Two major hospital systems, Bon Secours Mercy Health and Cleveland Clinic, generated hundreds of millions of dollars in revenue by purchasing discounts 340B drugs from manufacturers and then charging patients marked-up prices, according to the report by the Senate Health, Education, Labor, and Pensions Committee.
“This report confirms that hospitals and pharmacy benefit managers are exploiting the 340B program while providing little to no benefit to patients,” said Terry Wilcox, Co-Founder & Chief Mission Officer at Patients Rising. “We commend Chairman Bill Cassidy for standing up for patients and working to bring transparency to the broken 340B program.”
Senate Report: Millions to Hospitals, No Savings for Patients
Congress created the 340B program to help vulnerable patients access to discounted medications through hospitals and clinics. However, the Senate investigation reveals that hospitals and PBMs have hijacked the the 340B program to boost profits.
Richmond Community Hospital (part of Bon Secours Mercy Health) brought in $276.5 million in 340B revenue from 2018 to 2023 without passing those savings on to their patients. Cleveland Clinic pulled in nearly $933.7 million over just three years — with no direct benefits to patients.
“The report is a significant step in exposing how far the 340B program has strayed from its original mission,” said Ted Okon, Executive Director of the Community Oncology Alliance. “It offers clear evidence of how the lack of transparency and accountability has enabled many hospitals and PBMs to profit at the expense of patients and the broader health care system.”
Senator Bill Cassidy: 340B Program Needs Transparency
Senator Bill Cassidy, M.D., Chair of the Senate Health, Education, Labor, and Pensions Committee, released the report after multi-year investigation into how hospitals, pharmacy benefit managers, and third party administrator extract massive profits from a program intended to serve the poor.
U.S. Senator Bill Cassidy, M.D., of Louisiana
“Congress needs to act to bring much-needed reform to the 340B Program,” said Dr. Cassidy. “This investigation underscores that there are transparency and oversight concerns that prevent 340B discounts from translating to better access or lower costs for patients.”
PBM & Third Party Administrators Pocket Billions in Fees
It’s not just hospitals. Pharmacy benefit managers and other third party administrators siphon off 340B funds by adding administrative fees and pharmacy service charges.
Under an agreement with Cleveland Clinic, CVS Health charges patients with insurance “dispensing fees” on brand-name prescriptions. These fees reach up to $85 per prescription. The same patients without third-party prescription insurance coverage pay a dispensing fee on brand-name drugs of just $15.
Both CVS Health and Walgreens also add a third party administrative services fee as part of their pharmacy services agreements. The Senate HELP Committee found that these fees are “a significant revenue source for contract pharmacies” generating hundreds of millions of dollars per year.
Earlier this year, a study published in the peer-reviewed public health journal Inquiry found that hospitals were using the 340B program to generate higher profits by selling 340B drugs at higher margins in richer areas. A 2025 IQVIA analysis showing insured patients nationwide pay hundreds of dollars in higher costs due to 340B markups.
Take Action Now: Join the Patient’s Right to Know
Patients Rising has launched the Patient’s Right to Know Campaign to advocate for patient-centered reforms that ensure the 340B Program helps patients in need. By signing the Patients Rising petition, you are standing up to make sure hospitals use their savings to help the patients who need it most.
You have a Right to Know:
- Am I a 340B patient?
- Am I helping the hospital make extra money that should instead be helping patients?
- Am I getting the savings from the 340B program?
- Where is all the extra money going?
Join the Patient’s Right to Know Campaign and sign the petition today to make healthcare fair and accessible. Help us fix 340B for the people who need it most.
Click here to support the Patient’s Right to Know Campaign
Patients deserve transparency. Patients deserve care. Patients deserve better.