DPC Urges North Dakota Senators to Reject 340B Expansion

The Domestic Policy Caucus wrote to members of the North Dakota Senate today, urging them to vote against HB1473, which would expand the flawed federal 340B program.

In the letter, DPC wrote, in part,

North Dakota’s unique pharmacy ownership rules are just another reason you should have serious concerns about HB1473. According to the Pioneer Institute, 51% of current 340B contract pharmacies are located outside of North Dakota (of the 254 contract pharmacies, 129 are outside North Dakota). Supporting this bill will mean there will be unlimited contracts with the likes of CVS and Walgreens in Moorhead or East Grand Forks--or as far away as Hawaii. Meaning, those 340B funds meant to help North Dakotans are leaving the state. Layer that on top of what we heard in earlier testimony on this bill some days ago, where one hospital system official talked about using North Dakota's 340B funds to provide a variety of services in Minnesota...

Disappointingly, HB1473 does not have any transparency provisions, which House members had said they wanted added to the bill when they voted it out of the first chamber...

Read the full letter here.

DPC Testifies Against 340B Expansion Bill before North Dakota Senate Human Services Committee

Domestic Policy Caucus Secretary/Treasurer Kent Kaiser, Ph.D., testified virtually before the North Dakota Senate Human Services Committee on March 12 to oppose House Bill 1473, which would expand the federal 340B program in the state.

Among other points, Kaiser said, "...North Dakota's unique pharmacy ownership rules are just another reason you should have serious concerns about HB1473. According to the Pioneer Institute, 51% of current 340B contract pharmacies are located outside of North Dakota (of the 254 contract pharmacies, 129 are outside North Dakota). Supporting this bill will mean there will be unlimited contracts with the likes of CVS and Walgreens in Moorhead or East Grand Forks--or as far away as Hawaii. Meaning, those 340B funds meant to help North Dakotans are leaving the state. Layer that on top of what we heard in earlier testimony on this bill some days ago, where one hospital system official talked about using North Dakota's 340B funds to provide a variety of services in Minnesota..."

Listen to the full hearing here, with DPC testimony beginning at about 10:22:15 AM.

DPC Requests Fiscal Note on South Dakota HB154 340B Expansion

DPC wrote to members of the South Dakota House of Representatives, requesting that a fiscal note be attached to proposed legislation, House Bill 154, which ais to expand the federal 340B program in the state.

DPC wrote: 

SB154, which aims to expand the 340B drug pricing program in South Dakota, has often been touted as cost-free to taxpayers, but this is totally false.

South Dakota taxpayers deserve a fiscal note for SB 154 to understand the full and true impact this legislation would have on small business owners as well as on the state health plan.

Every time someone in the State Employees Health Benefits Program fills a 340B-eligible prescription, the taxpayers pay. Any amount that the pharmacy or hospital charges the State Health Plan above the cost to acquire the drug is a windfall provided by tax dollars. South Dakotans deserve to know exactly what their contribution is to support the 340B program in the state.

Last year, the North Carolina State Treasurer released a report finding North Carolina 340B hospitals overcharged state employees for cancer drugs and reaped thousands of dollars per claim—all at taxpayer expense. There, 340B hospitals billed the State Health Plan 5.4 times their discounted acquisition costs, collecting as much as $6,026 in average profits per claim by charging up to 12.7 times their 340B acquisition costs for oncology drugs. South Dakota taxpayers should know whether they are being similarly gouged to support the 340B program in their state.

DPC Testifies Against HB154 340B Expansion in South Dakota

Today, Domestic Policy Caucus Secretary/Treasurer Kent Kaiser, Ph.D., testified against South Dakota House Bill 154, which would expand the flawed federal 340B drug pricing program in that state, before the House Health & Human Services Committee.

In part, Kaiser testified, "The 340B program has been in existence for about 35 years. So, simply ask your constituents whether they think they enjoy more affordable prescriptions today and more help paying for their copays and coinsurance now as compared to 25 or 30 years ago. Or do they think any benefits meant for them have been diverted into other programs and things. Ask them if they have more drug store options, closer to home, to buy their medicines. Or, does it seem like they have fewer drug store options, and that they have to travel farther from home to get their prescriptions filled? Ask them if they think they receive more personal care from their pharmacy today than they did 25 or 30 years ago. Or do they think their pharmacy is more impersonal and corporate. If you receive generally negative responses to these questions, then you know that the 340B program is not working the way it was intended and that it needs to be reformed on the federal level, way before it is expanded on the state level."

Listen to the full committee hearing here (DPC testimony starts at ~41:55).

DPC Appears on WZFG Radio to Discuss HB1473 in North Dakota

On February 27, Domestic Policy Caucus Secretary/Treasurer Kent Kaiser, Ph.D., appeared on WZFG radio's "What's on Your Mind" show to discuss why North Dakota House Bill 1473, which aims to expand the federal 340B drug pricing program, should be opposed.

