Community Oncology Alliance Urges Supreme Court to Review 340B Contract Pharmacy Mandate

Independent Oncology Practices Bring Firsthand Perspective on How PBM Control of Cancer Medications Affects Patient Access and Care

WASHINGTON, DC, UNITED STATES, October 27, 2026 /EINPresswire.com/ — The Community Oncology Alliance (COA) has filed an amicus curiae brief with the United States Supreme Court urging review of Mississippi’s 340B contract pharmacy law. The brief details how pharmacy benefit managers (PBMs) profit from the 340B Drug Pricing Program without demonstrating that those financial benefits reach the vulnerable patients the program was created to serve.

Filed in support of the petition in Novartis Pharmaceuticals Corporation v. Fitch, case number 24-60342, COA’s brief brings the perspective of independent community oncology practices and the patients they treat to a dispute often framed around the interests of pharmaceutical manufacturers, hospitals, and pharmacies.

– Click here to read COA’s full Supreme Court amicus brief.

A Frontline View of How PBM Restrictions Impact Cancer Care

Independent oncology practices are uniquely positioned to explain how the 340B program affects patients with cancer. These practices both treat cancer and, through in-office pharmacies or dispensing facilities, provide oral cancer medications directly to patients. As a result, they work closely with PBMs to obtain coverage and payment for those medications and see firsthand how pharmacy network restrictions and prescription steering affect treatment.

When PBMs require patients to use an affiliated specialty or mail-order pharmacy, oncology teams face additional barriers to coordinating treatment initiation, dose changes, refills, and monitoring.

“Independent oncology practices see every day what happens when a PBM stands between a patient with cancer and the medication prescribed by their oncologist,” said Ted Okon, executive director of COA. “That experience is the core of community oncology’s concern in this case. Protecting more contract pharmacy arrangements does not mean protecting patients; in fact, it will harm patients. We urge the Supreme Court to determine whether these arrangements actually make treatment more affordable and accessible for the people 340B was created to help.”

COA’s brief argues that Mississippi’s law reinforces these concerns by protecting 340B contract pharmacy arrangements without requiring demonstrated benefits for patients. The law restricts manufacturers from limiting delivery of 340B drugs to contract pharmacies, including those affiliated with PBMs. COA argues that these protections do not require evidence that the arrangements lower patients’ costs or improve access to treatment.

Research Raises Broader Questions About 340B’s Purpose and Impact

COA’s brief draws on recent research that raises fundamental questions about the 340B program’s expansion, financial incentives, and whether its benefits are reaching the vulnerable patients it was intended to serve.

A study published in The Milbank Quarterly examined the original legislative purpose of 340B, finding that Congress created the program to preserve discounted medicines for core safety-net providers. The authors concluded that the program’s current scope has expanded beyond that original intent. Similarly, in its October 2026 report, Mission vs. Margin, the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Planning and Evaluation (ASPE) examined how 340B’s financial incentives may prioritize revenue generation over patient needs and encourage consolidation that can undermine affordability.

Building on its 340B amicus filing in the Tenth Circuit and brief supporting Arkansas’ law regulating PBM pharmacy ownership, COA continues to bring the firsthand experience of independent community oncology providers and their patients to the courts. The research cited in this brief reinforces COA’s updated 340B position statement for transparency, accountability, and reforms that return the program to its core purpose: helping vulnerable patients access affordable care.

Read COA’s full Supreme Court amicus brief at https://mycoa.communityoncology.org/publications/amicus-briefs/coa-amicus-brief-in-mississippi-340b-case.

The brief was submitted on COA’s behalf by Frier Levitt, LLC. Inquiries may be directed to (973) 798-1853.
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About the Community Oncology Alliance (COA)
The Community Oncology Alliance (COA) is a nonprofit organization dedicated to ensuring that patients have access to the highest-quality, most affordable, cutting-edge cancer care close to home. COA is the only national organization focused exclusively on community oncology, where the majority of Americans with cancer receive treatment. Through policy, advocacy, and community, COA works to support independent community oncology practices and advance access to high-quality cancer care for patients nationwide. Learn more at www.communityoncology.org.

Julie McDowell
Community Oncology Alliance
info@coacancer.org
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