Opinion: Big Pharma is lying about 340B, and New Yorkers are the ones who will pay

Something is happening in New York this year that should bother anyone who cares about affordability and basic fairness. On one side are community health centers – organizations that stretch every dollar to keep their doors open and deliver care to people who need it most. On the other side is one of the richest industries in the world, using its power to squeeze those local providers so it can pad its profits. It’s a backwards version of Robin Hood – taking resources out of patient care and handing more leverage to corporate boardrooms. That fight has a name: 340B. And this year, Albany needs to take action to protect it.

Let’s start by getting one thing straight: 340B is not a loophole or a “giveaway.” It’s one of the few tools we have that helps keep healthcare accessible and affordable in New York, at no cost to taxpayers. It lets community health centers, Ryan White providers, safety-net hospitals and other providers that serve Medicaid patients and low-income communities buy certain medicines at a discount and reinvest the savings into patient care. 

And Big Pharma hates it because it limits their profits. So they lie about it, flood the zone with spin and try to change the rules to squeeze more out of patients and the safety net.

The good news is this: the state Senate has already shown it understands what’s at stake. The 340B Prescription Drug Anti-Discrimination Act, introduced by state Sen. Gustavo Rivera and Assembly Member Amy Paulin, was included by Senate Democrats in our one-house budget – a clear signal that protecting 340B is a priority for our conference. I want to thank Senate Majority Leader Andrea Stewart-Cousins and my colleagues for putting patients and providers ahead of corporate pressure. Now we just need the Assembly and Gov. Kathy Hochul to follow our lead and get this done in the final budget.

This fight is real for me. The son and grandson of autoworkers, I was raised by a single parent, and I know what it feels like when costs keep climbing and your paycheck doesn’t. Healthcare is one of the biggest pressure points on family budgets – and on communities. When a local provider cuts services, it’s not a line item. It’s a missed appointment, a disrupted treatment plan, a crisis that ends up in an emergency room.

That’s what Big Pharma is playing with. Look at providers like Trillium Health in Rochester and Evergreen Health in Buffalo – community health centers that don’t turn people away and that treat the whole person. They combine primary care and behavioral health with the supports that make treatment possible: transportation help, care coordination, nutrition support, harm reduction and outreach. Those services are sustained by programs like 340B that let providers stretch scarce resources.

Now here’s what Big Pharma claims. They’ll say this is about “program integrity.” They’ll say they’re just trying to prevent “duplicate discounts.” They’ll pretend they’re protecting taxpayers. Give me a break.

This is an industry that reports eye-popping profits. In 2022, the top five drug companies reported $81.9 billion in combined earnings. And when Washington started talking about lowering what Medicare pays for certain drugs, Big Pharma didn’t respond by lowering prices. They responded by spending: in 2025, pharmaceutical-sector lobbying in Washington hit record levels, reported at $452 million.

Now they’re trying to choke off 340B. Drug companies are restricting local contract pharmacies – which is how many patients actually get their medicine. Pharmacy middlemen are piling on with contracting tactics, added fees and payment games tied to whether a prescription is filled through 340B. The moves can get technical fast, but the outcome is simple: fewer services as providers are forced to scale back or shut their doors.

The 340B Prescription Drug Anti-Discrimination Act is a straightforward patient protection bill that can stop Big Pharma. It would stop drug companies and pharmacy benefit managers from singling out 340B providers with added restrictions or payment cuts. It would protect the ability of community health centers and hospitals to use contract pharmacies. And it would give the state Department of Health the authority to enforce the law and hold violators accountable.

This is about affordability. It’s about whether we stand with working families and the providers who keep our communities healthy, or whether we let multibillion-dollar corporations rewrite the rules.

The Senate has done our part by putting this bill in our one-house budget. Let’s get the Assembly onboard with passing it, and urge Hochul to sign it so we can protect 340B and stop Big Pharma from blocking care.