John O'Brien headshot
John O'Brien, architect of ex-President Trump's drug pricing blueprint, calls for more 340B transparency in a commentary for STAT.

HHS Official Under Trump Calls for “Honest Conversation” About 340B at it Reaches Age 30

Getting 340B pharmacy data to study trends and public health impacts “is like trying to catch a will-o’-the-wisp,” a former senior Trump administration health care official said in a commentary last week in the life sciences news publication STAT.

“The data released on 340B to date indicate there are fundamental questions about this program that need to be answered,” John O’Brien, a pharmacist, wrote in an Oct. 26 opinion article pegged to the 340B program’s 30th anniversary this Friday. STAT is widely read by health and pharmaceutical policy makers.

O’Brien held several senior roles at the U.S. Department of Health and Human Services in the Trump administration. He was Deputy Assistant Secretary for Health Policy from 2017-2018 and one of the main designers of Trump’s drug pricing blueprint. He next was Adviser and then Senior Adviser to HHS Secretary Alex Azar.

O’Brien now is the President and CEO of the drug-industry sponsored National Pharmaceutical Council and also serves as a senior fellow at the USC-Schaeffer Center for Health Policy and Economics. The Schaeffer Center advisory board includes nine senior executives from biotechnology manufacturers, three from large health-systems, one from a hospital association, and a number from the insurance industry and think tanks. The center’s Value of Life Sciences Innovation Program has argued against price controls saying they would hamper innovation and could reduce life expectancy over the long term by 3%. 

“I commend every team of researchers that has attempted to peer into 340B’s murky waters, because it is a big challenge,” O’Brien continued. “But it’s critical to answer these questions because, as my colleagues and I often say, good policy requires thorough research.”

“If hospitals, contract pharmacies, and third-party administrators have more data that can add more detail to this discussion, the research community must be given access to it so their work can restore confidence that the program is helping those it is supposed to help,” he said. “It’s time to have an honest conversation and recognize that the 340B program has grown far beyond its intended purpose. Protecting the charity care it provides requires measuring and ferreting out the profiteering the law has enabled. An important first step is more transparency into how 340B works and who is truly benefiting from it.”

Prior to his time in the Trump administration, O’Brien was a Vice President of health insurance company CareFirst Blue Cross Blue Shield and a former Senior Director at PhRMA.

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