A new report on the 340B Drug Pricing Program released Thursday by the chairman of the Senate Health, Education, Labor and Pensions Committee calls for “much-needed” legislative reforms around transparency and oversight of the contentious discount program.
Chairman Bill Cassidy, M.D., R-Louisiana, kicked off his investigation in late 2023 as a response to substantial increases in the program’s utilization among providers. Over 60,000 total covered entities were participating as of February 2025, per the report, with federal and proprietary data from 2023 suggesting that the roughly $66.3 billion in discounted outpatient drugs purchased through the program would have hit $124.1 billion wholesale.
The senator’s investigation was also prompted by ongoing court battles over restrictions imposed by drugmakers on covered entities dispensing the drugs through multiple contract pharmacies, which they argued would limit abuse of the substantial discounts. Providers have contended that the expansions are necessary to fend off financial losses and ensure low-income patients’ access to care in line with the program’s intent.
The years since have seen providers and pharmas alike lean into their positions, with additional restrictive policies that provide the statutory discounts as rebates taking center stage of the debate. Other lawmakers have also waded into the issue, particularly in light of investigative reports finding some health systems benefitting from the program appeared to pass few of the savings along to underserved communities.
The investigation from Cassidy—a leading figure on Congressional health policy—involved information requests to eight program participants that had been the subject of some of these reports. This approach, though “limited in scope,” sought to paint a picture of the program’s participants without singling out any specific type of entity, according to the report.
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