Pricing Program has evolved into a significant revenue stream for hospitals and requires reform to ensure benefits are directed towards patients. The statement was made on X.
"One-off drug deals make headlines," said Dobrinsky. "But the 340B program has quietly become a $40B side business for hospitals—leaving patients behind."
Federal and state policymakers are currently debating reforms to the 340B Drug Pricing Program for 2024–2025. According to the Congressional Research Service, Congress is considering updates to address manufacturer contract-pharmacy restrictions, transparency mandates, and patient-eligibility rules. Several states are also pursuing their own 340B access laws amid ongoing federal court challenges.
The market size of the 340B Drug Pricing Program has seen substantial growth. IQVIA estimates that 340B drug purchases reached $124.1 billion in 2023, marking a 16.5 percent increase from 2022 and more than doubling since 2018. This expansion reflects the increasing involvement of hospital systems and contract pharmacies in program participation and discount utilization.
The number of entities covered by the 340B program and their contract-pharmacy relationships has expanded significantly over the past decade. According to Drug Channels’ June 2025 analysis of HRSA data, there were 229,531 active contract-pharmacy relationships among 12,298 covered entities, compared to tens of thousands in 2015. The report notes approximately 32,000 unique pharmacy locations now participate, raising questions about alignment with charity-care trends.
Dobrinsky serves as Chief of Staff at the Cardinal Institute for West Virginia Policy, where she manages operations and leads health-policy research on market-based reforms. According to her official biography at the Cardinal Institute, she previously worked as a policy analyst focusing on health care issues such as certificate-of-need reform and has published state policy commentary.
The Cardinal Institute for West Virginia Policy is a nonprofit research organization founded in 2014 to promote free-market solutions to state policy challenges. As reported by the institute’s FAQ page, it focuses on economic development, health care reform, education choice, and governance issues through research, public education, and advocacy initiatives.
