2025-05-20-艾昆纬-2024年340B计划的规模和增长（英）_13页_1mb

The 340B Drug Pricing Program in 2024 reached $147.8B in list price purchases, growing 16.7% year-over-year, compared to a mere 4.9% increase for non-program purchases, after accounting for contract pharmacy restrictions. Growth was influenced by state bills (e.g., Arkansas, Louisiana) allowing 340B pricing via contract pharmacies.

Channel Trends

• Retail and mail channels drove growth until 2021 before slowing due to restrictions, with hospital/clinic purchases growing faster, contributing to divergent trends. By December 2024, contract pharmacy bills boosted overall 340B growth (excluding rebates), exacerbating healthcare cost concerns.

Disease Areas

• The top five therapeutic areas accounted for 66.5% of purchases: oncology, immunologic agents, anti-virals, diabetes, and anti-arthritics (indexed to 2018: 446.3% for immunologic agents, 198.6% for anti-virals). Insulin price cuts (e.g., by 70–75%) lowered 2024 diabetes purchases.

Future Outlook

• Growth faces headwinds from potential federal Medicaid funding cuts, loss of disproportionate share hospital (DSH) status, and manufacturer shifts (e.g., replacing upfront discounts with post-purchase rebates), which could slow expansion. Conversely, state efforts to mandate contract pharmacy use may accelerate growth dynamics.

Data & Limitations

• IQVIA’s DDD Subnational Sales database (2018–2024) addressed limitations like incomplete market coverage and varying state exemptions, indexed for growth analysis.

Key Growth Factors: State mandates, manufacturer integrity programs, and concentrated use of 340B drugs raise costs and alter federal-state regulatory dynamics.