Sally Pipes, president of the Pacific Research Institute, said on May 10 that President Trump is seeking greater transparency in the federal 340B drug discount program and that hospital lobbyists are resisting the effort.
“Trump is trying to bring transparency to the bloated 340B program — and hospital lobbyists are panicking,” Pipes said in a social media post. “340B was created to help a handful of safety-net hospitals. Now it delivers tens of billions in discounts with virtually no oversight.”
The 340B program requires drug manufacturers to sell outpatient drugs at discounted prices to eligible safety-net hospitals and clinics. It was designed to help providers serving low-income and uninsured patients stretch limited resources, but it does not require discounts to be passed directly to patients or tied to specific services, according to JAMA Health Forum.
The number of 340B covered entity sites has more than doubled since 2013. The Government Accountability Office has said only five of 20 prior recommendations have been implemented, with ongoing concerns around audit processes, duplicate discounts, and eligibility verification for participating hospitals.
At an October 2025 Senate Health, Education, Labor and Pensions Committee hearing, Chairman Bill Cassidy said the program has “ballooned with limited oversight,” and raised questions about how revenue is used and whether it benefits low-income patients. He also cited concerns involving contract pharmacies, hospital consolidation, duplicate discounts, and transparency, according to the Senate HELP Committee.
Pipes is president and chief executive officer of the Pacific Research Institute, a San Francisco-based think tank founded in 1979. Before becoming president of PRI in 1991, she was assistant director of Canada’s Fraser Institute.
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