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LUGPA Policy Update – Connecticut Senate Bill 494: Prescription Drug Costs and 340B Program Changes

May 2026

At-a-Glance Essentials

  • What’s Happening: Connecticut Senate Bill 494 proposes changes to prescription drug rebate requirements and the 340B Drug Pricing Program.
  • Why It Matters: The bill risks expanding or reinforcing aspects of the 340B program without sufficient transparency, accountability, or guarantees that discounts will directly benefit patients.
  • Action Points: Connecticut LUGPA members should contact their legislators to oppose SB 494. Monitor the bill’s progress and its potential effects on drug acquisition costs and practice operations.

Background

Senate Bill 494 addresses recommendations from the state’s Prescription Drug Task Force. While the goal of improving affordability is shared, the legislation introduces new rebate requirements. It makes changes to the 340B program without first resolving core issues around transparency and patient benefit. The 340B program has grown significantly (reaching $81.4 billion nationally in 2024), yet concerns remain about how savings are used and whether they reach vulnerable patients.

Key Concerns

  • Limited transparency and accountability in how 340B discounts are passed to patients.
  • Rapid expansion of contract pharmacy arrangements (Connecticut hospitals maintain over 1,500, many out-of-state), with many not located in high-need communities.
  • Many participating hospitals provide low levels of charity care despite program savings.
  • New rebate mandates in Medicaid that could add complexity without clear standards or proven patient benefit.
  • Experience from other states (e.g., Minnesota) shows that substantial 340B revenue often goes to operational costs and third-party administrators rather than direct patient care.

Implications for Independent Urology Practices

  • Competitive Disadvantage: Further expansion or protection of 340B without stricter patient-benefit rules could widen the pricing gap between 340B hospitals and independent practices for oncology and specialty urologic drugs.
  • Drug Costs & Operations: Increased contract pharmacy activity and unclear rebate requirements may distort the marketplace, raise acquisition costs for independent groups, and complicate in-office dispensing and specialty pharmacy services.
  • Patient Access: Without stronger accountability, the bill may fail to meaningfully lower out-of-pocket costs or improve access for urology patients, particularly those with prostate, bladder, or kidney cancers.
  • Market Consolidation: Unreformed 340B growth tends to favor large hospital systems and could accelerate pressure on independent physician-led practices.

LUGPA Position

LUGPA opposes Senate Bill 494 in its current form. While we support the goal of improving prescription drug affordability and access, the bill risks reinforcing the shortcomings of the 340B program without adequate transparency, accountability, or requirements that discounts directly benefit patients. We urge lawmakers to oppose SB 494 and instead pursue reforms that better align the program with its original safety-net purpose and create a level playing field for all providers.

Next Steps

  • Contact Connecticut legislators to express opposition to SB 494.
  • Review your practice’s exposure to 340B-related drug pricing differences.
  • LUGPA will continue to monitor the bill and provide updates on state-level 340B and drug pricing developments.

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