Annette Meeks, CEO of the Freedom Foundation of Minnesota, said on March 11 that new state transparency data highlight a central weakness in the federal 340B drug-discount program, with hospitals and clinics able to generate substantial revenue from discounted medicines without clear requirements to show how patients benefit.
According to Minnesota’s February 2026 340B legislative report, covered entities generated at least $1.34 billion in net 340B revenue in calendar year 2024—more than double the prior year’s total. The Department of Health noted the figures do not indicate how that revenue was used or how much patients benefited, making the report a key marker in the transparency debate highlighted by Meeks.
"When it was passed in 1992, no one thought to mandate how hospitals and clinics would spend the deep discounts they receive on prescription drugs. The program has morphed into a veritable ATM for hospitals, whereby they 'pocket' the savings they make by purchasing deeply discounted drugs from manufacturers. More than $1 billion worth of profit was made off the backs of the poorest Minnesotans. The 340B programs need congressional reform and improved transparency," Meeks said according to MinnPost.
At the federal level, HRSA said 340B covered entities purchased $81.4 billion in discounted outpatient drugs in calendar year 2024. Separately, CBO reported 340B drug purchases grew from $6.6 billion in 2010 to $43.9 billion in 2021, showing the program’s rapid expansion well beyond its original scale and helping explain why transparency and oversight questions have intensified.
A 2025 GAO report said HRSA’s oversight of the 340B program has improved but still has notable weaknesses, including limited ability to assess compliance risks across covered entities and pharmacies. The report also noted that the number of covered-entity sites more than doubled from 2013 to 2023, showing how program growth has outpaced federal oversight capacity.
Health systems participating in 340B often generate large profits by marking up discounted drugs. According to a 2022 report by the Community Oncology Alliance, hospitals marked up oncology drug prices by up to eleven times their discounted acquisition cost. A Milliman study also found that hospitals participating in the program charge nearly twice as much for outpatient drugs to commercial insurers compared with non-340B hospitals.
Meeks leads an organization focused on individual liberty, personal responsibility, economic freedom, and limited government according to Freedom Foundation of Minnesota. That background helps explain why her critique centers on accountability and whether public-policy benefits are reaching intended patients.
Meeks leads the Freedom Foundation of Minnesota, a group that advocates for economic freedom and limited government. Her critique centers on accountability and whether public-policy benefits are reaching intended patients.
