Trump administration revises 340B rebate pilot, sparking hospital backlash

The Health Resources and Services Administration announced a revision to the 340B drug pricing program’s rebate pilot, slated to begin on Jan 1, 2027.

Under the new rules, participating manufacturers can provide “timely” rebates instead of the traditional upfront discounts, a move intended to increase transparency of 340B transactions.

The change focuses on drugs and companies involved in the first two rounds of the Medicare Drug Price Negotiation Program, but hospital groups have voiced anger, fearing it could erode discount benefits.

Officials argue the revision modernizes oversight and helps preserve the program’s long‑term sustainability for patients and communities.