Op-Ed: Letter to the Editor – Illinois lawmakers are currently considering legislation to expand the federal 340B drug discount program. While the program was created to help safety-net providers serve vulnerable patients, expansion without guardrails risks further disconnecting the program from that original purpose.
Independent data should give policymakers pause. According to a December 2025 analysis by IQVIA, nearly all 340B contract pharmacies, more than 99 percent nationwide, operate as “open” pharmacies that serve the general public, not exclusively low-income or uninsured patients. In other words, access to these pharmacies is rarely dependent on 340B eligibility at all.
Even more troubling, the same analysis shows that patients almost never receive a 340B discount at the pharmacy counter. IQVIA found that only about 3 to 5 percent of branded prescriptions dispensed through 340B contract pharmacies resulted in direct financial assistance to patients, despite far higher levels of need among the populations the program is supposed to serve.
Illinois already faces rising prescription drug costs and increasing pressure on community pharmacies. Expanding a program that allows profits to grow without transparency while also delivering minimal benefit to patients at the point-of-sale risks worsening those challenges rather than solving them.
Before Illinois moves forward with 340B expansion, lawmakers should focus on accountability: ensuring discounts reach patients directly, protecting independent pharmacies, and preserving the intent of a program meant to support true safety-net care.
Expansion without reform is not progress. Illinois can and should do better.
Op-Ed: Letter to the Editor
