The 340B Drug Pricing Program, established by the Veterans Health Care Act of 1992, is a federal program in the United States that mandates drug manufacturers to provide outpatient drugs to eligible health care organizations and covered entities at significantly reduced prices.1 The intent of the program is to enable these entities, which often serve vulnerable and underserved populations, to stretch limited federal resources as far as possible, reaching more eligible patients and providing more comprehensive services. By reducing the cost of pharmaceuticals, the 340B program aims to improve access to medications and health services for those who need them most.
The 340B program has faced numerous challenges from various stakeholders, including health care providers, pharmaceutical manufacturers, and policymakers. The program has experienced exponential growth over the years: Sales through the 340B channel are estimated to exceed $124 billion and are growing faster than non-340B channels.2 Critics argue that the rapid expansion has led to some entities potentially exploiting the program’s benefits, diverting resources away from the intended low-income patients.
Drug manufacturers are actively pushing for changes to the 340B program, including proposing rebate models, engaging in audits, and initiating legal action, all aimed at reducing perceived abuse of the program. At the same time, parties from the provider side of the program seek to educate and advance alternative perspectives. Regardless of point of view, it is certain that the program will continue to be challenged. With multiple rebate-related suits from manufacturers against the HRSA and multiple audit-related suits from covered entities against the HRSA, outcomes of these cases will change the landscape whether or not the HRSA acts.