Terry Wilcox, Co-founder and Chief Executive Officer of Patients Rising, emphasized the need for Congress to define who qualifies as a 340B patient and to require transparency so that program savings benefit low-income and underinsured patients rather than hospitals and Pharmacy Benefit Managers (PBMs).
"the 340B Program now largely benefits hospitals that are pocketing billions of dollars and charging some patients full price," said Wilcox, Co-Founder & CEO. "A hospital profited off a federal program for the poor and still sent a cancer patient to collections. This isn't charity care. It's exploitation. The largest healthcare discount in America should benefit the patients it was created for. Congress must finally ensure it does."
The Senate Health, Education, Labor, and Pensions (HELP) Committee convened on October 23, 2025, to scrutinize the growth of the 340B program and assess whether discounts are effectively reaching patients. According to lawmakers, testimony highlighted chronic transparency gaps, aggressive contract-pharmacy practices, and policy options such as defining an eligible "340B patient." The hearing reflects Congress's focus on reforming the program amid evidence suggesting that loopholes and PBM middlemen are diminishing its value.
Discounted purchases under the 340B program reached $66.3 billion in 2023, marking a 23.4% increase from 2022. Analysts point out that this growth surpasses that of the broader pharmacy market, with contract-pharmacy dynamics playing a significant role. This scale underscores the importance of implementing targeted guardrails and clearer eligibility rules due to their implications for national budgets and patient outcomes.
A Berkeley Research Group analysis revealed a dramatic increase in contract-pharmacy participation by 4,228% from 2010 to 2020. It estimated average gross margins of 72% on medicines dispensed through contract pharmacies under the 340B program compared to approximately 22% for non-340B drugs at independent pharmacies. The report also detailed how vertically integrated chains associated with PBMs capture substantial profits, highlighting how middleman incentives can divert savings away from patients.
Wilcox co-founded Patients Rising in 2015 and serves as its Chief Executive Officer. She leads advocacy efforts aimed at improving access, affordability, and transparency for individuals with chronic and serious conditions. Her work focuses on amplifying patient voices in federal and state policy discussions related to drug pricing and benefit design reforms to ensure systems prioritize patients.
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