Hospital receive an average of 2.5 times what they pay for drugs in reimbursement from commercial payers, a white paper released by the trade group reports. And consolidation has increased the leverage hospitals wield in payment negotiations.

The US government program that allows safety net providers to purchase drugs at deep discounts is probably not what most American voters have in mind when they say drug pricing is a top issue. But the 340B program has been a rare area of consistent focus – and actual sustained change – in the Trump Administration.

Stakeholders differ on whether the rapid growth in spending is to be expected, given the realities in health care and specialty drug costs, or that the data underscores the need for oversight and reform of the 340B program.