not used title
not used title
Large hospitals, clinics and their for-profit partners in Minnesota generated at least $1.34 billion in net revenue from 340B medicine markups in 2024, according to the Minnesota Department of Health’s annual 340B transparency report.
Despite the profits reaped by tax-exempt hospitals, extensive independent research shows the 340B program often fails to lower costs or improve access for patients and instead drives higher costs for everyone.
Here are four key takeaways from the report:
- 340B is a hospital markup program. For the second consecutive reporting year, MDH data provide additional evidence that the 340B hospital markup program is being abused by tax-exempt hospital systems and for-profit middlemen to generate revenue at the expense of patients, employers and taxpayers.
- Big hospitals profit at the expense of true safety net providers. Just four large hospitals captured half of the $1.34 billion in 340B program profits. This illustrates how large hospital systems receive a disproportionate share of program profits in comparison to smaller clinics and hospitals.
- Prescriptions for low‑income patients are a key source of 340B profits. Nearly $261 million in 340B net revenue statewide came from markups on prescriptions filled for Medicaid patients—underscoring how the program is generating revenue from medicines for low‑income patients.
- Middlemen are in on the shell game. Thanks largely to vertical integration and consolidation, Pharmacy Benefit Managers (PBMs) have no shortage of ways to profit off medicines, and 340B is just another example. In Minnesota alone, contract pharmacies which are often owned by the three largest PBMs, received $120 million from the 340B program and roughly only half of those were in-state pharmacies.
Where is the money going? With hospitals in one state alone generating billions of dollars in net revenue each year from the program, it begs the question: where is the money going?
Since there are no guardrails on how program profits are used, and the program lacks transparency, it’s hard to say exactly. However, if you look at the receipts, many of the hospitals profiting most are spending money in egregious ways, without any evidence that patients benefit.
Bottom Line: If policymakers want to lower health care costs they must fix the federal 340B program. Until then, hospitals will continue to exploit the program for profit at the expense of patients, taxpayers and employers.
Reid Porter
Reid Porter is senior director of public affairs at PhRMA, where he focuses on key policy priorities, member engagement and state media relations. He brings over two decades of experience leading communications and managing complex issues across the biopharmaceutical, technology and energy sectors. Porter holds a B.A. from Middlebury College, where he double‑majored in English and Spanish, and a graduate certificate in Publishing from Columbia University. Outside of work, he enjoys writing, traveling, cheering for the Green Bay Packers, playing and watching soccer, playing the violin, rereading Hemingway novels and spending time with family.
As football season kicks off, hospitals keep scoring on 340B
September 9, 2026
ICYMI: Hospital consolidation is driving up health care costs
August 27, 2026
It's time to modernize 340B: The case for a rebate model
August 19, 2026
ICYMI: Fox business hosts call 340B a ‘Rotten System’ and ‘Cash Cow’ for hospitals
July 23, 2026
340B’s reality: A booming business for hospitals, pharmacies and corporate giants
June 25, 2026
Insurers are blaming medicines for premium hikes in Massachusetts. The state's own data suggests otherwise.
June 24, 2026
340B’s lack of guardrails lets big hospital systems turn it into an oversight-free revenue stream
June 22, 2026
Private equity's new play? Become a nonprofit to profit off 340B.
