A coalition of conservative groups, many funded by the pharmaceutical industry, urged Republican leaders to reform the 340B drug discount program. This program mandates drug manufacturers to offer discounted medications to rural healthcare providers. Critics claim hospitals misuse the program for profit, distributing drugs to affluent areas at higher prices. Nine signatories of the letter to Congress received significant funding from the Pharmaceutical Research and Manufacturers of America (PhRMA). For example, the Center for a Free Economy received over $500,000 from PhRMA. This push for reform highlights a conflict between reducing government regulation and ensuring affordable healthcare in rural areas. Hospital groups argue the program is vital for underserved communities.

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