A Health Affiairs Forefront DiGiorgio (2023), argues that the 340B has outlived it’s purpose. He wrote:
By mandating that drug companies give a large discount to covered entities, the majority of which are hospitals with disproportionate share or critical access designations, the 340B program was intended to provide a financial buffer for institutions such as the one where I work. The 340B program is being used by large corporations to increase revenues. It’s no longer fulfilling its original purpose.
This program is growing rapidly in hospitals serving wealthy patients. 340B hospitals are expanding into more affluent neighborhoods, and they are mindful of payer mix as they move into areas with fewer publicly insured patients. 340B institutions are more likely to avoid counties with lower income levels and more uninsured patients. While Rep. Waxman argues that these revenues are being used to increase service lines for low-income patients, the evidence suggest that 340B hospitals did not increase care for underserved populations or increase their rates of uncompensated care. There are many reforms which could preserve safety net funding while reducing abuses of 340B.