This white paper estimates that purchases under the U.S. 340B drug pricing program reached $179.5 billion at list prices in 2025, representing 20.3% year-over-year growth. After adjusting for sales missing from the study sample, IQVIA estimates total purchases at approximately $200 billion, close to the size of Medicare Part D. Since 2018, the program has more than tripled and expanded three times faster than the rest of the U.S. drug market, primarily because of increased utilization rather than higher drug prices. Hospitals and clinics account for nearly three quarters of purchases, while oncology, immunology, antivirals, diabetes, and anti-arthritic therapies represent over two thirds of sales. Future growth may be shaped by contract pharmacy mandates, patient eligibility rules, pricing

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