Measuring the Relative Size of the 340B Program: 2020 Update

In 2020, total sales under the 340B drug pricing program (“340B program”) reached $38.8 billion when measured at the discounted 340B price. This figure represents enormous growth—more than three times the level of 340B sales compared to just five years prior. However, $38.8 billion does not adequately represent the true size of the 340B program, as 340B prices were, on average, 59 percent lower than list prices in 2020, and the discounted 340B price for some medicines is just a penny. Expressed in terms of the undiscounted list price, measured as the wholesale acquisition cost (WAC), 340B sales reached $93.6 billion in 2020.

This study finds that even at the discounted 340B price, the 340B program is larger than all other federal drug programs considered, except for Medicare Part D. As the 340B program has grown, it has come to represent an increasingly large share of branded outpatient drug sales (17.3% as of 2020). Nevertheless, comprehensive data on the program remains sparse and program guidance remains vague.

Read the full update.

This study was funded by the Pharmaceutical Research and Manufacturers of America.