34 Years of 340B: Game Reset

Thirty-four years ago, the Veterans Health Care Act of 1992 established Section 340B, requiring drug manufacturers participating in Medicaid to provide outpatient drugs to eligible safety-net providers at discounted prices. 34 years later, the Health Resources and Services Administration reports data from the 340B Prime Vendor Program showing $100B in purchases in 2025. With the explosive growth of the program, it is no surprise that 340B has been the focus of Congressional Budget Office reports, litigation, agency action, and proposed rulemaking and reform. NPC President and CEO John O'Brien, Katheryne Richardson, and William Sarraille discussed the program’s history, recent dramatic growth, and current controversies. 0:01 Welcome 3:16 340B: Game Reset 6:08 The History of 340B 11:22 Misalignment 13:31 Contract pharmacy guidance evolution 22:11 The cost of 340B 30:03 Importance of data 34:38 Government oversight 39:02 Where do we go from here? 41:57 How is a 340B patient defined? 46:19 What policymakers should know about the 340B program 48:07 Audience Q&A 01:09:38 Final thoughts