Pharma companies like Eli Lilly, Sanofi, Novartis, and Bristol Myers Squibb are pushing for a rebate-based model to replace upfront 340B drug discounts, allowing greater oversight and claim vetting.1
HRSA submitted proposed 340B Rebate Guidance to the Office of Management and Budget on June 1, with finalization pending, potentially supporting pharma's rebate approach despite past blocks.1
A May court ruling granted Sanofi a partial win, directing HRSA to reconsider its rebate model after denial in December 2024, signaling judicial openness to changes.1
Growing momentum for reforms from policymakers, patient groups, labor, and employers, including Senate draft legislation for tighter oversight; PhRMA reports 340B now covers over $66 billion in drug costs.1
A 2024 Senate report by Bill Cassidy found hospitals often divert 340B savings to capital projects rather than patient care, bolstering pharma's abuse claims.1
Hospital groups like 340B Health and AHA oppose rebate models and restrictions, with ongoing legal battles including a 4th Circuit upholding block on West Virginia's 340B law on March 31.34
Sources:
1. https://www.pharmavoice.com/news/pharma-hospital-340b-drug-discount-pricing/750724/
3. https://www.340bhealth.org/newsroom/category/340bhealth-news-releases/
4. https://www.aha.org/news/headline/2026-03-31-4th-circuit-upholds-block-west-virginias-340b-law