For several years, some of the world’s largest pharmaceutical companies that participate in a U.S. drug discount program overcharged the federal government and numerous hospitals by hundreds of millions of dollars, according to claims made in a recently unsealed lawsuit.
The allegations, which were made by Adventist Health System, turn on the complicated, behind-the-scenes calculations used to provide medicines to what is known as the 340B program. The federal government program requires drugmakers to offer discounts on all outpatient drugs used by hospitals and clinics that primarily serve lower-income patients.
There are roughly 12,400 hospitals and clinics that participate across the U.S. and their number has grown over the years. As a result, the program has become a big market for pharmaceutical companies, which must agree to sell their medicines at discounts — typically at 25% to 50% — if they want their medicines covered and reimbursed by Medicaid and Medicare Part B outpatient insurance.
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