ACP says 340B Drug Pricing Program must be reformed to better patient health

PHILADELPHIA, April 21, 2026-The 340B Drug Pricing Program must be reformed to better patient health and disincentivize institutional profit-seeking behaviors, says the American College of Physicians (ACP). In a new policy, "Reforming 340B to Promote Program Integrity and Better Serve Vulnerable Populations: An American College of Physicians Policy Brief," published today in Annals of Internal Medicine, ACP issues recommendations to preserve the health and longevity of the program and its patients through policy changes.

The 340B Drug Pricing Program (340B Program) is part of a federal agreement that gives select health care entities that serve low-income and uninsured patients the opportunity to purchase heavily discounted drugs. The program exists to maximize federal resources while expanding treatment options for underserved populations, but shortcomings in its design, complexity, implementation and oversight have created inadvertent incentives for some health care organizations to undertake profit-seeking behaviors.

In the paper, ACP urges policy changes to protect the program and ensure it meets the intended mission of helping medically indigent populations. Evidence suggests that this mission is being undermined by some organizations' profit-seeking behaviors, such as using 340B Program revenues to open outpatient physician practices in higher-income communities. These practices can obtain discounted drug prices, and profits are increased because the patients are more likely to have insurance coverage that will reimburse the covered entity at a higher rate. The paper advocates for legislative and regulatory efforts to ensure the program has demonstrated benefits for the population it is intended to serve. Benefits realized by the program should be directly used toward further serving those patients. Participating health care systems who do not benefit their patients or meet program requirements should have their 340B Program eligibility revoked.

ACP supports using contract pharmacies to further the program's goals and provide sufficient access to 340B Program drugs. At the same time, ACP urges better oversight, scrutiny and auditing of those pharmacies to evaluate their potential impact and ensure they do not impose excessive payment pressure on participating organizations. Finally, the paper recommends that federal regulators be empowered with the resources and clear statutory authority necessary to engage in meaningful oversight of all 340B Program participants.

"The U.S. market sees some of the highest drug prices in the world. We have patients skipping doses and foregoing filling prescriptions because they cannot keep up with the rising cost of drugs. We must prioritize public policy that protects the health of vulnerable patient populations and expands their access to affordable care, including prescription medications," says Jan K. Carney, MD, MACP, president of ACP. "The 340B Drug Pricing Program is an important program used by most community health clinics around the country to help low-income and uninsured patients afford care. ACP's recommendations are a roadmap for reforming the program so it can continue its mission more effectively and equitably."

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The American College of Physicians is the largest medical specialty organization in the United States with members in more than 172 countries worldwide. ACP membership includes 163,000 internal medicine physicians, related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on X, Facebook, Instagram, Threads and LinkedIn, and subscribe to our new RSS feed.

Contact: Jacquelyn Blaser, [email protected], 202-261-4572