COA calls for patient-centered 340B reforms

The Community Oncology Alliance on July 9, 2026, released an updated position statement pressing for tighter oversight of the 340B Drug Pricing Program. COA says the changes are needed to make sure discounts reach vulnerable patients and not institutions, pharmacies, or intermediaries.

Why it matters: - The 340B Drug Pricing Program was created to help safety-net providers make medicines more affordable for uninsured, underinsured, indigent and medically vulnerable patients. - COA says the program now needs reforms to ensure discounts directly benefit patients and not institutions. - The group argues current 340B rules have helped drive provider consolidation, higher health care costs and reduced access to independent community oncology care.

What happened: - The Community Oncology Alliance on July 9, 2026, released an updated position statement on the federal 340B Drug Pricing Program. - COA said the updated statement reaffirms support for 340B’s original purpose while calling for comprehensive reform. - Johnetta Blakely, MD, MS, MMHC, COA’s chief medical officer, said the program has evolved in ways that increasingly benefit institutions instead of the patients it was intended to serve. - COA said the statement is intended to restore a patient-centered purpose to the program.

The details: - COA wants 340B discounts to follow eligible patients rather than institutions. - COA is calling for greater transparency and accountability around how 340B savings are generated and used. - The statement asks for clear, enforceable definitions of eligible patients and qualifying activities. - COA wants stronger oversight and auditing to protect program integrity. - The group is also calling for reform of contract pharmacy arrangements. - COA wants to eliminate financial incentives for pharmacy benefit managers and other third-party intermediaries that do not directly provide patient care. - The position statement says Congress established 340B in 1992 and later research shows the program has grown more complex, with unintended consequences. - COA said scholarship on the program’s legislative history indicates Congress meant to preserve access to discounted medicines for safety-net providers after the Medicaid Drug Rebate Program, not to create a broad institutional financing mechanism for hospitals. - COA said current 340B structures have contributed to hospital acquisition of physician practices, migration of care to higher-cost hospital outpatient departments and higher costs for patients, employers, taxpayers and Medicare. - COA position statements are the organization’s official policy recommendations on cancer care issues. - COA said the statements are developed with physician leaders and subject matter experts and approved by its board of directors. - The full library of COA position statements is available at the COA position statements page. - COA describes itself as a nonprofit focused on access to high-quality, affordable cancer care close to home. - COA says it is the only national organization focused exclusively on community oncology, where the majority of Americans with cancer receive treatment.

Between the lines: - The updated statement aligns COA with a broader push to redirect 340B away from hospital-centered revenue models and back toward direct patient benefit. - By emphasizing transparency, auditing and patient-level eligibility, COA is signaling that the dispute is as much about program design and enforcement as it is about drug pricing. - The statement also frames 340B as a policy issue tied to site-of-care shifts, market consolidation and Medicare spending, not just pharmacy discounts.

What's next: - COA is likely to use the updated statement to inform policymakers, health care stakeholders and the public as debate over 340B reform continues. - The group will continue advocating for independent community oncology practices and patient access to cancer care. - More information is available through COA’s published position statement library and its organization website Learn more.