Anthony DiGiorgio, Assistant Professor at the University of California, San Francisco (UCSF), said on X that Minnesota’s new 340B report shows the program is generating billion-dollar net revenue for hospitals and fueling consolidation rather than targeting safety-net care, as similar concerns grow in Missouri.
The topic has drawn attention as policymakers and health professionals debate whether the federal 340B Drug Pricing Program is fulfilling its intended purpose. DiGiorgio said, “$1.34 BILLION in net 340B revenue in a single year. That’s a massive, unregulated corporate windfall. These subsidies are unavailable to independent physicians.”
DiGiorgio added, “And no, this isn’t ‘for the safety net.’ ~81% of MN’s 340B net revenue was captured by just 23 DSH hospitals. Safety net clinics got under 1% of net 340B revenue statewide. So spare me the press releases about the underserved. They are the marketing face for a program that mostly bankrolls big hospital expansion. Judge a policy not by its intent but by its outcomes outcome is clear: it’s a disaster. The MN report proves 340B is no longer a small program for clinics; it’s a billion-dollar subsidy for hospital consolidation.”
The Star Tribune reported that Minnesota’s 340B net revenue is highly concentrated among the biggest hospital participants. M Health Fairview’s University of Minnesota Medical Center generated about $334.7 million in net 340B revenue in 2024, roughly one quarter of the statewide total by itself, while the largest hospitals collectively captured around 80% of Minnesota’s net 340B revenue, dwarfing smaller providers in the program.
In Missouri, 340B hospitals have 3,014 contract-pharmacy arrangements, and 50% are with out-of-state pharmacies. The same profile reports 53% of MO 340B hospitals provide below-average charity care, aligning with concerns that discounts can be converted into hospital margin rather than predictable patient assistance, especially for uninsured patients who may still face full retail pricing.
Created by Congress in 1992, the federal program requires Medicaid-participating manufacturers to sell outpatient drugs at discounted prices to eligible covered entities, with oversight from the Health Resources and Services Administration (HRSA). Recent Government Accountability Office reviews warn of persistent vulnerabilities such as duplicate discounts and gaps around contract pharmacies and recommend further actions to strengthen oversight.
DiGiorgio’s background includes clinical and research interests spanning traumatic brain injury and health policy, according to UCSF Profiles. He continues to comment publicly on issues related to healthcare programs like 340B.
