08 Oct The Contract Pharmacy Dilemma: What 340B Covered Entities Need to Know in 2025

The Shifting Landscape

In recent years, the 340B contract pharmacy landscape has been under intense pressure —and in 2025, covered entities are still navigating the fallout. Restrictions from manufacturers, lack of regulatory clarity, and growing scrutiny to justify program savings have left many organizations asking: “Should we scale back contract pharmacies, or fight to preserve them?”

At Ponaman Healthcare Consulting, we’ve helped clients across  the country  make informed, strategic decisions about their contract pharmacy arrangements. Here’s what you need to consider now.

Where Things Stand in 2025

As of mid-2025, more than 20 drug manufacturers continue to impose conditions on 340B pricing through contract pharmacies. HRSA guidance remains non-binding on manufactures, leading to inconsistent enforcement and often case-by-case outcomes. Litigation is ongoing, but many providers have seen long-term erosion in the savings they once counted on. In short: uncertainty continues to define the environment.

Common Mistakes Covered Entities Are Making

Despite best intentions, many covered entities are stumbling in three major areas. First, there’s overreliance on TPAs—some providers are blindly trusting their third-party administrators without conducting regular audits or reconciliations. Second, poor documentation is putting entities at risk. Some organizations may struggle to demonstrate patient eligibility during HRSA audits or manufacturer challenges. And third, many fail to reassess their contract pharmacy strategy altogether. What worked previously may no longer make financial or compliance sense in 2025.

Should You Keep or Cut Contract Pharmacies?

There’s no one-size-fits-all answer. At Ponaman, we help covered entities weigh the financial return on investment, assess compliance risk, and consider the impact on patient access. For some, trimming contract pharmacy relationships makes sense. For others, restructuring agreements rather than retreating is the smarter move.

How Ponaman Can Help

Ponaman’s 340B Contract Pharmacy Services are built around this complexity. We offer in-depth contract pharmacy assessments, financial impact modeling under current restrictions, compliance audits of TPAs, policy updates aligned with HRSA expectations, and support for managing correspondence with manufacturers. We partner with you to build a sustainable, defensible 340B program in a rapidly changing world.

Contract pharmacies are not dead—but the days of “set it and forget it” are long gone. In 2025, intentional strategy and compliance discipline are essential to keeping this part of your 340B program viable.

Ready for a contract pharmacy checkup?Let’s talk. Schedule a consultation here.