💉 HRSA pilots 340B rebate model with 9 major drugs

The US Health Resources and Services Administration (HRSA) has approved nine top-selling drugsincluding oncology and chronic disease agentsto test a new 340B rebate model, following legal pressure from pharma giants.

Why It Matters To Oncology

▪ The pilot includes Imbruvica (ibrutinib), a key blood cancer therapy, spotlighting how 340B reform could impact access and drug pricing for oncologic agents.

▪ Many pilot drugs are blockbusters, with oncology and immunology relevance, raising questions about future reimbursement, market access, and drug development incentives.

The Financials

▪ Pilot drugs like Imbruvica, Stelara, and Eliquis drive billions in annual sales; Eliquis alone reported $3.7B in revenue in recent quarters.

▪ The rebate model shifts provider discounts from upfront to post-sale rebates, potentially changing cash flow for hospitals and manufacturers.

▪ All nine drugs are also subject to upcoming Medicare price negotiations starting January 2026.

What They're Saying

▪ Pharma companies (J&J, Eli Lilly, BMS) argue the 340B program is exploited by large health systems; they pushed for rebates to promote "fairness" and transparency.

▪ HRSA says the pilot will take a "methodical and thoughtful approach" to test a transparent rebate process.

What's Next

▪ The HRSA rebate pilot launches January 1, 2026, with nine drugs, including oncology-relevant agents.

▪ Outcomes could influence long-term 340B reform, reimbursement models, and potentially impact future oncology drug discovery and market strategies.