ROI NJ: Congress Must Put Patients First in 340B Reform

By Jeanette Hoffman, Patients Come First New Jersey’s Executive Director

When Congress created the 340B Drug Pricing Program more than three decades ago, the goal was simple and noble: help hospitals and clinics stretch limited federal dollars so they could provide affordable medicines to patients who might otherwise go without.

Today, that promise is slipping away — and nowhere is that more evident than in New Jersey, where patients continue to face sky-high drug costs even as some hospitals reap enormous savings from 340B.

At a recent Senate Health, Education, Labor, and Pensions (HELP) Committee hearing, lawmakers sounded the alarm. Their bipartisan investigation found that while the program has ballooned to more than $66 billion in discounted drug purchases, too few of those savings are reaching the very people 340B was meant to help: patients.

New Jersey Patients Are Paying the Price

The issue isn’t whether the 340B program helps hospitals — it’s whether it helps patients. Across New Jersey, residents struggle with some of the highest healthcare costs in the nation. According to data from the Kaiser Family Foundation, New Jersey patients pay nearly 20% more than the national average for prescription drugs.

Yet, several major New Jersey health systems participate in 340B, buying medications at deeply discounted prices. If those discounts aren’t being passed through to the patient, in the form of lower co-pays, reduced hospital bills, or expanded charity care, then something is fundamentally wrong.

For an uninsured parent at a community clinic in Camden, or a senior on fixed income in Toms River, it doesn’t matter how much a hospital saves if their own prescription costs stay the same.

Transparency and Accountability for New Jersey Families

The Senate HELP Committee, led by Senator Bill Cassidy (R-LA), called for a series of reforms to restore integrity to the program. And New Jersey’s congressional delegation should take a leading role in that effort. Real protection for New Jersey families requires ensuring that 340B savings directly lower patient costs.

Among some of the reforms Congress may consider:

• Mandate public reporting from hospitals on how they use 340B savings, so New Jersey patients can see whether discounts are helping them.

• Ensure discounts follow the patient, not just the institution, by clarifying who qualifies as a “340B patient.”

• Require transparency from contract pharmacies, which often manage discounted drugs but may keep a share of the savings.

• Tie savings to measurable patient benefits, specifically lower out-of-pocket costs for prescriptions as it was intended.

Protecting Safety Net Patients

Some hospital groups argue that reform could harm safety-net providers. But transparency and accountability shouldn’t be viewed as threats. Rather, they’re the only way to protect the integrity of programs meant to serve vulnerable populations.

In New Jersey, we’ve seen what happens when costs rise unchecked: families delay care, seniors skip prescriptions, and community clinics strain to meet growing demand. Reforming 340B isn’t about punishing hospitals. It’s about rebuilding trust between patients, providers, and policymakers.

By supporting patient-centered reform, they can ensure that federal discounts truly benefit New Jersey’s working families, not just hospital balance sheets.

Read the full op-ed in ROI NJ here.