At the 340B Winter Conference 2026, PharmaForce Chief Product Officer Anthony Velasquez took the stage to talk about something every 340B program manager knows but rarely gets to say out loud: the job has gotten exponentially harder, and the tools haven't kept up.
He opened with a story. Years ago, managing a 340B program with three EMRs, three TPAs, and a psych clinic still on paper charts, he fell asleep at his desk doing audits — two months behind and dreading every second of it. If you've managed a 340B program, that probably sounds familiar.
But here's the thing: that was 2019. And compared to today, 2019 was manageable.
The 340B Role Has Fundamentally Changed
The title on the badge may be the same, but today's 340B Program Management workload is unrecognizable.
340B program managers are navigating manufacturer restrictions that have increased by four-to-six times. TPAs are handling five-to-eight times more decision logic per claim. Reporting obligations have multiplied across HRSA, manufacturers, and state-level requirements.
This additional operational burden amounts to an additional 20-to-30 hours per week to defend and capture 340B pricing on eligible prescriptions. It's taking twice the staff to manage the same number of pharmacies.
In 2019, manufacturer-imposed access conditions, rebate models, and expanded reporting requirements simply didn't exist. In 2026, these additional hurdles to 340B savings define the daily reality for covered entities everywhere.
340B Teams Are Asking for AI
Enter AI, which promises to ease the burden and manpower required to complete rote tasks. And it's not just tech vendors like PharmaForce who are developing AI to ease burden on pharmacy directors. Entities are starting to ask for it.
RFPs from large health systems are asking about AI capabilities as applied to audits, program reporting, and financial modeling.
Resource-strapped entities are looking to advanced technology not as a casual solution, but as a necessity.
AI Applied to 340B In Practice
During his presentation, Anthony walked through two use cases that resonated with the audience.
First: Day-to-day program monitoring. Program monitoring is one of the most time-intensive parts of 340B management. Program managers typically spend five-to-ten hours per week reviewing and troubleshooting interfaces and configurations. With AI-enabled tools, that same comprehensive "health check" — savings summary, top-performing locations, areas of concern, and recommendations — can be generated in roughly 60 seconds.
Second: Financial impact. When leadership asks for the savings impact of blocking all rebate manufacturers from a 340B program, that analysis can take hours to assemble manually. With AI, the same output is delivered in about a minute.
Hours become seconds. These use cases aren't hypothetical — these are capabilities that exist today.
AI Doesn't Replace Human 340B Expertise
When discussing AI, it's important to discuss responsible use, and to delineate between what AI is, and what it isn't. AI is not a replacement for people. It's not going to eliminate audit oversight. And it's not interpreting compliance rules without human review.
What AI does is act as a force multiplier. AI-supported systems manage rule volume, reporting, and exceptions at scale. Manual work gets reduced where tasks and rules are repeatable, and human oversight refocuses on the decisions that actually require strategy and expertise — not data wrangling.
The broader healthcare industry is already proving this model works across scheduling, clinical documentation, triage, and pattern detection. The 340B space is on the same trajectory.
The Bottom Line
Anthony asked the audience to think about the most time-intensive, dreaded 340B program management task.
In a mature program, that work isn't manual anymore. It's AI-supported.
Embracing AI in 340B isn't about replacing teams. It's about empowering pharmacy teams with tools capable of reducing today's operational complexity to 2019 levels.