This white paper evaluates whether a rebate-based 340B purchasing model would create a significant financial burden for participating providers. Using January 2026 list prices for ten drugs subject to Maximum Fair Price rules, the authors modeled cash flow and borrowing costs for disproportionate share hospitals, other hospitals, and federal grantees. Estimated annual interest costs ranged from $590 for federal grantees to $23,649 for DSH hospitals, representing less than 1% of combined list-price purchases. The analysis also considers wholesaler payment terms and recent list-price reductions, which may further limit costs. The findings challenge claims that rebates would impose crushing financial pressure and conclude that associated interest expenses are generally marginal.

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