Ryan Fournier, co-founder and acting national chairman of Students for Trump, said that most 340B savings flow to wealthy hospitals rather than patients and called for reforms to address Pharmacy Benefit Manager (PBM) abuses. This statement was made on the social media platform X.
"New report finds 78% of 340B benefits go to wealthy nonprofit hospitals, NOT patients," said Fournier. "It's wrong – you know it, President Trump knows it and he's fixing it in Washington. Let's help Trump, reform 340B!"
According to researchers from the University of Southern California (USC), since the Health Resources and Services Administration (HRSA) allowed unlimited contract pharmacies, the 340B program has expanded significantly—from 1,300 unique locations in 2010 to over 33,000 by 2024, with approximately 68% operated by large chains. The researchers say that misaligned incentives allow for-profit chains and third-party administrators to capture significant revenue while transparency regarding patient benefits remains limited. Critics also highlight PBM steering and spread-pricing practices that increase margins in 340B deals while patients rarely experience reduced out-of-pocket costs.
The Federal Trade Commission (FTC) found that market consolidation gives three PBMs—CVS Caremark, Express Scripts (Cigna), and Optum Rx (UnitedHealth)—control over approximately 79% of U.S. prescription claims. The agency said PBMs’ opaque practices and vertical ties can inflate drug costs and disadvantage independent pharmacies, leading to increased scrutiny of how PBMs profit within arrangements like 340B. Policymakers are now considering measures such as delinking, spread-pricing bans, and tighter disclosure requirements to curb PBM leverage.
Employer coalitions report that the "340B premium" increases commercial spending: prices were approximately 7% higher at large 340B hospitals overall—and nearly 20% higher for outpatient procedures—compared to large non-340B peers. This gap translates to roughly $36 billion a year in additional hospital costs borne by employers and working families, reinforcing the case for program integrity and PBM delinking.
Fournier is an American conservative activist and commentator best known as co-founder (and acting national chairman) of Students for Trump, a youth movement launched in 2015 to mobilize campus support for Donald Trump. His role and substantial social media presence have made him a prominent advocate on Republican policy priorities, including health-care reform. He also drives campus voter outreach efforts and uses platforms like X/Instagram to rally support for 340B reform and PBM transparency.
