HRSA pilots 340B prescription drug rebate program

The Trump administration has released a highly anticipated list of 10 drugmakers that it will allow to shift discounts on drugs from upfront savings to back-end rebates in a controversial federal program (Source: “HRSA discloses manufacturers approved for revised 340B rebate pilot,” Healthcare Dive, Oct. 1).
 
Starting Jan. 1, major pharmaceutical companies including AbbVie, Merck and Pfizer will only have to pay savings to providers participating in the 340B drug discount program after they verify the transaction qualifies, according to the Health Resources and Services Administration, the HHS subagency that oversees 340B.
 
The rebate pilot is meant to assuage concerns from drugmakers and some lawmakers that hospitals and their pharmacies are profiteering off the decades-old drug discount program.
 
HRSA greenlit rebate plans from more manufacturers — and for more drugs — than during its previous attempt to get a 340B rebate pilot off the ground. The expansion is sure to upset hospitals and other 340B providers, which vehemently oppose changes to 340B’s payment structure and argue drugmakers’ concerns about fraud and waste in the program are overblown.
 
340B is meant to give needy safety-net providers reliable access to expensive prescription drugs. But spending in the program increased 9% in 2025 to $901 billion, according to HRSA, leading to calls for increased oversight into how the providers are taking in and spending dollars from the program.