Who is required to provide medications at reduced rates to 340B-eligible institutions?

• A. Physicians
• B. Insurance companies
• C. Wholesalers
• D. Manufacturers who participate in Medicaid

Answer: (D)

340B pricing is built on a requirement that drug manufacturers who participate in Medicaid sell outpatient medications to eligible covered entities at a discounted price. This means the reduced rates come from the manufacturers themselves, not from physicians, insurers, or wholesalers. Covered entities—such as safety-net clinics and certain hospitals—purchase these drugs directly from the manufacturers at the 340B price (the ceiling price set for 340B transactions). Wholesalers merely distribute the drugs and don’t set or provide the discount, and physicians or insurance companies aren’t the source of the 340B pricing.