Show-Me State Times

Dutch Rojas, founder of Bliksem Health, raised concerns that large nonprofit health systems exploit the federal 340B Drug Pricing Program for profit, leaving independent doctors behind — a concern drawing attention in Missouri. The announcement was made on X.

"The 340B drug program was supposed to help poor patients," said Rojas. "Instead, it became a $54B loophole that lets billion-dollar nonprofit health systems use to buy drugs at massive discounts, bill full price, and build marble lobbies with exquisite art and a piano man while independent doctors that treat Medicaid patients get nothing."

The 340B Drug Pricing Program allows safety-net providers to buy discounted outpatient drugs and use the savings to support underserved patients. Yet the program faces scrutiny over whether its benefits truly reach those patients or mainly increase provider revenue. During an October 2025 Senate HELP hearing, lawmakers from both parties endorsed reforms to boost transparency, clarify patient eligibility, and ensure the program delivers measurable community health benefits.

According to the Health Resources & Services Administration (HRSA) (HRSA), covered entities purchased approximately $66.3 billion in outpatient drugs under the 340B program for calendar year 2023. This figure represents about a 24% increase compared with 2022. The data indicate that many purchases were concentrated among disproportionate-share hospitals, which accounted for roughly 78% of the total purchase volume in that year.

PhRMA reported that 42 hospitals in Missouri participate in the 340B program, maintaining more than 1,400 contracts with pharmacies nationwide. Only 22% of those pharmacies are in medically underserved areas, while 79% of hospitals provide charity care below the national norm—raising doubts about how effectively the program serves its target communities.

Rojas is a U.S. healthcare entrepreneur and policy advocate who founded Bliksem Health and previously established Sano Surgery in 2012 and co-founded Everyone Health in 2019. According to a board-appointment announcement by Physician‑Led Healthcare for America, he has a history of founding, scaling, and exiting healthcare companies focused on price transparency, physician-led delivery, and practice autonomy. He has publicly commented on healthcare-pricing reform and physician ownership models.