Robert Zirkelbach, chief public affairs officer at PhRMA, said the 340B Drug Pricing Program has changed dramatically over the past decade, with nearly two-thirds of U.S. pharmacies now participating and little transparency into how patients actually benefit.
"The 340B program has changed dramatically over the past decade," said Zirkelbach on X. "Today, nearly two-thirds of U.S. pharmacies participate in 340B, yet there's little transparency into how patients benefit. Greater transparency and accountability are needed."
Nearly two-thirds of the entire U.S. pharmacy industry now participates as contract pharmacies for 340B hospitals and federal grantees. Five for-profit chains, including CVS, Walgreens, Walmart, Express Scripts, and Optum Rx, now hold a record 76.8 percent of all 340B contract pharmacy relationships, up from 57 percent in 2017, with nearly half of the top 25 companies on the Fortune 50 generating profit from 340B, according to PhRMA.
HRSA reports 2025 340B purchases hit a record $100 billion, up from $81.4 billion in 2024 and $66.3 billion in 2023, with the program growing at a compound annual rate of approximately 23.5 percent from 2015 to 2024, roughly five times the overall growth rate of manufacturer net drug sales over the same period, according to IntuitionLabs.
The program does not require hospitals to report how much money they make through 340B or how the funds are spent. Research on nonprofit hospitals shows most do not direct the majority of their 340B revenue toward helping low-income patients, according to the Paragon Health Institute.
Robert Zirkelbach is chief public affairs officer and head of strategic initiatives at PhRMA, the trade association representing the leading pharmaceutical research and biotechnology companies in the United States. PhRMA members are committed to discovering and developing medicines that enable patients to live longer, healthier, and more productive lives.
