On December 11, the Health Resources & Services Administration (HRSA) released the 2024 update to its annual report on 340B covered entity purchases. The agency highlighted that drug purchases at discounted 340B prices reached a record of $81.4 billion in 2024, representing a 23% increase from 2023. This data allows stakeholders to better understand the size of the 340B program and its use by different covered entity types.

Disproportionate share hospitals (DSHs) made approximately $64.1 billion in 340B purchases in 2024, accounting for approximately 78% of total 340B drug purchases. The next largest category of purchases was for health center programs, accounting for about $4.7 billion (5%) of total purchases, followed by children’s hospitals, which made up roughly $2.3 billion (2%) of total purchases. The data reported by HRSA is from the Prime Vendor Program, which captures most, but not all, 340B transactions.

Continued 340B Program Growth and Stakeholder Responses

Over the past decade, the 340B program has continued to grow significantly.

Figure 1. 340B Drug Sales, 2015–2024, in Billions

FQHCs: Federally Qualified Health Centers; RWCs: Ryan White Clinics

Among government funded programs, 340B drug spending is now second in size only to that of Medicare Part D, with 340B purchases outpacing net Medicare Part B and Medicaid spending on prescription drugs. The 340B program growth has prompted manufacturers to impose contract pharmacy restrictions, HRSA to introduce the forthcoming 340B Rebate Model pilot, and lawmakers to increase attention to program reforms (e.g., reintroducing the 340B ACCESS Act, and 340B PATIENTS Act).

A Closer Look at the Top 10 Drugs Based on 340B Sales:

According to HRSA, the top 10 340B drugs accounted for roughly one-third of all 340B purchases in 2024 (Table 1).

Table 1: 2024 340B Sales Compared to 2022 Medicare Spending for Top 10 340B Drugs

Source: Data from HRSA

Conclusion

Given the latest figures demonstrating continued 340B program growth despite mitigation strategies enacted by manufacturers, bipartisan conversations around reform will likely continue in 2026. The data is also being released in advance of implementation of the 340B Rebate Model Pilot Program, which will allow for retrospective rebates on products negotiated in 2026 instead of discounts at time of purchase. This will impact 1 of the top 10 340B drugs from 2024.

In the 119^th Congress, multiple bills (e.g., 340B PATIENTS Act, 340B ACCESS Act) have been reintroduced, including proposals to codify the role of contract pharmacies, shift how patients may benefit from program savings, and increase program transparency.

Staying ahead of the latest trends and 340B policy developments will be critical for stakeholders looking to engage in a 340B reform conversation in early 2026. To learn more about how Avalere Health can support you on 340B policy and strategy, connect with us.