Pembrolizumab (Keytruda) dose

Hospital buy vs billed (illustrative WAC/GPO/340B blend) Specialty distributor; 340B eligible orgs deep discount · Acquisition ≈ ASP; margin thin outside 340B

What the hospital pays (acquisition)$11,500

Cash$14,500

Medicaid$10,500

Medicare$12,200

Insured$16,800

Medicaid

$10,500

Medicare

$12,200

Cash

$14,500

Insured

$16,800

Insured path is $2,300 (16%) above cash. Hospital buy $11,500 vs insured $16,800.

Payers: modeled — see evidence.