Jenny Goins, chief of staff at the National Alliance of Healthcare Purchaser Coalitions, said on March 3 that Kentucky should pursue greater transparency in the federal 340B prescription drug program and examine its impact on employers, workers, taxpayers, hospitals, clinics, and contract pharmacies.
Goins said Kentucky lawmakers should support HB 685 and back broader federal reforms focused on transparency and patient benefit.
“340B is the second-largest federal drug program behind Medicare Part D. Limitless expansion of contract pharmacies in particular has turned 340B into a massive profit center for large hospital systems, pharmacy benefit managers (PBMs) and big chain drug stores. 340B needs a big dose of transparency. Given the tremendous burden that the 340B program places on working families’ paychecks and employers’ bottom lines, the federal government must rein in the program’s unchecked expansion,” Goins said in remarks published by The Lane Report.
The 340B program requires drug manufacturers to sell outpatient drugs at discounted prices to eligible safety-net hospitals and clinics. It was created to help providers serving low-income and uninsured patients stretch limited resources, but it does not require discounts to be passed directly to patients or savings to be directed to specific services. Peer-reviewed commentary in JAMA Health Forum has raised concerns about limited transparency, rapid growth, contract pharmacy expansion, and whether savings consistently translate into measurable patient benefit.
Concerns about oversight and program growth have also been raised in congressional discussions.
At an October 2025 Senate Health, Education, Labor and Pensions Committee hearing, Chairman Bill Cassidy said the 340B program had “ballooned with limited oversight,” questioning how revenue is used and whether it reaches low-income patients. Cassidy also pointed to broader concerns tied to contract pharmacies, hospital consolidation, duplicate discounts, and transparency requirements, saying program growth has been linked to higher health care costs.
340B covered-entity purchases totaled $81.4 billion in discounted outpatient drugs, according to the Health Resources and Services Administration (HRSA), reflecting the scale of purchasing through the program. The figure represents acquisition costs under 340B across eligible entity types, rather than the list price of the drugs.
The U.S. Government Accountability Office has also identified oversight gaps in the program, including limits in auditing for duplicate discounts, incomplete assurance that noncompliance is corrected, and challenges in verifying eligibility. These gaps affect enforcement of diversion rules, Medicaid rebate protections, and participation requirements.
Jenny Goins serves as Chief of Staff at the National Alliance of Healthcare Purchaser Coalitions and leads strategic planning and operational development across events and education, healthcare advancement, communications and member services. She previously served as president and CEO of the Kentuckiana Health Collaborative.
