In calendar year 2023, 340B covered entities purchased $66.3 billion in covered outpatient drugs under the 340B Program. The program enables safety-net providers to stretch scarce federal resources as far as possible, reaching more eligible patients and providing more comprehensive services for the communities that they serve. The information below details the aggregate 340B purchases by covered entity type in 2023.
| Entity Type | 2023 Total Purchases |
|---|---|
| Disproportionate Share Hospitals | $51,886,954,092 |
| Health Center Programs | $3,604,902,123 |
| Children's Hospitals | $2,068,940,096 |
| Rural Referral Centers | $1,466,883,786 |
| Ryan White HIV/AIDS Program Part A | $1,509,011,588 |
| Sexually Transmitted Disease Clinics | $1,656,919,741 |
| Critical Access Hospitals | $955,896,370 |
| Ryan White HIV/AIDS Program Part C | $706,922,298 |
| Sole Community Hospitals | $554,770,578 |
| Free-standing Cancer Centers | $506,321,424 |
| Ryan White HIV/AIDS Program Part B | $303,659,916 |
| Ryan White Part B AIDS Drug Assistance Program (ADAP) Direct Purchase Option | $242,321,523 |
| Comprehensive Hemophilia Treatment Centers | $340,953,762 |
| Federally Qualified Health Center Look-Alike Program | $344,997,724 |
| Family Planning Clinics | $37,879,948 |
| Ryan White HIV/AIDS Program Part D | $35,126,473 |
| Tribal Contract/Compact with IHS (P.L. 93-638) | $58,967,807 |
| Tuberculosis Clinics | $7,859,813 |
| Urban Indian Hospitals | $2,545,040 |
| Black Lung Clinics | $843,769 |
| Ryan White Part B ADAP Rebate Option | $42,455 |
| Native Hawaiian Heath Care Programs | $62,307 |
| Total | $66,292,782,635 |
Key Data on 340B Sales
- Prescription drug spending in the U.S. increased 8.4% to $405.9 billion in 2022, faster than the 6.8% growth in 2021.1,,2
- Specialty medicines accounted for 54% of the national drug spending in 2023, primarily driven by growth in immunology, oncology, and HIV.3 Trends impacting the healthcare market nationally are also reflected in the 340B space.
- The 340B Program is limited to outpatient settings. The scope of ambulatory care has expanded in volume and complexity of interventions over the past decade.4 As care increasingly shifts from inpatient to outpatient settings, spending on drugs associated with outpatient care increases. For example, separately payable drugs had a large share of outpatient prospective payment system (OPPS) spending, growing from 16.3% in 2015 to 27.4% in 2022.5 These drugs include advanced treatments such as specialty medications for patients with complex and chronic conditions or rare diseases.
- High-cost pharmaceuticals purchased through specialty distribution channels represent an increasing proportion of the amount of spending in the 340B Program. While representing only 36% of all 340B units purchased, these high-cost pharmaceuticals purchased through specialty channels accounted for 60.6% ($40 billion) of reported 340B purchases – illustrating the significant impact that the relatively smaller numbers of specialty units purchased has on overall 340B purchases.
- In 2023, the top 10 drugs in terms of 340B purchases represented approximately one third of the total spending in the 340B Program.
| Brand Name | Primary Indications | 2023 Total 340B Sales |
|---|---|---|
| Keytruda | Oncology | $6,905,377,755 |
| Biktarvy | HIV | $3,577,083,273 |
| Opdivo | Oncology | $1,953,824,181 |
| Darzalex Faspro | Oncology | $1,891,559,523 |
| Ocrevus | Oncology | $1,850,213,455 |
| Trikafta | Cystic Fibrosis | $1,817,226,143 |
| Humira (CF) Pen | Immunology | $998,809,804 |
| Descovy | HIV | $969,510,516 |
| Entyvio | Immunology | $949,744,300 |
| Durvalumab | Oncology | $889,594,527 |
Note: These purchase data are provided by the 340B Prime Vendor Program, which was established by the 340B statute. The Prime Vendor Program is managed through a contract with the Health Resources and Services Administration. The Prime Vendor Program captures the vast majority but not all 340B transactions. These figures are accurate as of Aug. 12, 2024. The purchase data provided is a culmination of transactional data captured at a given point in time, as corrections and adjustments are made to invoices on an ongoing basis.
1 See: https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/nhe-fact-sheet
2 See: https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/projected
3 See: https://www.iqvia.com/insights/the-iqvia-institute/reports-and-publications/reports/the-use-of-medicines-in-the-us-2024
4 See: Ambulatory Care | Agency for Healthcare Research and Quality (ahrq.gov)
5 See: https://www.medpac.gov/wp-content/uploads/2024/07/July2024_MedPAC_DataBook_SEC.pdf (PDF - 13 MB)