Show-Me State Times

Reid Porter, senior director of state public affairs at PhRMA, said state and federal probes reveal 340B is misused for profit and called for reforms to curb middlemen’s influence — a debate gaining traction in Missouri. The announcement was made on X.

According to Axios, in 2025 debates over 340B reform and PBM oversight escalated as states advanced restrictions and Congress weighed transparency measures. Arkansas passed the nation’s first ban on PBM ownership of pharmacies, prompting litigation and positioning the state as a test case, while federal policymakers cited concerns over contract pharmacy practices and pricing power in the supply chain.

PhRMA estimates that hospital markups under the 340B program now add nearly $65 billion annually to brand-drug spending, shifting costs to patients, employers, and taxpayers. The group also calculates that state and federal Medicaid programs lose about $6.5 billion a year in rebates due to these markups, fueling calls for reform.

PhRMA reported that 42 hospitals in Missouri participate in the 340B program, holding more than 1,400 contracts with pharmacies nationwide. Only 22% of these contract pharmacies are located in medically underserved areas. Additionally, 79% of participating hospitals in Missouri provide charity care below the national average, raising questions about whether the program is effectively serving its intended populations.

Reid Porter is Senior Director of State Public Affairs at PhRMA, where he leads policy engagement on issues like PBM regulation and 340B reform. With a background in public affairs and communications, he focuses on building relationships with state policymakers and stakeholders to advance industry positions on affordability and access.

PhRMA, founded in 1958, is the Washington, D.C.–based trade association representing leading U.S. biopharmaceutical research companies. Its mission is to advance medical innovation, protect patient access to medicines, and advocate for market-based health policies. In 2025, its priorities include addressing PBM transparency, 340B reform, and opposing drug price controls.