Marion Mass, founder of Practicing Physicians of America (PPA), said the federal 340B drug pricing program generated over $54 billion in discounted sales in 2025, primarily to hospitals rather than directly aiding low-income patients as intended.
The issue is significant because the 340B program was designed to help economically disadvantaged patients by providing lower-cost medications through eligible healthcare providers. However, questions have been raised about whether these benefits are reaching those most in need.
"Last year, sales at the 340B price were > $54 billion, and the vast majority of that went to hospitals. These lower drug prices are supposed to be for the economically needy, but it seems that the drugs are not always going there," according to Marion Mass on X. Mass shared a link to an Ohio Capital Journal article detailing questions over Cleveland Clinic's handling of 340B subsidies.
The post highlighted that discounted drug sales under the program exceeded $54 billion last year, with hospitals receiving the bulk rather than ensuring benefits reach economically disadvantaged patients. This reflects ongoing concerns about program implementation.
According to a U.S. Senate investigation, Cleveland Clinic in Ohio received $934 million in 340B benefits over a period ending June 2023 and directed these funds into general revenues without direct pass-through to patients. The hospital provided $261 million in free or discounted care in 2023, but critics note funds support executive pay, including over $7 million for the CEO. Reports from the Ohio Capital Journal indicate Cleveland Clinic qualified for 340B as a rural-referral center despite its urban setting and reported $911 million net income in 2023. State-level data shows similar patterns where subsidies bolster hospital finances over direct aid.
National figures from the Health Resources and Services Administration show that discounted purchases under the program reached $81.4 billion in 2024, up by 23% from the previous year, with hospitals accounting for most transactions. Studies indicate much of the spread between discounted and reimbursed prices funds operations rather than patient savings.
Mass practices as a pediatrician in suburban Philadelphia and co-founded PPA in 2017 to advocate for physician interests and patient care reforms.
