Employers for Hospital Accountability said hospitals participating in the 340B drug discount program are amassing outsized financial assets compared to non-340B hospitals while facing no oversight on spending, driving up costs for employers.
According to Employers for Hospital Accountability, "340B was built to support vulnerable patients, but today, participating hospitals are stockpiling far more assets than similar non-340B hospitals, with no accountability for how the money is used, even as 340B drives up costs for employers."
A peer-reviewed study published in Health Affairs Scholar found 340B participating hospitals had 47.5% greater total assets than comparable non-340B hospitals, with real assets growing 1.4% annually at 340B hospitals compared to 1.0% at non-340B hospitals. The average 340B disproportionate share hospital held $831 million in total assets in 2023, translating to roughly $276 million more in assets and about $7 million more in annual administrative salary spending than a comparable non-340B hospital, according to the National Pharmaceutical Council. Applied across the 1,029 disproportionate share hospitals in the study sample, the 340B-related asset growth totaled an estimated $284 billion.
The same study found that 340B hospitals charge commercially insured patients about 7% more than non-340B hospitals for comparable care, with outpatient procedure prices nearly 20% higher. This results in approximately $36 billion a year in extra costs for employers, according to the National Alliance of Healthcare Purchaser Coalitions.
The scale of the program has grown substantially; the 340B program reached $100 billion in discounted drug purchases in 2025, up from $81.4 billion in 2024. The gap between list prices and discounted prices—the amount retained by covered entities—reached $79.5 billion, according to Drug Channels.
Employers for Hospital Accountability is a campaign powered by the National Alliance of Healthcare Purchaser Coalitions that supports reforms promoting transparency, strengthening competition and lowering hospital costs for working families. Its partners include Small Business Majority, the Retailers Association of Massachusetts and the Employers Council on Health Affairs, according to the group's website.
