The 340B Prescription Drug Discount Program

Origins, Implementation, and Post-Reform Future

by Andrew W. Mulcahy, Courtney Armstrong, Jeffrey Lewis, Soeren Mattke

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The federal 340B Drug Pricing Program lowers outpatient drug prices for specific categories of "covered entity" hospitals and clinics. Covered entities can access 340B drug pricing for all of their eligible patients, including those with insurance. The program has always generated some level of controversy, but more in recent times. Drug manufacturers and safety net providers are using a wide array of tools and outlets — including interest groups, lobbying, and media — to share their divergent perspectives on the purpose and appropriate role of 340B. While interest groups are becoming more vocal, the federal government is simultaneously implementing changes in program administration and oversight in response to internal and external calls for transparency and accountability. This Perspective presents the history, current status, and future trajectory of the 340B program.

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