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340B drug sales grew at a slower rate in 2021, the first year of 340B contract pharmacy restrictions, IQVIA reports.

340B Sales Growth Rate Slowed in 2021, the First Year of 340B Contract Pharmacy Restrictions

Prescription drug sales at 340B-discounted prices grew 15.9% year-on-year from 2020 to 2021, drug industry consulting and contract research firm IQVIA reports, an annual growth rate below that for the two preceding years.

Last year, IQVIA reported that 340B sales grew 18.1% in 2020. The year before, it reported that 340B sales grew 17.1% in 2019.

340B sales of diabetes products fell 7.4% in 2021, IQVIA said in an April 5 blog post. It pointed out that insulin and diabetes drug manufacturers were among the first to impose conditions on 340B pricing when covered entities use contract pharmacies. IQVIA reported that 340B sales of targeted oncology, immunology, anti-arthritic, and hemostatic drugs all grew by more than 20% last year.

340B sales through retail pharmacies “were essentially flat in 2021,” IQVIA said, reflecting the impact of contract pharmacy restrictions. 340B retail sales grew 22% in 2020. 340B mail-order sales grew 34% in 2021, down from 56% in 2020, it said.

For the nine drug manufacturers with 340B contract pharmacy restrictions in place in 2021, 340B retail sales fell 32% and 340B mail-order sales fell 20%, IQVIA found. For all other manufacturers, 340B retail sales grew 16% and 340B mail sales grew 44% in 2021, it reported.

In this and preceding years’ analyses, IQVIA reported 340B sales not in real dollars, but instead “dollarized using WAC [wholesale acquisition cost] pricing.”

Using this methodology, it said, “In 2021, 340B program sales reached $93.6 billion,” up from $81 billion in 2020.

Last month, the U.S. Health Resources and Services Administration reported, “In 2020, total sales in the 340B program were approximately $38 billion.”

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