The bipartisan group of six U.S. House members that got 217 total representatives last fall—173 Democrats and 44 Republicans—to sign a letter opposing efforts to replace up-front 340B drug discounts with back-end rebates began circulating a new 340B sign-on letter in the House this morning.
A draft of the group’s new letter is addressed to U.S. Health and Human Services Secretary-designate Xavier Becerra and copied to Acting Secretary Norris Cochran. It asks Becerra, upon confirmation, to
- Begin assessing civil monetary penalties on manufacturers that deny 340B pricing to covered entities in violation of their obligations under the 340B statute
- Require manufacturers to refund covered entities the discounts they have “unlawfully withheld since 2020”
- Halt, through guidance or other means, any attempt to unilaterally change 340B upfront discounts to post-sale rebates
- Immediately seat the new 340B administrative dispute resolution (ADR) panel to begin processing disputes within the program.
Reps. Abigail D. Spanberger (D-Va.), Cindy Axne (D-Iowa), David McKinley (R-W.Va.), Dusty Johnson (R-S.D.), John Katko (R-N.Y.), and Doris Matsui (D-Calif.) are the new letter’s driving force. They are the same representatives who spearheaded the November 2020 letter to then-HHS Secretary Alex Azar asking him to clarify that manufacturers may not implement a 340B rebate model without approval from the U.S. Health Resources and Services Administration (HRSA) nor without first soliciting feedback and publishing guidance through the notice-and-comment process.
The lawmakers have asked their colleagues to sign on to the letter by Feb. 11. The letter is endorsed by Ryan White Clinics for 340B Access, the National Association of Community Health Centers, the American Hospital Association, and 340B Health.