ADAP Advocacy Launches Campaign Highlighting Declining Charity Care in 340B Hospitals

ADAP Advocacy has launched a national advocacy campaign focusing on declining charity care among hospitals eligible for the 340B Drug Pricing Program. The campaign, which includes a new commercial, questions whether the program has become "too big to fail" while highlighting disparities in care for low-income patients.

The 340B Drug Pricing Program was designed to allow hospitals serving vulnerable populations to purchase medications at reduced rates from manufacturers. These savings were intended to be reinvested in expanded care for low-income patients, particularly through charity care programs that provide free or discounted medical services. However, ADAP Advocacy's campaign points to data showing that 69% of 340B disproportionate share hospitals offer charity care at rates below the national average.

Brandon M. Macsata, CEO of ADAP Advocacy, explained the core concern: "Drug manufacturers offer medications to hospitals at reduced rates so that they, in turn, can serve more low-income patients—but that isn't happening because these hospital systems are pocketing the money." This discrepancy between program intent and actual outcomes forms the basis of the organization's advocacy efforts.

The campaign highlights several interconnected issues beyond declining charity care, including rising healthcare executive compensation and increasing patient medical debt. ADAP Advocacy has developed an interactive map to visualize these trends across different regions and hospital systems. The commercial supporting the campaign is available online at https://youtu.be/7uqGTHT7Zx4.

The implications of these findings are significant for healthcare policy and patient access. When hospitals receiving 340B discounts fail to provide adequate charity care, vulnerable populations—particularly minority communities that disproportionately rely on these safety-net hospitals—face reduced access to essential medications and services. This creates a ripple effect throughout the healthcare system, potentially increasing emergency room visits for preventable conditions and worsening health disparities.

For the pharmaceutical industry, these concerns about 340B program integrity could lead to increased scrutiny of discount arrangements and calls for greater transparency in how savings are utilized. Manufacturers providing discounted drugs may face pressure to ensure their products are actually reaching the intended patient populations rather than simply boosting hospital profit margins.

The "340B Too Big To Fail" campaign raises fundamental questions about accountability in healthcare programs designed to serve vulnerable populations. As healthcare costs continue to rise and disparities persist, the effectiveness of programs like 340B becomes increasingly important for policymakers, providers, and patients alike. The campaign's focus on measurable outcomes—specifically charity care rates—provides a concrete metric for evaluating whether the program is fulfilling its intended purpose.

ADAP Advocacy's work through the 340B Project reflects broader concerns about healthcare system transparency and equity. By highlighting the gap between program design and implementation, the organization contributes to ongoing discussions about how to ensure that healthcare resources reach those most in need. The campaign's findings suggest that without reforms or increased oversight, programs intended to support vulnerable populations may inadvertently perpetuate the very disparities they were created to address.