Virginia Society of Rheumatology president on 340B: It has become ‘disconnected from the people it was created to help’

Harry Gewanter, president of the Virginia Society of Rheumatology, said on May 28 that the federal 340B Drug Pricing Program has shifted away from its original intent to benefit patients and now primarily functions as a revenue source for large hospital systems.

"What was meant to be a patient-focused program is now a hospital markup program where large, tax-exempt hospital systems buy discounted drugs, mark them up by as much as 1,000% or more and bill patients and insurers the list price," Gewanter wrote in an opinion piece published by Cardinal News. 

"These hospitals provide little transparency while facing minimal accountability for how they use these 340B profits. As a physician who has spent decades caring for children with chronic illnesses, I am appalled that a program intended to support the most vulnerable patients is now so disconnected from the people it was created to help. The program should be held accountable with more transparency and ensure that all savings are clearly tied to patient benefit," he added.

Gewanter’s comments come as Congress continues to review the 340B program, including recent hearings in which lawmakers questioned hospital executives about how savings from the initiative are used. The program was originally designed to allow certain health care providers to purchase discounted medications for low-income and uninsured patients.

The National Consumers League found broad support among Virginia residents for reforms to the program. According to its polling, 78% of respondents support requiring hospitals to pass savings directly to patients, while 78% support increased transparency and 76% express concern about debt collection practices tied to 340B-participating facilities.

Analyses of the program’s financial impact have found substantial gains for some hospitals. One review cited by policy groups found disproportionate share hospitals generated more than $44 billion in profits from the program in a single year. 

Other studies have linked the program’s structure to increased hospital consolidation due to incentives created by drug discount mechanisms, according to AIR340B and Congressional Budget Office findings.

Gewanter practices pediatric rheumatology in Richmond and serves as president of his professional society, where he advocates for improved access to specialty care for children with chronic illnesses.