STAT+: Sales from controversial U.S. drug discount program rose to $100 billion last year
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- 340B Drug Discount Program purchases of prescription medicines reached $100 billion in 2025, a 22.8% increase from the prior year, according to the Health Resources and Services Administration.
- HRSA, the agency overseeing the program, reported that expensive medicines accounted for $61.9 billion — roughly 62% — of all prescription drugs purchased under 340B, signaling that high-cost specialty drugs are an outsized and growing share of the program.
- Merck's Keytruda immunotherapy led all drugs with nearly $8.9 billion in 340B purchases, followed by Gilead Sciences' Biktarvy HIV treatment at more than $4.47 billion, meaning two products alone accounted for over $13 billion of the program's volume.
- 340B requires drugmakers to offer discounts typically estimated at 25% to 50% off list prices — though discounts can run higher — on outpatient drugs sold to hospitals and clinics that primarily serve lower-income patients.
- HRSA's data mark a steady year-over-year rise in program sales, underscoring how 340B has become an increasingly large channel for outpatient drug distribution despite its long-running political controversy.
Why it matters: Safety-net hospitals and clinics rely on 340B savings to fund care for low-income patients, but with $61.9 billion of the $100 billion total concentrated in high-cost specialty drugs like Keytruda and Biktarvy, drugmakers face mounting pressure over the program's reach and the discounts they are required to provide on their most expensive products.
