Prescription Drug Spending

CMS to Resolve 340B Payment Mixup With $9B Lump-Sum Fix

July 10, 2023 - CMS has proposed to pay $9 billion to hospitals impacted by payment cuts to the 340B Drug Pricing Program between 2018 and 2022. The proposal is CMS’ remedy to cutting 340B payments from the average sales price (ASP) of covered outpatient drugs plus 6 percent to ASP minus 22.5 percent. CMS previously contended the lower 340B payment rate...

Read More


More Articles

Lawmakers Seeking Stakeholder Input to Improve 340B Drug Pricing Program

by Victoria Bailey

A group of bipartisan lawmakers is seeking feedback from stakeholders on how Congress can improve the 340B Drug Pricing Program and ensure transparency and stability within the program. US Sens. John...

340B Drug Pricing Program Eligibility Tied to Lower Biosimilar Use

by Victoria Bailey

Participation in the 340B drug pricing program was associated with reduced biosimilar use and more biologic administrations, a study published in Health Affairs found. The 340B program allows eligible...

National Healthcare Spending Grows 2.7% as COVID-19 Relief Runs Dry

by Jacqueline LaPointe

National healthcare spending is slowing down in the US compared to a significant 10.3 percent increase in 2020. However, healthcare costs remain high as US health expenditures reach $4.3...

CMS Will Apply Higher 340B Hospital Reimbursement Rate After Court Ruling

by Jacqueline LaPointe

Following a court order, CMS is revising its methodology for paying 340B hospitals for outpatient drugs and reprocessing claims paid on or before the Sept. 28th ruling. CMS will reimburse hospitals...

More Pharma Companies Limit 340B Discounts to Safety-Net Hospitals

by Jacqueline LaPointe

Bristol Myers Squibb has notified safety-net hospitals participating in the 340B Drug Discount Program that it will only recognize two designated contract pharmacy locations per hospitals. The company...

High Healthcare Spending Shifts to Uninsured, Prescription Drugs

by Victoria Bailey

In nearly two decades, the overall concentration of healthcare spending has remained steady, but there has been an increase in the concentration of prescription drug spending, according to a study in...

Before COVID-19, Healthcare Spending Increased by 4.6%

by Jacqueline LaPointe

National healthcare spending continued to grow right before the COVID-19 pandemic hit, increasing by 4.6 percent in 2019 to a total of $3.8 trillion, the American Medical Association (AMA)...

AHA, Hospital Groups Continue Fight Over 340B Drug Discounts

by Jacqueline LaPointe

Leading industry groups representing hospitals and pharmacists have written a letter to new HHS Secretary Xavier Becerra asking him to take action against six major pharmaceutical companies that are...

Hospital Outpatient Payment Would Suffer If 340B Cuts Reversed

by Jacqueline LaPointe

Outpatient payments would decrease for the majority of hospitals if HHS reversed a controversial policy reducing 340B drug reimbursement, according to a new Avalere analysis. The analysis examined...

AHA Decries UnitedHealthcare’s Diagnostic, Drug Coverage Policies

by Jacqueline LaPointe

The American Hospital Association (AHA) is seeking immediate relief from UnitedHealthcare’s new benefit design program that would restrict in-network diagnostic providers. The hospital group...

HHS Guidance Clarifies Use of Contract Pharmacies in 340B Program

by Jacqueline LaPointe

New guidance from HHS has clarified that hospitals and other covered entities in the 340B Drug Pricing Program are entitled to discounts for covered outpatient drugs even if they use contract...

Hospitals File Lawsuit to Settle 340B Issues with Pharma

by Jacqueline LaPointe

The American Hospital Association (AHA) and four other hospital organizations are suing HHS after the department failed to enforce 340B Drug Pricing Program requirements when major pharmaceutical...

US Healthcare Spending Declines from COVID-19, But Remains High

by Jacqueline LaPointe

Healthcare spending in the US is declining for the first time in years because of the unprecedented COVID-19 pandemic, according to a new report from the Peterson-KFF Health System...

What Contributes to High US Healthcare Spending?

by Jacqueline LaPointe

Prescription drug prices are contributing to high US healthcare spending, but are not the top driver of costs, according to a recent analysis from the Peterson-KFF Health System Tracker. The analysis...

Hospitals Wage War with Pharma Over 340B Drug Pricing Program Cuts

by Jacqueline LaPointe

The controversy surrounding the notorious 340B Drug Pricing Program continues with more than 1,100 hospitals now urging HHS to stop pharmaceutical companies from refusing discounts for drugs covered by...

AHA Slams Big Pharma Over Efforts to Limit 340B Drug Discounts

by Jacqueline LaPointe

The American Hospital Association (AHA) is demanding that five major pharmaceutical companies cease new efforts to curtail 340B drug discounts. In the past couple of weeks, Merck, Eli Lilly, Sanofi,...

Hospitals Lose Case Challenging 340B Hospital Payment Reduction

by Jacqueline LaPointe

An appeals court recently ruled against hospital groups seeking to block a nearly 30 percent reduction in 340B hospital payments to hospitals participating in the federal drug discount program. The...

Group Purchasing Reduces Healthcare Supply Chain Costs by 13%

by Jacqueline LaPointe

Group purchasing organizations (GPOs) are delivering critical cost-savings to providers, as well as increasing competition, transparency, and even emergency preparedness for events like COVID-19,...

New List of Essential Drugs Shows Hospital Supply Chain Fragility

by Samantha McGrail

A new list of essential medications is highlighting the fragility of the hospital supply chain. The list devised by group purchasing organization Vizient names 200 drugs that, if unavailable due to...

Recent Articles