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Across the nation, voters are frustrated with hospital markups, drug middlemen practices and lack of transparency that make it harder to access medicines.  

In new polling with Morning Consult, 20,012 Americans across all 50 states and 435 congressional districts were surveyed to discover how widespread frustrations with hospital systems and other drug middlemen have become. Americans are tired of unfair and unaffordable hospital practices, especially aggressive markups. Nine in 10 Americans (87%) are concerned about hospitals’ price markups on medicines. This includes 88% of Republicans and 90% of Democrats concerned.

Too often, lifesaving medicines purchased by hospitals at reduced prices are then resold to patients at massive markups. The majority of Americans are concerned about these hospital medicine markup practices, as well as other hospital antics meant to boost profits at the expense of patients. 

The majority of hospitals now participate in a little-known federal program called 340B. Congress created 340B in 1992 to help patients access more affordable medicines. Today, the program has become less about low-income patients and more about boosting the bottom lines of large hospital systems and for-profit pharmacies. As Americans learn about the 340B program, they are highly concerned about specific ways hospitals are exploiting it for profit. Key drivers of concern include:

• Hospitals buying medicine for as little as a penny and marking it up by thousands of dollars (84%)
• 340B hospitals pursuing aggressive debt collection (83%)
• 340B program driving up taxpayer costs - $20 billion in increased costs to Medicaid and Medicare in one year alone (82%)

Frustrations with drug middleman practices drive call for solutions. It’s not surprising that Americans want reforms that prioritize patient savings and increase transparency. 83% agree that policymakers should focus on cracking down on the abusive practices of health insurance companies and middlemen. 

Policymakers that want to offer Americans some relief from health care costs and access barriers have multiple pathways supported by the public. For example, 81% of Americans are concerned about the lack of transparency and accountability in how pharmacy benefit manager (PBM) practices affect patients’ access to care. To address these issues, Americans favor PBM reforms that prioritize patient savings and increase transparency:

• 80% favor requiring insurance companies and PBMs to pass rebates/discounts directly to patients.
• 77% favor caps on out-of-pocket prescription costs.
• 76% favor requiring health insurance companies and their PBMs to count patient assistance received from drug companies, such as copay coupons, toward the deductible.

The calls for federal reform are loud and clear from voters in all 50 states, and policymakers must heed these concerns and finally address abusive PBM practices and 340B hospital markups, to help ensure that the 340B program actually benefits patients as intended.

Learn more at PhRMA.org/340B, PhRMA.org/PBMs or PhRMA.org/States.

Cynthia Hicks

Cynthia Hicks is Senior Director of Public Affairs at PhRMA focusing on polling and opinion research that supports advocacy communications and strategy. Prior to joining PhRMA, Cynthia worked as a consultant, marketer, and head of polling for a civic technology company where her work supported issue advocacy organizations and policy makers on both sides of the aisle. Cynthia is a proud Los Angeles native and outside of the office she enjoys an early morning HIIT workout and spending time with friends and family.

Cynthia Hicks

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