SUSTAIN 340B Act

Key Points

• This bill updates the federal 340B program, which requires drug companies to give discounts to hospitals and clinics that serve low-income patients. It clarifies that manufacturers must provide these discounts even when a patient picks up medicine at a contract pharmacy instead of the hospital.
• Hospitals can keep using outside pharmacies but must follow stricter rules. They have to register each contract pharmacy arrangement with the government and cancel contracts with pharmacies that have not dispensed any covered drugs in the past 12 months.
• Hospitals must be more open about how they use their savings. They must report how many patients they helped, what insurance those patients had, and how the savings were used, and the government will publish this data.
• The bill stops insurers and pharmacy benefit managers from paying covered entities and pharmacies less just because they use 340B drugs, with penalties up to $5,000 per violation per day.
• A new independent national data clearinghouse will track drug sales to prevent duplicate discounts. Starting in fiscal year 2031, participating hospitals and clinics will pay user fees totaling $50 million a year to fund program oversight.
• The bill sets a clearer legal definition of who counts as a patient, including a two-year lookback and rules for referral prescriptions, and excludes drugs that are only infused or administered by a clinician from many contract pharmacy arrangements.