01/21/2026
Cancer treatments account for 41% of all 340B drug purchases. Keytruda alone generated $6.9 billion in 340B sales in 2023.
The financial impact is extraordinary:
• 340B margin for cancer therapies = 45% of total reimbursement
• Non-340B providers earn just 4% margin on the same drugs
• "Penny pricing" can create margins approaching 100% on established chemotherapies
But this opportunity comes with extreme complexity:
• Weight-based dosing requiring precise unit conversions
• Combination therapy protocols with multiple billing codes
• Novel immunotherapies with evolving coverage policies
• State-specific modifier requirements varying by Medicaid program
The convergence of high financial value and operational complexity makes specialized oncology billing expertise not just valuable—but essential.