Curated News
By: NewsRamp Editorial Staff
September 10, 2025
ADAP Advocacy Urges HRSA to Scrap Flawed 340B Rebate Pilot Program
TLDR
- ADAP Advocacy's proven rebate model offers hospitals a competitive advantage by maximizing 340B program benefits while ensuring compliance with legislative intent.
- ADAPs have successfully operated a retrospective rebate system for 27 years, increasing funding from 5% to 55% of program costs through efficient administrative processes.
- Implementing ADAP's rebate model nationwide would improve healthcare access for vulnerable HIV/AIDS patients by ensuring 340B funds serve as true payor of last resort.
- 340B hospitals receive 87% of program benefits yet provide only 2.15% charity care, while ADAPs demonstrate rebates can fund 55% of patient services effectively.
Impact - Why it Matters
This news matters because the 340B Drug Pricing Program affects healthcare accessibility for vulnerable populations, particularly those living with HIV/AIDS. The program's integrity directly impacts prescription drug affordability and the quality of care for millions of Americans. When hospitals profit excessively from 340B benefits while providing minimal charity care, it undermines the program's original mission of helping low-income and uninsured patients. The proven success of ADAPs' rebate model demonstrates that efficient systems already exist to ensure program funds actually reach patients in need. This debate affects healthcare costs, drug pricing transparency, and ultimately determines whether safety-net programs fulfill their intended purpose of serving as a true payor of last resort for America's most vulnerable populations.
Summary
ADAP Advocacy has issued a pointed written comment urging the Health Resources and Services Administration (HRSA) to abandon its proposed 340B rebate pilot project, calling it deeply flawed and potentially contrary to the Administrative Procedure Act. The advocacy group argues that State AIDS Drug Assistance Programs (ADAPs) have already served as the de facto pilot for this rebate model for 27 years, demonstrating that retrospective rebates work without causing delays or undue administrative burdens. CEO Brandon M. Macsata emphasized that ADAPs' ability to account for how 340B rebates are used is widely considered the 'gold standard' among covered entities.
The organization highlights concerning disparities in how different entities benefit from the 340B program, noting that while ADAPs and smaller covered entities utilize the program to assist the uninsured and underinsured—reflecting its original intent—many 340B hospitals receive 87% of program benefits while providing abysmally low levels of charity care. ADAP Advocacy's 340B map reveals a disturbing pattern of hospitals growing their 340B programs while their charity care commitments erode and executive compensation increases dramatically. The data shows that in 2002, 340B hospitals devoted just 2.15% of their spending to charity care, raising serious questions about program integrity and patient benefit.
The evidence from ADAPs demonstrates the rebate model's effectiveness: 340B drug rebates funded just 5% of ADAP programs in 1997 but grew to 47% by 2022—an increase of over 800%—and are estimated to fund 55% of programs in 2025. This growth has enabled dramatic expansion of drug and non-drug services for HIV/AIDS patients, including direct financial assistance and funding for support services. ADAP Advocacy contends that larger, better-resourced hospitals are in an even better position to operate effectively under this proven rebate model than the pharmacies participating in ADAPs.
Source Statement
This curated news summary relied on content disributed by 24-7 Press Release. Read the original source here, ADAP Advocacy Urges HRSA to Scrap Flawed 340B Rebate Pilot Program
