BRG Study Finds 340B Drug Margin Hit $142 Billion in 2025
In its "6 study notes" roundup, Becker's Hospital Review reports on an October Berkeley Research Group study estimating patients and payers spent $244.3 billion on 340B drugs in 2025, more than double 2021's $108.4 billion. BRG calculates a "340B drug margin", the gap between covered entities' discounted acquisition cost and what patients and payers are later charged, at $142.2 billion in 2025, over double the 2021 figure. Commercial insurers bore 63% of that margin, Medicare 25%, and Medicaid managed care 7%, while Medicaid fee-for-service generates no margin since it reimburses at acquisition cost. BRG attributes growth to hospital acquisition of off-site clinics, expanded hospital participation, and a surge in contract pharmacies from roughly 1,300 in 2010 to about 35,000 today.
The widening gap between 340B acquisition cost and reimbursement directly affects Medicaid managed care plan drug spending and intensifies scrutiny on contract pharmacy arrangements that states and plans must account for in rate-setting and program integrity oversight.
Pharmacy · Managed Care · Finance
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