As the federal 340B Drug Pricing Program continues to face scrutiny and legal challenges, states are increasingly stepping in to define how the program operates within their borders. In 2025, a growing number of state legislatures are introducing or enacting laws aimed at preserving 340B access, particularly in response to manufacturer-imposed restrictions on contract pharmacy arrangements.
This post provides an overview of recent state-level developments, highlights key trends, and offers considerations for covered entities navigating this evolving policy landscape.
As of mid-2025, at least 22 states are considering or have enacted legislation related to the 340B program. These laws primarily focus on:
States such as Mississippi and Missouri have enacted laws that prohibit drug manufacturers from restricting 340B entities' use of contract pharmacies to distribute 340B drugs. Similarly, states like Kansas, Maryland, and West Virginia have passed legislation to protect 340B contract pharmacy access.
These state laws have prompted legal challenges from pharmaceutical manufacturers, arguing that such statutes conflict with federal 340B regulations. For instance, a U.S. District Judge blocked West Virginia's 340B contract pharmacy law, citing conflicts with federal provisions. Conversely, a federal court dismissed pharmaceutical manufacturers' lawsuit against Minnesota's 340B law, giving states more confidence to proceed with similar legislation.
These divergent judicial outcomes underscore the complexity of the legal landscape and the ongoing tension between state initiatives and federal oversight.
States with enacted 340B contract pharmacy access laws have taken legislative action to prevent drug manufacturers from limiting or conditioning access to 340B pricing at contract pharmacies. In these states, laws have been passed that prohibit manufacturers from requiring claims-level data submission (such as through ESP) as a condition for 340B discounts or from restricting the number or type of contract pharmacies a covered entity can use. These protections aim to preserve the original intent of the 340B program — ensuring that covered entities can access discounted drugs through their full pharmacy networks without added barriers. For covered entities operating in these states, this legislation may provide additional leverage when responding to manufacturer-imposed restrictions or negotiating pricing access.
These states have passed laws prohibiting manufacturers from restricting 340B pricing at contract pharmacies:
The following states have introduced or are advancing bills aimed at protecting 340B contract pharmacy arrangements:
***Kansas enacted 340B contract pharmacy access provisions in 2024, but the state attorney general argued in federal court that the law is unenforceable and does not “prohibit or forbid anything.”
Several of these state laws have faced legal challenges from pharmaceutical manufacturers. Notably:
For a comprehensive and up-to-date overview of state-level 340B legislation, including detailed summaries and legal analyses, you can refer to the National Association of Community Health Centers (NACHC) State-Level 340B Laws and Legislation Tracker: nachc.org
If you need assistance interpreting how these state laws may impact your organization's 340B program or require guidance on compliance strategies, feel free to reach out.
