Cindy Rubi Estrada, executive director of the New York City Hispanic Chamber of Commerce, said on April 10 that New York lawmakers should avoid expanding the 340B Drug Pricing Program without first strengthening transparency and accountability standards.
The issue comes as the 340B program has grown into a major channel for outpatient drug purchases nationwide. Covered entities purchased $81.4 billion in covered outpatient drugs through the program in calendar year 2024, according to the Health Resources & Services Administration, drawing increased scrutiny over how discounts are used and whether savings are reaching patients.
“Expanding the 340B program without first addressing serious transparency gaps risks creating unintended consequences for patients, employers, and taxpayers alike. Over time, the program has grown dramatically in size and complexity, and oversight has not kept pace,” Estrada wrote in an op-ed.
She pointed to recent analyses of New York data raising concerns about how the program operates in practice.
“In New York, recent data has raised legitimate concerns about how the program is functioning in practice. One analysis found that between 2024 and 2025, 340B providers marked up discounted medicines by an average of 148%, generating an estimated $118.4 million in additional costs for New York State employee health plans and their enrollees. Before expanding the 340B program, New York should first establish strong transparency and accountability standards,” she added.
Additional analysis cited in reporting found that state employee health plans faced about $1 billion in annual 340B-related upcharges on self-administered drugs nationwide, with a weighted average markup of 162%. New York recorded the highest estimated state total at $89 million from the third quarter of 2024 through the second quarter of 2025. Nationally, about 12% of patient out-of-pocket costs were attributed to markups above acquisition prices, according to IQVIA.
A Government Accountability Office review found that only 30 of 55 covered entities reported providing discounts to low-income or uninsured patients at some or all contract pharmacies, suggesting inconsistent pass-through of savings. The report highlighted concerns about the gap between discounted drug acquisition prices and direct patient benefit.
A peer-reviewed study published in PMC found hospital participation in the 340B program was not associated with increased uncompensated care spending, raising additional questions about how savings are used.
Estrada has served as executive director of the New York City Hispanic Chamber of Commerce since 2015, after previously serving as vice president since the organization’s founding in 2006. She is a longtime Bronx resident and former small business owner with decades of experience in community and business leadership.
