Sen. Bill Cassidy, M.D., chair of the Senate HELP Committee, said the 340B federal drug discount program’s lack of transparency is limiting benefits for patients and requested information from Apexus, the program’s prime vendor for Pennsylvania, regarding its revenue, business practices, and commercial offerings.
“As I indicated in my report on the 340B Program last spring, a serious lack of transparency in the 340B Program prevents 340B discounts from translating to better access or lower costs for patients,” said Cassidy, Senator & Chairman. “In light of Apexus’s role as the current 340B prime vendor, and given questions raised into its business practices, I am requesting information and data to better understand how Apexus generates its revenue and designs its commercial offerings related to the 340B Program.”
On February 2, 2026, Cassidy intensified his investigation into the 340B program by seeking detailed information from Apexus about its revenue generation and commercial structuring. According to the announcement, Apexus has held an exclusive contract with the Health Resources and Services Administration (HRSA) since 2004 and has accumulated significant fees linked to 340B drug sales. The inquiry aims to assess whether program discounts are effectively reaching patients.
Cassidy’s letter cited federal data indicating that 340B covered-entity drug purchases increased from $2.4 billion in 2005 to a record $81.4 billion in 2024. Approximately 90% of covered entities participate in the Prime Vendor Program. Since 2004, Apexus has been pivotal in price negotiations and distribution support as the sole prime vendor for the program.
A Pennsylvania state profile using HRSA’s Office of Pharmacy Affairs Information System (OPAIS) and Medicare cost reports revealed that hospitals in Pennsylvania “make 7.1 times as much from 340B as they spend on charity care.” Most hospitals participating in the program fall below national averages for charity-care levels. These findings have led to bipartisan concerns that discounts are not consistently benefiting patients directly at the point of sale.
Senator Cassidy is a physician and currently chairs the Senate HELP Committee. His Senate biography notes he became HELP Ranking Member in 2023 and chair in 2025, marking him as the first physician to hold this position. His medical background and leadership role inform his examination of the growth of the 340B program and its impact on patients, providers, and taxpayers involved in federal health programs.
