ADAP Advocacy aired a commercial on December 11, 2025, as part of its 340B Project, calling for reforms to the 340B Drug Pricing Program. The commercial highlights declining charity care among hospitals eligible for the program, with disproportionate impacts on minority communities. It poses the question of whether the program has become "Too Big to Fail."
Brandon M. Macsata, CEO of ADAP Advocacy, stated that the program is designed for hospitals to provide free care and financial aid to poor patients, known as charity care. Drug manufacturers offer medications at reduced rates so hospitals can serve more low-income patients. However, Macsata claims this is not happening, as hospital systems are "pocketing the money." A recent report indicates that 69% of 340B disproportionate share hospitals offer charity care at a rate below the national average.
The commercial is part of the '340B Too Big To Fail' national advocacy campaign, running through the end of the year. It addresses declining charity care, rising healthcare executive compensation, and increasing patient medical debt. ADAP Advocacy's interactive map has helped visualize these trends. The commercial is available online at https://youtu.be/7uqGTHT7Zx4.
This issue is important because the 340B Program is intended to support vulnerable populations, including those living with HIV/AIDS, by making healthcare more accessible. If hospitals are not using the savings from discounted drugs to provide charity care, it undermines the program's purpose and harms low-income and minority communities who rely on these services. The campaign raises critical questions about accountability and transparency in healthcare funding, with potential implications for policy reforms and patient trust in medical institutions.
ADAP Advocacy's mission focuses on promoting and enhancing AIDS Drug Assistance Programs and improving access to care for persons living with HIV/AIDS. The organization collaborates with advocates, community groups, healthcare providers, government agencies, patients, pharmaceutical companies, and other stakeholders to raise awareness and foster community collaboration. The declining charity care trend highlighted in the campaign could signal broader systemic issues in how healthcare resources are allocated, affecting not only individual patients but also public health outcomes and healthcare equity nationwide.
