The Health Resources and Services Administration has approved manufacturer 340B Rebate Model Pilot Program plans, which will begin on Jan. 1, 2026. NCPA submitted comments on the proposed rebate model back in September. In our comments, we called for timely reimbursement to pharmacies and stipulated that no additional administrative costs of running the rebate model be imposed on pharmacies.
The rebate pertains to the transaction between the manufacturer and the covered entity (CE). The pilot program will apply to the NDC–11s of the first 10 drugs in the Medicare Drug Price Negotiation Program, regardless of payer. The pilot program will last for a minimum of one year.
Basically, the rebate would be a reimbursement made from the manufacturer to the CE in the amount of the acquisition cost less the 340B ceiling price. The 340B covered entities would have to purchase these drugs at the going rate and wait for the rebate from the manufacturer.
HRSA has approved the plans for the following drugs: Eliquis (Bristol Myers Squibb); Enbrel (Immunex Corporation); Farxiga (Astra Zeneca); Imbruvica (Pharmacyclics); Januvia (Merck Sharp Dohme); Jardiance (Boehinger Ingelheim); Novolog/Novolog Flexpen/Novolog Penfill/Fiasp/Fiasp Flextouch/Fiasp Penfill (Novo Nordisk Inc.); Stelara (Janseen Biotech, Inc.); and Xarelto (Janssen Pharmaceuticals).
For more details, click here. We will keep members updated on developments.
