340B Under Pressure: Inside Pharma's Push for Greater Clarity

When a drug already sold at a steep 340B discount generates another rebate request, how can manufacturers determine whether they owe it? That question — and the resulting potential for significant revenue leakage — sits at the center of the increasingly contentious battle over the 340B Drug Pricing Program.

In this Pharmaceutical Executive podcast episode of Pricing & Policy with Model N, Jesse Mendelsohn, senior vice president at Model N, dives into drugmaker concerns about overlapping discounts, the gaps in claims visibility that make them difficult to identify and the push to verify dispensing before paying a 340B rebate. Mendelsohn also explores disputes over claims collection, the support smaller community clinics need and how 340B intersects with Medicare, Medicaid and commercial rebates.

Notably as well, the conversation digs into the Health Resources and Services Administration’s planned 340B rebate model pilot, set to take effect in January 2027. Joining host Mike Christel, Mendelsohn discusses whether the approach could help bring greater transparency and accountability to the 340B program while preserving its underlying purpose and what implementation could mean for covered entities.

00:55 - The evolution of 340B
03:39 - Understanding program's growth and impact
07:27 - Manufacturer challenges/complexities in compliance
10:43 - 340B's twisting path: Rebate pilots and more
15:44 - Pharma as key stakeholder
18:25 - Claims collection hurdles
20:56 - Lilly and industry strategy shifts
23:19 - Assessing the litigation landscape
25:37 - 340B's role in pricing pie, GTN management
29:20 - Fueling future debate? The two drivers

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