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Let me start by saying that I have been to the 340B Coalition conferences since 2012, and every year entities have feared significant changes and the threat of problematic legislation becoming law. Fortunately, this has not happened, except for the year 2020 when the drug manufacturer restrictions started. As a former 340B program manager at a 340B covered entity, I know firsthand that 340B is an integral part of our healthcare system, and is the reason millions of patients can afford vital healthcare services and prescriptions.
Capturing the mood and energy of covered entities at last week’s 340B Coalition Conference in San Diego is no easy task, but I’ll do my best. One thing is for sure: one of the consistent topics of conversation at every conference is how the 340B program is supposedly ending or being cut. Thankfully, despite painful restrictions that are certainly undermining access to care, the program is resilient and continues to have strong support at the state and federal level.
If you’ve attended my monthly webinars, listened to my podcast, or caught me speaking at conferences, you know that I always lean toward optimism. I believe it’s a far better way to move through life than constantly anticipating what could go wrong—though being prepared for change is just as important. Pessimism only distracts from your goals and what you need to accomplish.
To get a sense of the overall mood at the conference, I made a point to ask as many attendees as possible one simple question: “How are you feeling as you go through the conference?” And I heard exactly what I expected.
One gentleman put it bluntly: “A little depressed. There’s so much unknown, especially with this rebate model situation.” The possibility of shifting 340B from an upfront discount program to a rebate model was a top concern for many people I spoke to, adding to the uncertainty already weighing on them.
Another attendee shared their frustration: “I feel like no one is doing anything. Why is no one helping us? Our system lost $50 million in savings last year because of manufacturer restrictions.”
One attendee told me their health system nearly didn’t allow them to come to the conference at all due to financial strain from these restrictions. And they weren’t the only one. That’s exactly why now, more than ever, 340B professionals need to show up, stay informed, and prepare for what’s ahead. Attending conferences and keeping up with resources like 340B Report is critical to ensuring covered entities can navigate the challenges ahead. It’s very important to me, which is why I host my monthly 340B webinars and podcast.
One of the speakers at the conference made an interesting point: “We may not see 340B legislation enacted this year because this administration is focused on cost-cutting, and 340B isn’t a target for that.”
I also heard concerns that the SUSTAIN 340B Act—a bipartisan bill that, while not perfect, offers some long-term positives—may have lost some momentum. This is due in part to new leadership of the Senate committee overseeing the 340B program.
Later, during Lessons From The Field, I gave a 20-minute presentation on the possibility of 340B rebate models becoming a reality this year and what that could mean for providers. While I am hopeful this won’t happen—and that the new administration will align with HRSA’s long-standing opposition to such a fundamental change to how the 340B program works—you need to be prepared.
I won’t bore you with the full details here, but if you’re interested in my take, I encourage you to check out this webinar.
The morning remarks on Wednesday, however, painted a different, more positive picture. As I was listening to the predictions that pro-340B legislation will continue to move forward, I couldn’t help but return to hope: What if things turn out differently? What if this is the year where the value and importance of the 340B program is highlighted, and legislation passes that supports covered entities overwhelmingly?
Just look at the progress happening at the state level—particularly in red states—where legislators are standing firm against misleading and unfair attacks to restore access to 340B pricing in the contract pharmacy setting.
Despite the worries around manufacturer restrictions and rebate models, I choose to be hopeful about three key areas — and I encourage you to do the same:
1. Impressive Progress in State Legislation – Contract pharmacy access bills continue to pass legislative chambers across the nation. Already in 2025, 23 states have introduced access bills in 2025, and eight passed legislation in previous sessions. With the possibility of several more state laws being enacted early this year, this momentum is something for providers and patients to be excited about.
2. Strong Opposition to Rebates – Despite the looming threat of 340B rebate models, legal battles over contract pharmacy access have largely favored covered entities, pushing back against manufacturer-imposed “hoops” that make 340B savings harder to access. In addition, a group of close to 200 bipartisan House members have expressed strong opposition to these rebate efforts.
3. Strength in Numbers – Despite the loss of savings from drug manufacturer restrictions and ongoing uncertainty about the future, the presence of 1,600+ attendees at this winter’s conference shows that the 340B community is engaged, resilient, and ready to fight for the program’s future. While many questions remain, our focus remains clear—doing our best to offer 340B TPA services that benefit the patients and the communities we serve.
In the end, it was another valuable and informational conference connecting 340B covered entities and creating great networking opportunities. I’m already looking forward to the next one!
Anthony Velasquez is Chief Product Officer at PharmaForce. He can be reached at avelasquez@thepharmaforce.com.
