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Hospital official warns 340B rebate pilot could sharply raise drug costs
Summary
Hospital representative told commissioners a federal rebate pilot could make 340B medications cost up to 800–1,000% more at wholesale acquisition cost, threatening services at critical-access hospitals that spent about $1.3 million on affected drugs this year.
A county hospital representative told Graham County commissioners that a federal 340B rebate pilot could sharply increase medication costs for critical-access hospitals and complicate local patient care.
"We spent about $1,300,000 just on 340B medications this year alone," the hospital representative (Speaker 3) said, and described the pilot as potentially forcing hospitals to buy drugs at wholesale acquisition cost and then pursue rebates from manufacturers, which would increase administrative burden and could multiply acquisition costs 800% to 1,000%.
The speaker also described an on-site safety issue: the county is evaluating whether to build a firewall around an oxygen/air gas tank or to relocate a generator and tank because of state fire marshal concerns. "It's turning into a little bit more of a headache," the speaker said.
Commissioners acknowledged the financial and logistical strain; no formal county action was recorded. Officials said the hospital will present options from its architecture group by the end of the week and that the county would work with staff to manage interim patient needs and equipment placement.
Next steps: hospital and county staff will evaluate architectural options for fire mitigation or equipment relocation and continue monitoring developments around the 340B pilot through 2026.
