On May 11, 2018, President Trump and HHS Secretary Alex Azar introduced their “American Patients First” initiative, described as a blueprint to lower drug prices and reduce out-of-pocket costs for patients. The plan also included a request for information (RFI) seeking input from stakeholders. One area of focus for stakeholder feedback included ways to shift the 340B program back to its “intended purpose” by imposing changes to patient definition, contract pharmacies, and eligibility for child sites.