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July 14, 2025 • 54 mins

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🎙️ 340B or Bust: Is This Program Failing the Sick?

This week on Real Pharma, hosts Dr. Na-Ri Oh and Ian Wendt dive into the tangled world of 340B with returning guest William “Bill” Sarraille—one of the most respected voices in healthcare law, an active patient advocate, and a rare disease patient himself.

The 340B Drug Pricing Program was intended to help vulnerable patients by requiring drug manufacturers to provide discounted medications to covered entities. But as Bill puts it, has the program strayed too far from its patient-first mission? With explosive growth, patchwork state laws, opaque data, and billions on the line, is it still doing what it was designed to do—or are the sick paying the ultimate price?

🔍 In this episode, we explore:

✅ How 340B ballooned from a modest program to a behemoth that may soon outpace Medicare Part D ✅ Why transparency remains elusive—and who’s resisting it ✅ The uncomfortable reality: charity care rates at major hospitals vs. billions in 340B profits ✅ The looming risks to rare disease innovation and patient access ✅ Bill’s insider perspective on why patients often aren’t seeing the savings ✅ What changes might be coming from state houses, courts, and possibly Washington

Bill also shares candid insights from his own journey as a rare disease patient—and why that makes him both more hopeful and more skeptical than ever.

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