The Congressional Budget Office (CBO) released a new analysis of the 340B Drug Pricing Program, underscoring both its rapid growth and its influence on the broader healthcare market. Between 2010 and 2021, 340B purchases rose from $6.6 billion to $43.9 billion, growth driven not only by higher drug spending but also by hospital consolidation, expanded eligibility under the Affordable Care Act, and the sharp increase in contract pharmacy arrangements. CBO found that facilities often generate significant revenue by purchasing drugs at steep discounts and receiving higher reimbursement, creating incentives to expand prescribing volumes and favor higher-cost therapies. 

The report also draws a connection between 340B and consolidation trends, with hospitals acquiring more off-site clinics to extend program benefits. While the program provides critical financial support for safety-net providers, CBO noted that its structure may encourage behaviors that increase federal spending and reshape competitive dynamics in the healthcare sector. Released just as the American Hospital Association pressed the FTC to examine rebate models tied to 340B, the report is likely to intensify debate among policymakers and health system leaders about the program’s long-term impact on costs, care delivery, and market integration. 

Access the CBO report