A report from Minnesota shows that large hospitals continue to dominate the 340B drug rebate program.[1] Minnesota hospitals and clinics that participate in the program will generate at least $1.34 billion in revenue in 2024.[1] They received $3.045 billion in discounted drugs, but paid $1.53 billion plus $165 million in administrative fees.[1] The largest hospitals received more than $1 billion, accounting for 80% of total revenue.[1] For 2023, Minnesota providers earned at least $630 million in net 340B revenue, the difference between $1.5 billion in payments and $734 million in drug purchases plus fees.[3][4][9] This figure may be underestimated because it includes only part of the expenses.[3] Minnesota is the only state that collects and analyzes such data publicly.[1] The 340B program is controversial in the debate about rising drug prices in the US.[1]