Show host Scott Hennen and Kaiser discussed how the federal 340B program needs to be reformed so that the financial benefits flow to patients in the form of lower drug prices and help paying prescription drug copays and coinsurance, instead of to large hospital systems and national pharmacy chains.

Listen to the show below.

The Oklahoman op-ed: “This bill was supposed to help OK patients. It fattens hospital wallets instead.”

In The Oklahoman of Oklahoma City today, Domestic Policy Caucus Secretary/Treasurer Kent Kaiser, Ph.D., has an op-ed published, asking lawmakers to reject legislation that aims to expand the federal 340B program. 

In part, DPC wrote, "[A] loophole in the law allows hospital systems and pharmacy chains to keep for themselves the financial benefits that are meant for patients. Obviously, this well-intentioned but seriously flawed program needs to be fixed, and expanding it is not the answer to prescription drug affordability in Oklahoma."

Read the op-ed here.

New Domestic Policy Podcast Episode: The Folly of 340B Expansion in North Dakota

In a new Domestic Policy Podcast episode released February 20, Dr. Kent Kaiser and North Dakota Watchdog Network Managing Director Dustin Gawrylow discuss the folly of North Dakota House Bill 1473. The bill aims to expand the federal 340B drug pricing program in the state.

During the episode, Gawrylow said, in part, “Like most government programs, this is one of those that had a good initial intention, but government is really bad at making sure that the programs that it develops actually benefit the people it intends to benefit. This is definitely one of those where there's not a lot of accountability and oversight on ensuring that the intended beneficiaries of the program actually see that benefit.”

Listen to the full episode here.

Domestic Policy Caucus Signs on Coalition Letter to Legislators to Stop 340B Expansion in North Dakota

The Domestic Policy Caucus joins American Free Enterprise, AFP North Dakota, and North Dakota Watchdog Network to warn against House Bill 1473, as it would expand the federal 340B Rx drug program and cost North Dakota taxpayers and employers millions of dollars.

The following are key findings from the 2025 financial impact report from IQVIA, which analyzes the cost of forgone rebates to employers and state/local governments: 

• Nationally, forgone rebates on prescriptions filled with 340B pricing increased commercial employer costs by over $6.6B and state and local government plans by $1B in 2023.

• In North Dakota, forgone rebates on 340B prescriptions increased commercial employer costs by over $53.4M and state and local government plans by $9.5M in 2023.

• For North Dakota, 340B contract pharmacy mandate bills would further increase this cost by $13.9M for commercial employers and $2.5M for state and local governments.

Read the full letter here.

DPC Writes to Oklahoma Legislators to Request a "No" Vote on 340B Expansion

Domestic Policy Caucus Secretary/Treasurer Kent Kaiser, Ph.D., today wrote to members of the Oklahoma House of Representatives Civil Judiciary Committee to request a "no" vote on House Bill 2048, which would expand the 340B drug pricing program in the state.

In part, DPC wrote, "Before it is ever expanded, the 340B program needs to be reformed. You should pursue reforms that include oversight and transparency so that hospitals and pharmacies must report exactly how much revenue they generate from the 340B program and exactly how much of that money is used to provide prescription drug discounts to patients like the original law intended. You should also define exactly who is a 340B patient, and you should require that patients be notified if they are designated as 340B patients. This would be a good start before ever thinking about expanding the 340B program in Oklahoma... Please vote “no” on expanding 340B. Oppose HB2048."

Read the full letter here.

DPC Testifies in Opposition to 340B Expansion in North Dakota

On February 10, Domestic Policy Caucus Secretary/Treasurer Kent Kaiser, Ph.D., testified virtually before the North Dakota State House Committee on Industry, Business, and Labor in opposition to HB1473, which aims to expand the federal 340B drug pricing program in the state. 

In part, Kaiser testified, "Making a flawed program bigger is not the answer. The 340B program should be fixed before there’s any discussion about expanding it. You should provide oversight to hold covered entities responsible for delivering on 340B’s stated purpose. Simply defining who is a 340B patient and ensuring the money flows to those eligible patients—instead of big box pharmacies and hospital systems—is a commonsense first step."

"In addition, you should require entities receiving 340B windfalls to notify the people whom they consider to be 340B patients so those patients know they should be receiving discounts on their prescriptions. Finally, you have an opportunity to inject accountability and transparency into the system by requiring entities that receive 340B money to report exactly how much they receive and exactly where that money flows—specifically, to report exactly how much actually goes towards providing discounted medicines to patients like it was supposed to," Kaiser said.

Watch the full committee hearing here, (DPC testimony begins at ~3:50:00).