The Net Pricing Revolution in the Drug Channel: What’s Deflating the Gross-to-Net Bubble

As I highlighted last week, we are entering the Net Pricing Drug Channel (NPDC) era—a market environment in which net prices, not list prices, determine access, economics, and competitive strategy. This shift represents a structural change in how value is created and captured across the U.S. drug channel.

The NPDC will:

• Reward simpler pricing models

• Penalize rebate-heavy strategies

• Expose business models built on gross-to-net arbitrage

• Force channel participants to rethink how they add value when money flows more transparently through the system

The short video below, excerpted from my recent Drug Channels Outlook 2026, explains why this shift is accelerating.

It walks through the key forces now deflating the gross-to-net bubble and explains how manufacturers and other channel participants are responding.

Can’t see the video? Click here to watch the NPDC clip.

For a deeper, data-driven look at the trends, market forces, and policy developments shaping the U.S. drug channel in 2026 and beyond, watch the full webinar replay and download the complete slide deck.

UPCOMING 2026 LIVE VIDEO WEBINARS

The Drug Channels 2026 Video Webinar Series

During 2026, DCI will be hosting three live, interactive video webinars focused on the issues that matter most as they’re happening—policy shifts, market trends, and major company moves. Click here to register.

ADDITIONAL BACKGROUND AND ANALYSIS

For more context on the emergence of the Net Pricing Drug Channel and the slowdown in the gross-to-net bubble’s growth, see these Drug Channels articles:

• U.S. Brand-Name Drug Prices Fell in 2025 as the Net Pricing Drug Channel Emerges

• Gross-to-Net Bubble Hits $356B in 2024—But Growth Slows to 10-Year Low

• List Price Reductions Will Deflate the Gross-to-Net Bubble–and Threaten Pharmacy and 340B Profits from IRA-Negotiated Drugs