The costs of the 340B program exist of course. They are initially imposed on insurance companies and pharmaceutical manufacturers. But, the costs are not confined to just these industries. The costs created by the 340B program are ultimately integrated into the overall health care system and are manifested through rising insurance premiums, declining insurance coverage, declining innovation and productivity (especially for pharmaceutical drugs), and higher medical costs in unrelated segments of the health care system. Perhaps more troubling, the added noise created by the 340B cost shifting worsens the overall functionality of the U.S. health care system
