AHA accuses drugmakers of 340B ‘conspiracy,’ urges federal probe

Modern Healthcare – Monday, September 8, 2025
By Bridget Early

The American Hospital Association alleges that major pharmaceutical companies colluded to devise a plan to replace 340B Drug Pricing Program discounts with rebates.

In a letter sent to the Justice Department and the Federal Trade Commission on Monday, AHA General Counsel and Secretary Chad Golder urges federal authorities to investigate “recent concerted conduct” by Johnson & Johnson, Eli Lilly, Bristol Myers Squibb, Sanofi and Novartis.

“If successful, this potential antitrust conspiracy will devastate the 340B hospitals that serve America’s rural and other underserved populations,” Golder wrote.

Eli Lilly, Bristol Myers Squibb, Sanofi and Novartis did not respond to requests for comment. Johnson & Johnson deferred to the Pharmaceutical Research and Manufacturers of America, which did not respond to a request for comment.

The AHA’s plea to law enforcement agencies is the hospital sector’s latest attempt to undermine or prevent the implementation of a 340B rebates pilot program the Health Resources and Services Administration announced in July. The plan provoked strong opposition from safety-net providers that participate in 340B, which offers discounts of up to 50%.

Last year, the pharmaceutical companies named in the AHA letter attempted to substitute upfront discounts with post-sale rebates, a move HRSA quickly halted. The U.S. District Court for the District of Columbia affirmed the agency’s power to block the drugmakers — and its authority to allow them to proceed with federal permission.

The AHA letter lays out a timeline from July 2024 to January 2025 of each pharmaceutical company’s efforts to supplant discounts with rebates and suggests they worked together, in violation of antitrust laws.

“The announcement of these rebate models came like a bolt from the blue, shocking hospitals and health systems across the nation. There was no prior concerted lobbying effort on the part of drug companies prior to their announcement. There was no indication whatsoever. The world’s largest drug companies simply stated — within days and weeks of each other — that this was now how it would be done, take it or leave it,” Golder wrote.

The pharmaceutical industry and safety-net providers have been at odds over 340B for years, especially as the program has grown to include many more providers, resulting in lost revenue for drug companies.

Drugmakers contend that a rebate system would ensure that 340B savings go only to the providers and patients for whom the program is intended.

But the notion of exchanging upfront discounts for rebates after the fact rattles hospitals and other providers, who view the pilot set to launch in January as a threat to the safety net.

Access the article at its original source.