Impact: Immediate Savings to Requesting Rebates

WATKINSVILLE, GA / ACCESS Newswire / October 28, 2025 / Rural hospitals in the 340B program are about to feel a new financial pressure. On January 1, 2026, HRSA's 340B Rebate Model Pilot Program will kick off, eliminating upfront discounts on 10 popular medications.

"With this change, pharmacies of covered entities will need to buy these medications at full price, then submit transactions data to receive rebates from manufacturers within 45 days of purchase," states Matthew Wright, 340B Account Manager, PharmD On Demand. "For eligible hospitals and Community Health Centers with limited reserves that are unprepared, the disruption could quickly escalate from a siloed pharmacy adjustment to an enterprise-wide cash flow concern."

Additionally, Wright notes covered entities should also be aware there could be delays or variability in receiving rebates. Although manufacturers are required to release rebates within 10 days, details are not yet available on how they will be distributed - by mail, credit to wholesaler account, NCPDP profile, or other methods. This uncertainty adds a layer of operational complexity in tracking and reconciling these payments.

Know the Drugs on the List

To stay ahead of the change, what you can do immediately is ensure pharmacy staff are familiar with which 10 drugs will be included. They are:

1. Eliquis

2. Enbrel

3. Entresto

4. Farxiga

5. Imbruvica

6. Januvia

7. Jardiance

8. Novolog

9. Stelara

10. Xarelto

Next Step: See What Needs to Be Modified

To receive rebates, pharmacies will be required to submit specific, readily available data to the manufacturer within 45 days of the date of service. [That mandatory data includes: Date of Service; Date Prescribed; RX Number; Fill Number; 11-Digit NDC; Quantity Dispensed; Prescriber ID; Service Provider ID; 340B ID; BIN and PCN.]

If a pharmacy habitually waits the full 45 days before submitting, the disruption in cash flow could be significant. That said, there is one upside pharmacies can leverage: there is no requirement that states how soon a covered entity can request a rebate.

So, PharmD On Demand encourages covered entities to look closely at pharmacy operations to see where efficiencies might be built in. Do you need to establish new internal processes or channels for data transfer? What could you do to shorten the number of days from when drugs are purchased to rebate data is submitted?

Get Help If You Need It

Preparing for, then navigating this change once it is implemented, will take time and requires specialized expertise and proactive support. If your covered entity needs assistance, PharmD On Demand can assist in managing these complexities, ensuring continued compliance, mitigating potential cash flow challenges, and continuing to leverage the 340B program to benefit your patients and community.

Contact our dedicated 340B Team directly at 340Bhelp@pharmdondemand.com to discuss how we can support your hospital and pharmacy team through this critical change.

Please Note: The 340B Rebate Model Pilot Program is running parallel to the rollout of the Medicare Drug Price Negotiation Program (MDPNP). Both programs involve the same 10 drugs and share the same effective date of January 1, 2026. However, these programs are unrelated and are overseen by different governing bodies.

CONTACT:

info@pharmdondemand.com
706-389-9500

SOURCE: PharmD On Demand