Show-Me State Times

Nurses United for Healthcare Integrity said hospitals exploit the 340B program by buying drugs at discounts and billing patients full price, a concern drawing attention in Missouri. The announcement was made on X.

The 340B Drug Pricing Program was created by Congress in 1992 to give safety-net providers access to discounted outpatient drugs for vulnerable patients. According to the Health Resources and Services Administration (HRSA), manufacturers must provide drugs at significantly reduced costs to eligible hospitals and clinics, with the goal of stretching scarce federal resources to reach more patients. However, HRSA oversight reports note that the program does not legally require hospitals to pass savings directly to patients, allowing many to charge full price despite discounted acquisition costs.

The Government Accountability Office (GAO) has raised repeated concerns about how hospitals use 340B savings. In a 2023 report, GAO explained that covered entities often purchase drugs at 340B prices but bill insurers and patients at standard reimbursement rates, capturing the “spread” as revenue. This practice allows hospitals to profit significantly while leaving uninsured and underinsured patients facing the same high out-of-pocket costs, a finding that underscores why reforms are being demanded.

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.

Nurses United for Healthcare Integrity (NUHI) is a coalition of former and retired nurses focused on patient advocacy and healthcare accountability. The group’s mission emphasizes that programs like 340B should lower the cost of medicine for vulnerable patients and support frontline providers rather than serve as profit engines for large hospitals. According to NUHI’s website, the coalition is urging Congress to pass the 340B ACCESS Act, which would require transparency, prevent profiteering, and ensure that the program fulfills its original intent of helping patients.