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May 22, 2026Milbank QuarterlyOpen Access

Stretching Scarce Authorizing Legislation as Far as Possible: A Legislative History of the 340B Drug Pricing Program

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Authors

SNSAYEH NIKPAYMRM. L. ReinkeNQNicole Quinones

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Overview

Qualitative analysis clarifies Congress's intentions for the 340B program, indicating scope expansion.

Key Points

  • The aim was to clarify Congress's original intentions for the 340B Drug Pricing Program established in 1992.
  • Qualitative analysis of 175 internal primary source documents.
  • Conducted 19 structured interviews with 18 key informants about the 340B program's creation.
  • Congress aimed to address costs imposed by the Medicaid Drug Rebate Program on safety-net clinics.
  • 340B was intended to exempt clinics from best price provisions and to ensure minimum drug price discounts for core safety-net providers.
  • The program's current scope far exceeds the initial legislative intent established in 1992.

Cite This Study

NIKPAY et al. (2026) studied this question.

synapsesocial.com/papers/6a0ff452d674f7c03778da21https://doi.org/10.1111/1468-0009.70090
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