In 2024, 340B program purchases reached $147.8B at list price, growing 16.7% year-over-year and 174.6% since 2018, compared to 53.3% for non-340B drugs. Growth was fueled by state laws mandating contract pharmacy use; by year-end, eight states had passed such bills, driving 46% retail and mail channel growth in just nine months. Top therapeutic areas—targeted oncology, antivirals, immunologics, diabetes, and anti-arthritics—accounted for 66.5% of purchases. While expansion improves access, it displaces manufacturer rebates, raising costs for employers and states. Future growth faces uncertainty from policy shifts, Medicaid cuts, and rebate model adoption.

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