WSHA recently had the opportunity to write an op-ed in the Everett Herald regarding misrepresentations of the 340B Drug Pricing Program. The Washington State Legislature is currently considering legislation that would protect the program and the vital funding it provides to safety net health care organizations in Washington state. We are sharing the piece by WSHA President & CEO Cassie Sauer here.
Recent attacks on the 340B Drug Pricing Program claim hospitals are exploiting it, but that narrative collapses under basic scrutiny. The program is doing exactly what Congress designed it to do: help safety-net providers care for vulnerable patients as drug prices and drug company profits soar.
Created in 1992, 340B allows qualified nonprofit hospitals, health centers and HIV clinics serving low-income patients to stretch limited resources by purchasing medications at discounted prices from pharmaceutical companies.
Its growth reflects explicit federal policy choices, including the Affordable Care Act’s expansion of eligibility and regulatory decisions that allow patients to access medications closer to home. Rising drug prices and newer, extraordinarily expensive, life-preserving therapies have made the program more important, not more suspect.
What has changed is not hospital behavior, but the aggressiveness of pharmaceutical companies seeking to limit the discounts they are legally required to provide. For-profit drug manufacturers now refuse to provide some drugs at the 340B discounted price; including improved cancer treatments, drugs for HIV and mental health medications. New demands for extensive data submissions are bogging down hospitals, while drug companies withhold medications from contracted pharmacies that carry specialty drugs in local communities.
These attacks are led by profit-driven national and international corporations with a direct financial interest in weakening the program to increase their profits. Meanwhile, every 340B eligible hospital is a public or nonprofit institution that cares for a high proportion of low-income people. 340B hospitals reinvest in patient care, sustaining vital services such as rural obstetrics that may otherwise close, or offer community services like free dental clinics. 340B hospitals also use the savings from the program to provide free and reduced-cost care for low-income and uninsured patients.
Portraying Washington’s nonprofit community hospitals as bad actors while defending the interests of multinational for-profit drug companies turns reality upside down.
Claims that 340B raises employer costs are equally misleading. The 340B program was not designed to subsidize private insurance. It was designed to preserve health care access for the most vulnerable, and employers depend on the community benefits of the 340B program to maintain a healthy workforce. In 2024, Washington’s 340B hospitals provided more than $2.1 billion in free and reduced health care services through charity care and Medicaid underpayments, well above the value of their 340B discounts.
When it comes to transparency, hospitals already operate under strict federal oversight and audits. Drug manufacturers, by contrast, face no such scrutiny over their pricing practices and enormous profits.
After more than a decade of congressional inaction, states are stepping in to protect the federal framework that Congress created as manufacturers impose unilateral restrictions that threaten patient access. More than 20 states have already acted to preserve access to discounted drugs.
The real threat to 340B is not abuse by nonprofit hospitals; it is the effort by pharmaceutical companies to protect profits at the expense of patients and those who serve them.
Sincerely,
Cassie Sauer
WSHA President & CEO
[email protected]