This white paper quantifies the financial burden of the 340B Drug Pricing Program on state employee health plans. Using IQVIA claims and pricing data (pages 3–6), the authors estimate that state plans incur approximately $1.0 billion annually in 340B spread revenue on self-administered drugs alone, with potential exposure up to $1.9 billion under alternative coverage assumptions (page 10). Patients also face out-of-pocket overcharges totaling about $44 million nationally, with a weighted average spread of $139 per patient (pages 6–8). The report highlights significant state-level variation, rising premiums, and policy implications tied to transparency and reimbursement reform.

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