This article is the latest in IQVIA’s series of yearly reports on the size and growth of the 340B drug discount program. In 2022, 340B sales exceeded $100B in WAC dollars for the first time despite contract pharmacy restrictions imposed by manufacturers. 340B year-over-year growth in 2022 was 12.2%, versus 7.7% growth for the U.S. drug market as a whole, driven by the three largest disease areas — diabetes, targeted oncology, and immunology — in which 340B sales grew 20-25%. Looking forward, 340B growth is likely to be influenced by continued developments in contract pharmacy restrictions and related court cases, the impact of the Inflation Reduction Act, recent changes in pricing strategies in the insulin market, and the possibility of expansion of the 340B patient definition.