When Congress created the 340B drug discount program in the early 1990s, its mission was simple but powerful: Help safety net providers serve low-income patients by giving them access to discounted prescription medications. For West Virginia – a state with the nation’s fourth-highest poverty rate and among the highest rates of chronic disease – this program should be a lifeline.

Instead, it has become something else entirely.

What began as a targeted safety net initiative has grown into a $66 billion program with limited oversight, transparency or accountability. While the program continues to expand each year, the very patients it was designed to help are too often left behind.

The Congressional Budget Office’s recent report on 340B confirmed what many patient advocates have seen for y

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