340B is Under Attack

The 340B program, a critical lifeline for the nation’s public health safety net, is under attack 

Federally Qualified Health Centers (FQHCs), like Howard Brown, serve as an essential safety-net provider of primary care, behavioral health, dental, social, and wraparound services. The federal 340B program requires pharmaceutical manufacturers who participate in the Medicaid Drug Rebate Program to provide discounted pricing to FQHCs and other 340B covered entities. This allows FQHCs to pass along the discounts directly to uninsured patients to help them afford their medications.  Dispensed medications to insured FQHC patients can generate savings or revenue—at no cost to the patient—that FQHCs use to help afford free or discounted medical care and other essential services. The 340B program was designed to allow safety net providers “to stretch scarce federal resources as far as possible” – all at no cost to patients or taxpayers.  

Unfortunately, this critical program is under attack by pharmaceutical manufacturers, threatening to undermine the nation’s public health safety net. Without swift and meaningful action by federal authorities, manufacturers will continue to decrease prescription affordability and access to the most vulnerable patients at Howard Brown and across the country. If these attacks on the 340B program continue, Howard Brown and many other safety-net providers will have no other choice but to reduce services offered to help patients access basic subsidized healthcare and social services.  

Help save this crucial funding for patient care! Contact your state and federal representatives to tell them to take action to protect 340B. Contact your representatives today. 

340B and the Public Health Safety Net 

The 340B program plays a vital role in sustaining the healthcare safety net across the United States. By law, FQHC’s are mandated to provide care to every patient that comes through our doors, regardless of insurance status or ability to pay. Virtually every FQHC, Ryan White CARE Act HIV medical provider, and STI clinic in the country relies at least in part on 340B program savings in order to provide sliding scale and free care to patients with financial barriers. Nearly 25% of Howard Brown patients are uninsured and rely on 340B discounted drugs to treat chronic conditions including HIV, diabetes, respiratory disease, and hypertension.  

Manufacturer Attacks on 340B 

Despite the critical role of the 340B program in sustaining the nation’s safety net, pharmaceutical manufacturers have continuously attacked the program.  

Since 2020, 18 pharmaceutical manufacturers—including Eli Lilly, Merck, and Gilead—have restricted or eliminated access to 340B priced drugs through contract pharmacy partners, with 8 manufacturers specifically targeting FQHC contract pharmacies. This reduced pharmacy access is harmful to the patient populations that FQHCs primarily serve – with many living in pharmacy deserts, without transportation to travel to more distant pharmacies. A network of strategically selected contract pharmacies is essential to ensure Howard Brown patients have convenient access to affordably priced medications no matter where they live.  

In July, Bausch Health, a manufacturer of life-saving diabetes medication, became the 18th drugmaker to impose restrictions on the sale of 340B to entities that contract with commercial pharmacies.  For many patients, the broad network of commercial pharmacies increases convenience and availability, helping them adhere to their treatments. 

These restrictions allow pharmaceutical companies to keep for themselves the 340B savings that should be going to safety net providers. The resulting loss in 340B savings for FQHCs like Howard Brown significantly undermines our ability to continue to provide the continuum of care necessary to maximize patient access and health outcomes. Funding for critical positions that support traditional medical care teams, including case management, behavioral health services, and patient services, are also supported through 340B savings. All these programs and positions, and the patients who rely on them, are under threat by these manufacturer actions.  

Defend 340B Before It’s Too Late 

There is still time to protect the 340B program! We continue to engage our local, state, and federal government representatives around drug costs, pharmacy access, and 340B, and so can you! FQHC patients, staff, and community members alike are encouraged to engage with their state and federal representatives to tell them to take action to protect 340B. Contact your representatives today. 

Learn more about how health centers across the country use 340B savings to improve access to care and how recent attacks have impacted the public health safety net: https://www.nachc.org/wp-content/uploads/2022/06/NACHC-340B-Health-Center-Report_-June-2022-.pdf 


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