340B Contract Pharmacy Growth by Pharmacy Ownership: 2009-2022

The 340B program grants eligible healthcare providers (“covered entities”) access to discounted prices for outpatient prescription drugs. Covered entities frequently rely on retail pharmacies (“contract pharmacies”) to dispense discounted drugs. This analysis describes contract pharmacy participation by ownership: the top four chains, grocery chains, small chains, and institutional independent pharmacies. We find that 71% of pharmacies in the top 4 chains were contract pharmacies, 41% of institutional pharmacies, 38% of grocery store pharmacies, and 22% of independent pharmacies participated in 340B in 2022. The median number of contracts per pharmacy was 2 among the top four chains and grocery store pharmacies, versus 1 for all other pharmacy types. The median farthest distance in miles from contracting covered entities was largest for the top-four chains (19 miles) and small chains (18 miles) and smallest for independent and institutional pharmacies (10 miles). The top four chains held the highest proportion of contracts with core safety-net providers (75%, compared to 61% of institutional pharmacies).