Isoniazid Tablet Price Increase in Kansas 340B Program
Summary
The Kansas Department of Health and Environment (KDHE) has announced a 252% price increase for isoniazid (INH) tablets within its 340B program. This notice advises healthcare providers to prioritize alternative TB treatments for latent infections to preserve INH stock for active TB cases.
What changed
The Kansas Department of Health and Environment (KDHE) has issued a health alert regarding a significant 252% price increase for isoniazid (INH) tablets, a critical medication for tuberculosis (TB) treatment, within its 340B program. This price surge affects multiple INH product sizes and necessitates a change in prescribing practices to ensure availability for patients with active drug-susceptible TB disease.
Healthcare providers are instructed to follow CDC treatment guidelines, prioritize rifampin regimens for latent TB infection (LTBI) where clinically appropriate, and consult with KDHE before ordering INH-based regimens for LTBI. This action aims to manage the limited supply of INH due to the increased cost and ensure it is reserved for patients with active TB disease, potentially impacting treatment protocols for LTBI.
What to do next
- Prioritize rifampin regimens for Latent TB Infection (LTBI) where clinically appropriate.
- Consult with KDHE TB Controller prior to ordering INH-based regimens for LTBI.
- Continue to follow CDC treatment recommendations for drug-susceptible TB disease.
Source document (simplified)
Isoniazid Pricing and Availability
Kansas Health Alert Network (KS-HAN) Posted on March 17, 2026
The Kansas Department of Health and Environment’s (KDHE) 340B program is experiencing a 252% increase in pricing for 300mg/100 count bottles of isoniazid (INH) tablets, which are used to treat Tuberculosis (TB) or prevent its return (reactivation), and similar increases for 300mg/30 count and 100mg/100 count bottles of INH. Due to this increase in 340B pricing, it is essential that KDHE preserve available INH stock for patients with drug susceptible TB disease. We ask that alternative therapies be considered for Latent TB Infection (LTBI) wherever clinically appropriate.
Providers and clinics that diagnose or treat TB are advised to:
- Continue to follow the Centers for Disease Control and Prevention’s (CDC) treatment recommendations for drug susceptible TB disease. CDC Treatment for Drug-Susceptible Tuberculosis Disease
- Prioritize using rifampin regimen (4R) in the treatment of LTBI for HIV-negative adults and children of all ages if there are no contraindications (e.g., drug-drug interactions).
- Rifampin regimen (4R) should not be used with HIV-infected individuals being treated with certain antiretroviral (ART) therapies (e.g., protease inhibitors, non-nucleoside reverse transcriptase inhibitors (NNRTIs), integrase strand transfer inhibitors, or the CCR5 antagonist maraviroc). Please refer to, Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV .
Prioritize the use of INH based LTBI regimens in select patient situations (e.g., due to drug interactions with rifamycins). If 340B entities need to order an INH based regimen, please contact Lisa Edgerton-Johnston, KDHE TB Controller, for consultation and approval prior to ordering.
ResourcesCDC Core Curriculum on Tuberculosis: What the Clinician Should Know (2021)
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