June 5, 2026
340B is growing, but it is unclear if Illinois patients benefit
May 27, 2026
State price-setting boards create more questions than answers
May 20, 2026
Fox Business spotlights hospitals abuse of the 340B program
May 15, 2026
The Wall Street Journal raises new alarms about 340B
May 11, 2026
Hospitals in the hot seat: Congress sharpens focus on 340B, consolidation and rising costs
May 7, 2026
New "Goldmine” ad reveals hospitals hide how they profit from 340B markups
May 6, 2026
A program off track: How 340B drives both hospital consolidation and system gaming
April 27, 2026
Washington Post Editorial Board says 340B has become “corporate welfare”
April 27, 2026
States should avoid repeating the IRA’s price‑setting mistakes
April 21, 2026
Modernizing 340B using rapid verification: The case for a rebate model
April 20, 2026
Virginia should be cautious about importing federal price-setting mechanisms
April 1, 2026
Hospitals drive nearly 80% of the U.S. health spending gap
March 25, 2026
Congress should look under the hood of 340B, hospitals don't want them to
March 19, 2026
340B hospitals buy low and sell high, a new analysis shows
March 12, 2026
340B hospital markup scheme is costing states, taxpayers billions
February 25, 2026
Questions mount over 340B program and increased cost to everyone
February 23, 2026
PhRMA Forum 2026 highlights the importance of fostering the next era of American leadership
February 18, 2026
50-state poll says Americans are concerned that hospital markups hurt patients
January 27, 2026
New analysis finds 340B hospitals push patients toward costly care to boost profits
January 21, 2026
Data shows tax-exempt hospital profit-seeking behavior, not drug prices, is driving explosive 340B expansion
January 8, 2026
Big, tax-exempt hospitals are charging cancer patients, employers massive medicine markups
January 5, 2026
340B’s billion-dollar boom: Oversight lags as spending soars
December 19, 2025
New study: 340B rebate model pilot won’t hurt cash flow for providers
December 18, 2025
One thing the Senate can agree on: It’s time to fix 340B
November 25, 2025
California’s landmark PBM crackdown: A wake-up call for reform
November 13, 2025
Middlemen mark up drug prices and keep discounts meant for you
November 10, 2025
The Administration approves manufacturers’ 340B rebate pilot plans
November 6, 2025
340B abuses are fueling higher Medicare costs, new BRG report shows
October 15, 2025
ICYMI: The Wall Street Journal calls 340B reform a “good idea to cut drug costs”
September 23, 2025
340B hospitals use scare tactics to evade accountability
September 16, 2025
Why states struggle to deliver savings: Middlemen and 340B siphon dollars from patients and states
September 15, 2025
CBO: 340B program costs taxpayers, no evidence patients benefit
September 10, 2025
PhRMA stresses importance of 340B Rebate Model Pilot
September 9, 2025
New “Meet Mark” ad exposes how the 340B hospital markup program drives up costs for everyone
September 3, 2025
Medical innovation takes center stage in state legislatures
August 27, 2025
New study unmasks how big-city hospitals exploit 340B by posing as rural providers
August 21, 2025
Study: 340B hospitals drive up patient drug costs
August 15, 2025
Curbing 340B abuse and rising costs with the rebate model
August 12, 2025
North Carolina puts patients first with rebate pass-through law
July 29, 2025
The hidden cost of 340B: A multi-billion-dollar burden on taxpayers and Medicaid
July 14, 2025
Latest analysis from Ohio exposes growing abuses of the 340B markup program
July 7, 2025
New report finds rampant abuse of the 340B program
June 20, 2025
How the 340B hospital markup program could hurt Michigan patients
June 12, 2025
New “Balance the Scales” campaign highlights why Americans pay more for prescription medicines
May 21, 2025
How the 340B hospital markup program and PBMs drive up costs for U.S. patients
May 16, 2025
Foreign first pricing schemes don’t address why Americans pay more
May 15, 2025
When hospitals have free rein to mark up drug prices, who pays the price?
