The U.S. Court of Appeals for the D.C. Circuit on Tuesday backed manufacturers’ policies that limit the distribution of lower-priced drugs under the federal government’s “340B” drug discount program, joining the only other federal appeals court to rule on the dispute so far.

Under Section 340 of the Public Health Service Act, manufacturers that want to participate in Medicare or Medicaid must offer their drugs at a lower price to certain health care providers, called “covered entities,” that primarily serve low-income, uninsured individuals.