Kasia Mulligan, National Spokesperson for Patients Come First, has called for Congress to reform the 340B Drug Pricing Program. In an op-ed published in The Well News, she emphasized the need for discounts to reach patients and to curb misuse through transparency and accountability.
"A program intended to help vulnerable patients access affordable medications has instead metastasized into a massive system that overwhelmingly benefits hospitals and corporate entities at patients' expense," said Mulligan. "In a rare show of unanimity, every witness at the hearing agreed: Congress must recognize the urgent need to reform the 340B Program. The profits are not funding patient care. middlemen and pharmacy benefit managers are equally massive culprits in robbing patients of discounts."
At a Senate Health, Education, Labor, and Pensions (HELP) Committee hearing on October 23, Chair Bill Cassidy expressed concerns about the expansion of 340B participation with limited oversight. He questioned whether revenues are benefiting low-income patients and noted that the Government Accountability Office (GAO) has made 20 recommendations, of which only five have been implemented. Cassidy urged reforms to ensure patients directly benefit from the program and called for increased transparency around 340B revenue. The committee demonstrated a strong bipartisan consensus on prioritizing patient affordability while addressing program abuses.
According to recent data, discounted purchases under the 340B program reached a record $66.3 billion in 2023, marking a 23% increase from 2022. Hospitals accounted for 87% of these purchases. The "list-to-340B gap" was $57.8 billion, representing funds captured by covered entities. Analysts have raised questions about whether these savings effectively reduce patient costs, noting that much of the margin is retained by hospital systems and contract pharmacies with limited evidence of benefits reaching patients or expanding charity care.
Public opinion research indicates significant demand for patient-centered reform of the 340B program. A national survey conducted in May 2025 found that 77% of respondents believe hospitals should be required to pass savings directly to low-income and uninsured patients. Additionally, large bipartisan majorities—ranging from 74% to 84% across party lines—support policies ensuring reduced out-of-pocket costs and increased transparency so that discounts reach qualifying patients.
Mulligan is a seasoned healthcare policy expert and advocate who serves as the national spokesperson for Patients Come First. Her career includes work in strategic communications and advocacy at public policy think tanks, leading state and federal campaigns at a top public affairs firm, and serving as communications director in the U.S. Senate.