May 1, 2025
New report finds more abuse of 340B program by hospitals and drug middlemen
March 24, 2025
A closer look at how health care consolidation drives up patient costs, creates barriers to care
March 17, 2025
340B markup program is a hidden tax, increasing costs for employers, straining state and federal budgets
March 5, 2025
New report sheds light on payment flows in the pharmaceutical supply chain, including the role of 340B and vertical integration
February 13, 2025
Virginia, Don't Let Politicians Take Away Your Medicine
January 23, 2025
Wrapping up the J.P. Morgan Healthcare Conference
January 16, 2025
NYT exposes hospitals, middlemen make millions off a hospital markup program
January 15, 2025
PhRMA CEOs Tee Up Next Week's Health Care Conference
January 11, 2025
New study: Entities that don’t make medicines get half of what is spent on those medicines
January 7, 2025
A new administration poses new opportunities for patient access
December 17, 2024
New 340B report from Minnesota exposes steep hospital markups on medicines, patient benefits remain unclear
November 27, 2024
Michigan hospitals using federal program to markup cost of medicines, gouging patients
November 27, 2024
340B spending is exploding, forcing prices up for patients, employers and government programs
November 13, 2024
Three things to know about 340B contract pharmacies
November 12, 2024
PhRMA urges HRSA not to impede new 340B pricing approaches to improve transparency and integrity
October 18, 2024
7 reasons why states shouldn’t copy the IRA’s price setting mistake
October 15, 2024
Illegal abuse of 340B hurts us all
October 3, 2024
Three ways state drug price setting boards fail patients
September 18, 2024
340B sales go up, free or reduced-cost care offered at hospitals goes down
July 1, 2024
ICYMI: Health care policy should be driven by patients, not politics
June 10, 2024
The hidden bill patients don’t know they are paying
June 3, 2024
Biopharmaceutical industry supports jobs and drives economic growth across the United States
May 16, 2024
340B grows and grows, but patients do not see the savings
May 13, 2024
340B grows and grows, but patients do not see the savings
May 13, 2024
Government price-setting boards: Why Minnesota needs to take a better approach
May 9, 2024
Insurance data: PBM reform has no material impact on premiums
April 24, 2024
Government price setting won’t help patients in Illinois
April 22, 2024
PBMs using 340B program to drive profits at patients’ expense
March 28, 2024
Colorado is proof: Too many unanswered questions remain about state government price setting's impact on patients and providers
March 14, 2024
The truth about Nebraska's price setting push
February 13, 2024
What’s the 340B program like in your state?
February 7, 2024
New year, same exploitation of the 340B program
January 25, 2024
How the 340B program became a PBM giveaway
December 11, 2023
New report adds to questions about nonprofit status of 340B hospitals
November 7, 2023
ICYMI: Scott LaGanga and Matt Salo deliver a State of the Industry Report
October 25, 2023
4 truths about state government price setting
October 10, 2023
By the Numbers: 340B continues to climb in profits, dwindle with patient support
September 13, 2023
Three concerns about Colorado's approach to government price setting
August 23, 2023
Michigan proposal jeopardizes access to medicines
August 21, 2023
New 340B Mega Guidance
August 3, 2023
New report: Hospitals mark up medicine prices 500%
August 2, 2023
read more
August 2, 2023
PhRMA responds to Senate: Today’s 340B program leaves patients behind | PhRMA
July 28, 2023
New studies add to body of evidence questioning 340B efficacy
July 11, 2023
340B program reaches $100 billion in sales, while patients are left behind
June 14, 2023
A win for Indiana patients: “Sharing the savings” legislation now law
May 8, 2023
Nonprofit hospitals fall short on community benefit, studies show
April 24, 2023
Why Congress should prioritize fixing the 340B program
March 2, 2023
What they are saying: Nonprofit hospitals are gaming the system at the expense of patients
February 21, 2023
ICYMI: PhRMA kicks off the year at the 2023 J.P. Morgan Health Care Conference
January 19, 2023
340B program continues to drive shift in care to more expensive hospital settings
December 15, 2022
The 340B program is interfering with the U.S. biosimilars market and impacting patient costs
November 21, 2022
Three ways 340B is failing vulnerable patients
October 20, 2022
If patients aren’t benefiting from the 340B program, who is?
October 6, 2022
New data: The 340B program is driving up costs for patients and our health care system
September 15, 2022
Word of the Month: 340B covered entity
August 29, 2022
340B program remains second largest federal drug program, yet little solid evidence of benefits to patient
June 30, 2022
Study after study after study: Contract pharmacy expansion not aligned in communities 340B is meant to serve
June 24, 2022
New research finds gaps in charity care provided by 340B hospitals
June 2, 2022
New analysis confirms hospitals markup prices for oncology therapies
April 21, 2022
By the numbers: Contract pharmacy participation in the 340B program
March 31, 2022
340B 101: Three charts show the program maximizes hospitals’ bottom line with little consideration for patients
February 8, 2022
New study finds more than half of brand medicine spending goes to the supply chain and others
January 7, 2022
Making medicines more affordable: Preserving safety-net programs like 340B
December 17, 2021
Fact Check: Do contract pharmacies help patients access 340B medicines? No.
