Article
What the numbers show
The new HRSA figures put 2025 purchases at the program’s discounted prices at just over $100 billion, up from about $81.4 billion in 2024. Hospitals account for most of it. Disproportionate share hospitals alone bought about $79.2 billion, and 340B hospitals overall represented roughly 87% of the total. Children’s hospitals, rural referral centers, critical access hospitals and sole community hospitals each accounted for far smaller amounts.
HRSA tied the growth to the same forces shaping drug spending nationally. Care keeps moving from inpatient to outpatient settings, where 340B applies. Oncology drugs, biologics and infusions given in hospital outpatient departments are the fastest-growing segment. New therapies, higher use and price increases also played a part. Specialty drugs made up about 38% of units but about 62% of dollars, and the top 10 products, led by Keytruda, accounted for about 29% of spending.
Why the headline matters
Drugmakers and some lawmakers point to program growth as evidence that 340B has drifted from its purpose. A $100 billion figure will be quoted in hearings, in debates over rebate models and claims data demands, and in the reform drafts circulating on Capitol Hill. HRSA’s own explanation, that 340B growth tracks broader shifts in care and drug prices, gives hospitals a useful counterpoint, but it will not settle the argument.
It is also worth being precise about what the figure measures. It reflects purchases at discounted prices captured through HRSA’s prime vendor program, not the savings hospitals keep. Leaders who mix up purchases, savings and margin in public will lose credibility quickly.
What to do now
- Know your own numbers. Finance and pharmacy should agree on 340B purchases, estimated savings and how much depends on contract pharmacy and on a few high-cost oncology drugs.
- Connect savings to services. Show where the money goes, such as charity care, uncompensated care, clinics, outreach and drug assistance, in terms a legislator can repeat.
- Check concentration risk. If a handful of products drive most of your savings, model what happens if those manufacturers change pricing or impose new data conditions.
- Prepare the board. Directors should hear a short briefing on the program, its growth and your exposure before the next round of federal debate.
Archive entry for Jul 14, 2026, added Nov. 11, 2026.