ANALYSIS: Tussle Over Drug Discounts to Tip Pharma’s Way in 2026

After years of setbacks in state legislatures and federal courts, drugmakers opposing growth in the 340B Drug Pricing Program have found new openings that will likely begin to arrest the program’s expansion. Recent federal district court rulings and a new Trump administration initiative could force hospitals and clinics that rely on drug discount revenue to accept more financial and operational risks.

Enacted by Congress in 1992 and administered by HHS’s Health Resources and Services Administration (HRSA), the 340B program requires drugmakers to offer deep discounts on drugs to covered entities, which include hospitals and clinics that serve a disproportionate share ...