The Nurses United for Healthcare Integrity (NUHI) has raised concerns about the exploitation of the 340B Drug Pricing Program by hospitals. According to an announcement on its website, NUHI claims that hospitals are purchasing drugs at discounted prices through the program and billing patients at full price. The coalition is urging Congress to pass the 340B ACCESS Act to ensure that savings from the program reach vulnerable patients.
The 340B Drug Pricing Program was established by Congress in 1992 to provide safety-net providers with access to discounted outpatient drugs for vulnerable patients. According to the Health Resources and Services Administration (HRSA), drug manufacturers are required to offer drugs at significantly reduced costs to eligible hospitals and clinics. The aim is to stretch scarce federal resources to reach more patients. However, HRSA oversight reports indicate that there is no legal requirement for hospitals to pass these savings directly onto patients, allowing many institutions to charge full price despite acquiring drugs at a discount.
The Government Accountability Office (GAO) has repeatedly expressed concerns regarding how hospitals utilize 340B savings. In a report published in 2023, GAO said that covered entities often purchase drugs at 340B prices but bill insurers and patients at standard reimbursement rates, capturing the difference as revenue. This practice allows hospitals to profit significantly while uninsured and underinsured patients continue facing high out-of-pocket costs, highlighting the need for reforms.
The program's expansion has also led to increased scrutiny over oversight and transparency issues. Researchers at the USC Schaeffer Center found that the number of covered sites grew from 8,100 in 2000 to nearly 50,000 in 2020, with hospitals making up more than 60 percent of those sites. During this period, purchases under the program surged from approximately $4 billion annually to $38 billion, raising concerns about financial flows being poorly monitored and susceptible to exploitation.
NUHI is a coalition of former and retired nurses focused on patient advocacy and healthcare accountability. The group emphasizes that programs like 340B should reduce medicine costs for vulnerable patients and support frontline providers rather than serve as profit engines for large hospitals. NUHI's website states that they are advocating for 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.
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