Modern Policy Concerns Stemming from 340B

In June of this year, Pharmaceutical Executive reported on Eli Lilly’s efforts to cut off 340B discounts to hospitals that the pharma company says have not submitted claims data. In response, the American Hospital Association (AHA) requested that the federal government take action.

At the time, this was the latest chapter in the ongoing effort to implement the 340B Drug Pricing Program, which has seen the AHA face off against the various pharma companies whose drugs were included in the government’s list of covered products back in October, 2025.

Pharmaceutical Executive recently spoke with Tyler Seville, associate director of market access policy strategy at ADVI, about the ongoing 340B issues. He primarily focused on a recent study from ADVI that looked into policy concerns and operational challenges. He also discussed how 340B appears to be interacting with other drug pricing programs, such as the Inflation Reduction Act (IRA).

Pharmaceutical Executive: What are the modern policy concerns stemming from 340B?
Tyler Seville: This was a well-intentioned policy. However, it has grown to the point where it has become a major financial liability for manufacturers — manufacturers who are trying to help patients but are navigating an increasingly complex web of overlapping discount obligations across Medicaid, Medicare, and 340B simultaneously.

It is now an open question whether patients are truly benefiting from the program the way they were intended to. What we continue to see is covered entities — major health systems and hospitals — taking 340B revenues and not reinvesting them in high-need areas or using them to improve access for underserved patients. Instead, those revenues are being used to expand facilities in wealthy suburban areas. That is the perverse incentive the program has created, and it is a significant departure from what the program was designed to do.