It seems that Big Pharma's coffers are like a teenage athlete's appetite: endless and never satisfied.

As my colleague Joe Cunningham has covered previously, one of the industry's top priorities is gutting the 340B drug discount program, which "allows qualifying hospitals and clinics that treat low-income and uninsured patients to buy outpatient prescription drugs at a discount of 25 percent to 50 percent." The drugs are purchased through contract pharmacies, and there is zero taxpayer cost for this program. When the program started back in 1992 the main beneficiaries were urban hospitals, but as the program has grown (with a huge increase after the passage of the Affordable Care Act) it mainly assists rural hospitals and clinics, i.e., more conservative areas.

But just coming right out and saying, "Hey, our massive profits aren't quite big enough, so we'd really like to do away with this program that comprises less than 10 percent of the total U.S. drug market and benefits people who are poor and sick" wouldn't go over well with the public, so they're taking a multifaceted approach to the "problem."

One way they're attempting to gut the program is through implementing their own bureaucratic hoops, not mandated by the government, for contract hospitals and pharmacies to jump through before they can receive the discounts to which they're entitled. That hasn't gone over so well, and multiple drug companies are having to refund hospitals and pharmacies that were overcharged.

They're also resorting to lawfare, suing the State of Louisiana over a state law enacted to force Big Pharma to offer legally required discounts.

And now they're trotting out Howard Dean, a known Big Pharma shill, to claim that hospitals hijacked the program to increase their profitability; in other words, hospitals are really the greedy ones and that pharmaceutical companies are generous and altruistic, doing all they can to help the poor, but those mean hospitals just keep getting in the way. In an op-ed published November 30 at Real Clear Health, Dean begins:

Corporate greed is a powerful motivator. When our lawmakers draft legislation, they really ought to have a special committee to evaluate how corporations might exploit it.

No such committee exists, though. And that's one reason a program enacted in 1992 to give poor and underserved populations better access to costly prescription drugs has turned into a multibillion-dollar boondoggle for hospital mega-chains.  

It's high time for Congress to restore the 340B drug discount program to its intended purpose.

It's pretty ironic for Howard Dean to be decrying multibillion-dollar boondoggles, especially those that don't involve government money. Or is it that Dean would rather it all involve government money and not the money of his filthy rich clients, the big pharmaceutical companies?

Dean's op-ed is long on emotional appeals and out-of-context facts and figures and proposes solutions that (surprise, surprise) involve more bureaucracy and oversight -- but only for hospitals, clinics, and contract pharmacies. Any type of accountability or oversight for drug companies is strangely missing from his op-ed. Instead, he proposes "re-examining which hospitals should qualify, and ensuring that hospitals re-invest their savings into helping those who need it most." Can you guess which hospitals probably wouldn't qualify under whatever metrics Dean and PhRMA came up with?

While Dean's Real Clear Health piece notes that he's the former Governor of Vermont and the former Chair of the Democratic National Committee, strangely it doesn't note any of his connections to Big Pharma. As recently as 2021 Dean wrote an op-ed advocating against allowing other countries to produce generic versions of the COVID vax. Although most conservatives would say nobody should get the COVID vax at all, Dean's position is clearly in favor of Big Pharma profits and not looking out for the little guy.

And it's very clear that Dean's famous 50-state strategy has been thrown waaaay out the window.