Community Action for Responsible Hospitals (CARH) said the 340B Drug Pricing Program has crossed $100 billion in annual purchases while disproportionate-share hospitals cut spending on patient care, calling on policymakers to require covered entities to disclose how they use savings.
According to a Community Action for Responsible Hospitals X post, "The 340B drug discount program just crossed $100 billion in annual purchases. Ten years ago, that number was $12 billion, today 340B covered entities purchase roughly that amount every six weeks. Congress built 340B for vulnerable patients, but the data suggests Wall Street got there first. Policymakers must require 340B covered entities to show where the money is going."
Community Action for Responsible Hospitals reports that nearly nine in ten dollars spent in the 340B program now flow through hospitals, with disproportionate share hospitals alone accounting for $79 billion of the program's $100 billion in purchases in 2025. A study by Magnolia Market Access found that these hospitals cut their spending on free or reduced-cost care by an average of 22 percent over five years after enrolling in the program, while their financial investments grew by 89 percent during the same period. After joining the program, these hospitals saw little to no meaningful increase in hiring doctors, nurses, or frontline care workers, according to Better Hospitals Now.
High-cost pharmaceuticals purchased through specialty distribution channels accounted for nearly two-thirds of total 340B purchases in 2025 despite representing only about one-third of all units purchased. Therapeutic areas such as oncology, immunology, and obesity drugs are driving this growth, according to the Health Resources and Services Administration.
The size of the program now exceeds Medicaid's net prescription drug spending by more than seventy percent and accounts for nearly one-fifth of the total U.S. gross-to-net bubble. It ranks second among government-funded programs only behind Medicare Part D, according to Drug Channels.
Community Action for Responsible Hospitals describes itself as a nonprofit organization made up of patient-focused stakeholders including labor unions, faith leaders, health care providers, consumer advocates, and public interest groups dedicated to promoting transparency and accountability in hospital use of public resources, according to the group.
