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Prescription medicines purchased in the U.S. under a controversial government discount program amounted to $44 billion in 2021, a nearly 16% increase from the previous year, according to the Health Resources & Service Administration, which oversees the program.

The data mark a steady rise in sales under the 340B Drug Discount Program, which requires drugmakers to offer discounts that are typically estimated to be 25% to 50% — but could be higher — on all outpatient drugs to hospitals and clinics that primarily serve lower-income patients. There are roughly 12,400 entities participating in the program, a number that has grown substantially.

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Since it began 30 years ago, the program has ballooned and fed into the national clash over the cost of medicines. Some $38 billion in medicines were purchased under the 340B program in 2020, which was up from $29.9 billion the previous year. In 2016, 340B sales were $16.2 billion.

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