November 2, 2021
New video: Why changes to the 340B program are essential for patients
October 28, 2021
To drive up profits, hospitals continue unnecessary medicine mark-ups, burdening patients, employers and health care system
October 14, 2021
New analysis adds to research questioning whether 340B is working as Congress intended
October 13, 2021
340B hospitals among those that provide lowest levels of community benefit across the country
July 27, 2021
Getting the 340B program back on track in 2021
March 10, 2021
Correcting the record: Biopharmaceutical companies remain committed to the 340B program and helping patients
December 17, 2020
Fact Check: How hospitals continue to drive health care spending
December 3, 2020
PhRMA submits comments on ways to refocus the 340B program on America’s vulnerable patients
November 2, 2020
340B hospitals and for-profit pharmacies generating significant revenue from program meant to help needy patients
October 23, 2020
Survey found insurance premiums grew faster than inflation in 2020
October 20, 2020
Growth in 340B program has not translated to improvements for patients
October 5, 2020
Cancer medicines cost twice as much at hospitals, study finds
January 21, 2020
New GAO report: Some hospitals participating in 340B may not be eligible for the program
January 14, 2020
Nearly 50% of brand medicine spending goes to the supply chain and others
January 9, 2020
New NHE data: Medicine prices declined, and hospitals were biggest driver of health care spending in 2018
December 6, 2019
Hospitals make 9 times more than physicians’ offices on provider-administered medicines
September 10, 2019
340B Spotlight: How for-profit middlemen are taking advantage of a program meant to support nonprofit entities and patients
August 20, 2019
Study finds hospitals continue to mark up medicines up to 500% of their cost
July 9, 2019
Fresh data show, yet again, 340B is growing while charity care dwindles at many 340B hospitals
May 16, 2019
New study finds hospitals continue to push patients to costlier outpatient settings
May 13, 2019
340B continues to drive shift in site of care for physician-administered medicines to more expensive hospital settings
April 5, 2019
New study finds hospitals prescribe more medicines, and more expensive medicines, after joining 340B program
December 18, 2018
New study finds some hospitals mark up medicine prices at least 700 percent
September 5, 2018
New analysis finds 340B medicine sales hit record high in 2017 and continue to grow as a share of total drug spending
August 20, 2018
PhRMA submission to HHS on blueprint to lower drug prices and reduce out-of-pocket costs
July 16, 2018
GAO again recommends improvements to 340B program
July 11, 2018
ICYMI: Analysis finds higher outpatient drug spending at 340B hospitals
June 18, 2018
New 340B analysis: Hospitals raking in billions while uncompensated care drops by billions
May 15, 2018
Patients pay the price when hospitals mark up cancer medicines
April 5, 2018
340B Spotlight: How much money are hospitals pocketing under 340B and what are they doing with those profits?
March 28, 2018
340B Spotlight: Hospital system adds voice to comments about flawed 340B program
February 2, 2018
Fact Check Friday: The truth about the cost of 340B to patients
January 26, 2018
340B Spotlight: New pieces of legislation continue momentum to fix 340B program
January 18, 2018
340B Spotlight: ICYMI – 340B hearing, new reports highlight growing need for program reform
October 20, 2017
How much are hospitals marking up the price of medicines? The answer may surprise you.
October 17, 2017
340B Spotlight: New analysis finds 340B program growth continues to accelerate despite false claims
July 13, 2017
340B Spotlight: ICYMI – AJC looks at how some Georgia hospitals are profiting off 340B
June 20, 2017
340B Spotlight: 340B hospitals continue to benefit from consolidation at expense of patients
April 27, 2017
340B Spotlight: Audit findings show importance of increased oversight of 340B program
February 9, 2017
340B
Hospitals
State Policy
New report from Minnesota: 340B is generating billions for big hospitals
March 9, 2026