Missouri Biotechnology Association (MOBIO) wishes to draw our members' attention to a new piece of 2025 legislation as filed in HB 781.

During the 2024 session, Missouri enacted government-mandated measures in the name of reforming the 340B process. These measures ended up being costly to MOBIO members. They set our state apart from other states regarding reimbursement certainty, bringing comprehensive reforms to the complexities of getting essential products to deserving patients. MOBIO opposed that legislation, as it ignored many other cost drivers and monetary diversions within that complex private marketplace environment, and it did not have the market analysis summary of the resulting long-term impact on the state. 

In its initial introduced form:

·  HB 781 requires transparent annual reporting of how 340B proceeds are used to offset costs or provide medical care for Missouri’s most vulnerable patients.

·  HB 781 ensures that the proceeds from dispensing 340B drugs benefit Missouri's most vulnerable patients.

·  Currently, covered entities are not required to use the profits generated from discounted 340B purchases to help low-income or vulnerable Missourians afford their treatments. 

·  HB 781 would be an important step in bringing needed oversight and accountability to 340B in Missouri.

·  Transparency of 340B proceeds would ensure program integrity and patient benefits, enabling Missouri to protect vulnerable populations' access to care. 

The 340B program requires pharmaceutical manufacturers to give significantly discounted outpatient prescription drugs to healthcare organizations called “covered entities” and “for-profit contract pharmacies.” Some proponents argue that Instead of passing savings from 340B prices to patients, as the original federal program intended, many of these covered entities and contract pharmacies are profiting at over three times what they are spending on 340B medications. Most often, savings are not being shared with the patients for whom the 340B program was designed to benefit.

MOBIO encourages Missouri legislators to consider the important goals of HB 781. The 340B program is an important safety net for Missourians to access their medications, but it has strayed off course. HB 781 would ensure that vulnerable patients benefit from the program as intended and require annual reporting on how 340B profits are spent to achieve that critical goal in our state.

MOBIO continues to advocate for transparency and efficient governmental policies that fairly allow the marketplace to best serve underserved populations, and robust debate that elevates comprehensive approaches to healthcare delivery.

MOBIO also reminds policy makers that we aren’t an island.  Just last week there was an important article in the Washington Post about President Trump’s plans for additional federal oversight.  Under the Trump/ Mehmet Oz proposal, HHS would have increased oversight of the 340B drug discount program, with new rules proposed that would require participating medical centers to charge no more than the actual cost of acquiring and dispensing drugs to low-income patients.

While this leaked budget represents a draft and has yet to be finalized, it does demonstrate a legislative climate that is in constant flux, with biomanufacturers having another level of uncertainty of whether their investments will be recouped.

Note: HB 781 has been introduced but has not been referred to a committee for a hearing. At this stage in the session, a broader coalition needs to elevate appropriate solutions to these ongoing concerns. If interested in being part of that policy solution, please reach out to Kelly Gillespie, kelly@mobio.org.