Kasia Mulligan, national spokesperson for Patients Come First, said the 340B Drug Pricing Program is driving up drug costs and pushing patients toward financial ruin, calling on Congress to take action.
"This is the ultimate irony of the modern 340B program: a mechanism designed to lower the cost of care is instead driving up list prices, inflating cost-sharing percentages, and pushing patients to the brink of financial ruin," according to Mulligan.
Three major hospital systems—Mount Sinai, University of Michigan Health, and the University of Kansas Hospital Authority—filed separate federal lawsuits alleging that CVS and its affiliates ran a coordinated scheme to pocket nearly $250 million in 340B drug savings between 2020 and 2025. According to the complaints, CVS allowed vulnerable patients and their insurers to pay full price for critical specialty drugs while using its affiliated entities to slash reimbursement rates behind closed doors and absorb the difference as corporate profit, Mulligan wrote in RealClear Health.
Mulligan cited the experience of Virginia King, a metastatic breast cancer patient who received treatment at a 340B hospital. The specialty drug stopping her cancer from spreading carried a list price of roughly $2,700, yet her insurance company was billed $22,000 for the same drug. This left King with an out-of-pocket bill exceeding $2,500—more than her entire bi-weekly paycheck—according to RealClear Health. The Congressional Budget Office has noted that the current structure of 340B actively incentivizes providers to prescribe higher-cost drugs over cheaper alternatives and accelerates consolidation between large hospital systems and independent clinics.
The 340B program reached $66 billion in discounted purchases in 2023. Despite tens of billions of dollars changing hands annually, there is still no federal statutory requirement that hospitals pass steep discounts directly to patients at the pharmacy counter, according to HRSA.
Mulligan is national spokesperson for Patients Come First, a consumer patient advocacy organization that promotes transparency, accountability, and patient-centered reform across the U.S. health care system—including issues related to the federal 340B drug discount program. She called on lawmakers "to ensure this program delivers on its original promise rather than contributing further harm."
