by Lidia Rodriguez-Hupp, Chief Customer Officer
July 1, 2026
Once again, Eli Lilly has made history in the 340B program — for the wrong reasons.
The Indianapolis-based drugmaker has begun excluding hospitals from accessing 340B pricing after they refused to comply with its demands to submit sensitive claims data, including from in-house pharmacies. Hospital groups denounced the move and called on Congress or HRSA itself to take action to stop the company’s unilateral actions.
The group 340B Health is asking members to contact their U.S. representatives in support of a bipartisan letter, led by Reps. Doris Matsui (D-Calif.) and Jack Bergman (R-Mich.), urging the Trump administration to take enforcement action against Lilly and restore 340B pricing.
I’ve spoken with a few customers who’ve been cut off from 340B pricing because they did not cede to Lilly’s demands to fork over detailed patient data. Everyone expects there will be a lawsuit against the company, though it’s not clear from whom. Frankly, I’m surprised it hasn’t happened already. Maybe if the members of Congress or the Trump administration understood that their own personal health data could be divulged to pharmaceutical manufacturers, we would see them step in and stop this lunacy.
Lilly has firmly established a pattern of brazenness in its 340B dealings. It was the first manufacturer, in 2020, to announce contract pharmacy restrictions and claims data submission requirements. It was also the first to expand its demands for data to medical claims and in-house pharmacies, not just contracted retail locations.
On June 1, Lilly notified HRSA that it was giving what it described as a “minority of entities—led by the country’s largest and best-resourced hospitals and organized through their trade associations” five business days to comply or lose access to 340B prices on its drugs.
Hall Render, a law firm that represents 340B covered entities, has a devastating letter in which it demolishes each of Lilly’s contentions in turn and concludes that, “An OIG investigation into Lilly would be justified both legally and financially.” I urge you to read it and share with your networks.
Meanwhile, just as Lilly set off a domino effect with contract pharmacy restrictions — today there are 43 drugmakers with similar policies — there are already 12 manufacturers now requiring data from in-house pharmacies. Three more made announcements in June: Boehringer Ingelheim, GSK and Sobi. The expectation is that many of them will take their cue from Lilly and start threatening to cut off 340B pricing to non-complying entities.
340B Rebates Move Forward
More signs that HRSA is full steam ahead on its plans to institute a 340B rebate pilot starting in 2027.
It issued another request for information regarding the data-collection burdens for its proposed pilot, giving stakeholders 30 days, or through July 15, to respond. It also posted information regarding the related data requirements, rules for how manufacturers can deny rebates, and outlining its rationale for its estimate that rebates will require covered entities only five hours per week for compliance.
I’m planning to submit comments on behalf of The Craneware Group that will focus not on the actual workflow burden itself — we’re not a covered entity, after all — but on the difficulty of accessing the data HRSA and manufacturers say they will want.
One interesting side note: Panelists on a 340B Health webinar predicted that many of the states that have passed contract pharmacy access laws may amend those laws to prohibit rebates.
Lastly, lame duck Sen. Bill Cassidy (R-La.) released an 88-page draft bill to make sweeping restrictions to 340B. It’s a dubious move from a lawmaker who lost his GOP primary in May, and his proposal will go nowhere in Congress.
340B in the States and Courts
- A new law signed by Vermont Gov. Phil Scott makes changes to the 340B statute the state enacted just last year. It repeals the law’s outright prohibition on rebates but bars manufacturers from requiring the submission of claims data from in-house pharmacies, adding to an existing ban on data from contract pharmacies.
- Illinois lawmakers sent legislation prohibiting contract pharmacy restrictions and requiring reporting to J.B. Pritzker, who has 60 days to sign it.
- Virginia Abigail Spanberger signed spending legislation that contained a controversial amendment requiring quarterly reporting on 340B dispenses in the Medicaid program.
- Legislation to prohibit contract pharmacy restrictions and differential reimbursement from PBMs in New York died in the state Assembly, despite passing the state Senate, as time expired on the legislative session.
- The Department of Health and Human Services is asking a federal court to dismiss AbbVie’s lawsuit challenging HRSA’s definition of a 340B patient. “This case presents an attempt by a highly profitable pharmaceutical company to upend the long-settled operation of the statutory 340B program that provides discounted medication to healthcare providers and their patients,” the motion reads. 340B Health and two health systems also asked to join HRSA as defendants.
- Speaking of AbbVie, a federal judge rejected its bid to block Mississippi’s contract pharmacy access law.
- A federal judge also allowed Washington’s contract pharmacy and reporting law to take effect starting June 11, rejecting a challenge from the drug industry while the full lawsuit continues. Washington’s law requires 340B reporting from both providers and manufacturers.
Finally, CMS published instructions for its first-ever federal 340B data depository, a voluntary reporting system the agency will use starting this fall to calculate Medicare rebates when manufacturers raise prices faster than the rate of inflation.
Your voices make a difference. Don’t forget to tell HRSA what you think of their five-hours-a-week administrative burden by July 15, and contact your U.S. representative and urge them to support the Matsui-Bergman letter opposing Lilly’s outlandish moves.
If you’d like to continue this conversation, please contact me at [email protected].