Drug Channels delivers timely analysis and provocative opinions from Adam J. Fein, Ph.D., the country's foremost expert on pharmaceutical economics and the drug distribution system. Drug Channels reaches an engaged, loyal and growing audience of more than 100,000 subscribers and followers. Learn more...
Today’s guest post comes from Deepak Thomas, Founder and CEO of PHIL.
Deepak explores how demographic shifts and digital expectations are reshaping patient engagement. He argues that to stay competitive, pharmaceutical manufacturers must adopt integrated direct-to-patient (DTP) platforms that streamline access, support insurance coverage, and deliver sustainable commercial impact.
The 340B Drug Pricing Program has emerged as a growing source of profits for pharmacies and pharmacy benefit managers (PBMs).
Drug Channels Institute’s latest exclusive analysis of the 2025 market reveals a highly concentrated market structure increasingly dominated by a handful of major players:
About 32,000 pharmacy locations—nearly 60% of the entire U.S. pharmacy industry—function as contract pharmacies for the hospitals and federal grantees that participate in the 340B program.
The 340B contract pharmacy has become increasingly concentrated with five multi-billion-dollar, for-profit, publicly traded pharmacy chains and pharmacy benefit managers (PBMs)—Cigna (via Express Scripts), CVS Health, UnitedHealth Group (via Optum Rx), Walgreens, and Walmart.
It’s time for Drug Channels’ annual update on drug pricing trends at the largest pharmaceutical manufacturers.
This year’s review includes the following nine companies: Bristol Myers Squibb, Eli Lilly and Company, Genentech, GlaxoSmithKline, Johnson & Johnson, Sanofi, Takeda, Teva, and UCB. You can find links to each company’s data below.
These data highlight divergent trends reshaping the gross-to-net bubble:
Rebates, discounts, and other fees reduced the selling prices of brand-name drugs at the biggest drugmakers to less than half of their list prices.
When accounting for all list price reductions, average brand-name drug prices declined at three manufacturers and increased at six others.
Gross-to-net difference in price changes ranged from −12.8% to +6.3%, reflecting significant differences in the manufacturers’ portfolio mix and pricing strategies.
As I noted in last week’s gross-to-net bubble analysis, manufacturers’ evolving market access strategies increasingly aim to offset—or circumvent—growing pricing pressure from both commercial and government payers. Drug pricing flat earthers (#DPFE) will be challenged by falling net prices, while policy wonks will be amazed at the unintended consequences unleashed by our crazy system.
The 2025 launch of biosimilars to Johnson & Johnson’s Stelara (ustekinumab) marks another turning point in pharmacy benefit dynamics. But unlike the chaotic rollout of Humira biosimilars, pharmacy benefit managers (PBMs) came prepared.
Private label strategies, aggressive pricing, and exclusive formulary deals have transformed what might have been a slow-crawling biosimilar introduction into a full-on pricing war. As with Humira, the reality of biosimilar economics is far messier—and more revealing—than the policy narratives suggest.
In this post, I examine how the major PBMs—and some of the smaller ones—are handling Stelara biosimilars, what’s changed since the Humira experience, and why their strategies reflect the growing dominance of private-label rebating schemes.
As always, with great pricing power comes great responsibility. Excelsior!
Drug Channels readers save 10% with code 25DRCH10*
Informa Connect's PBM Contracting Summit returns to Chicago this December! Join the industry as expert speakers navigate the complex PBM landscape, gaining unparalleled strategies to enhance patient care and effectively manage costs.
The 2025 event features:
A regulatory snapshot, reviewing state mandates and federal enforcement
Analysis on rebate transparency and next-generation PBM contracting
A look inside the GLP-1 challenge, with a focus on balancing momentum with sustainable models
Perspectives on alternative funding programs with a focus on risk, compliance and cost in managing high-cost therapies
Expert analysis of AI and automation, focusing on prior auth, precision medicine and the future of pharmacy
Examination of digital health disruption and the PBM model
Overview of specialty pharmacy access
Insights into the rise of disruptor PBMs, biosimilars and more
Deep dives into the 340B firestorm, covering policy, pricing and practical fixes
Coverage on redefining network adequacy while balancing access and geography
An outlook into Medicaid for the year ahead
An inside look into the patient voice within PBM contracting
PLUS! Attend a Pre-Summit Workshop on December 8th: GLP-1 Cost, Coverage, and Care - Continuum or Conundrum?
The PBM Contracting Summit remains essential to tackle the rising drug costs head-on–Spotlighting bold innovations in contracting, GLP-1 strategy, AI-powered solutions and federal & state driven regulatory change.
Drug Channels readers will save 10% off when they use code 25DRCH10 and register prior to November 3, 2025.*
*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rates or other offers. Other restrictions may apply.
The content of Sponsored Posts does not necessarily reflect the views of HMP Omnimedia, LLC, Drug Channels Institute, its parent company, or any of its employees. To find out how you can publish an event post on Drug Channels, please contact Paula Fein(paula@DrugChannels.net).
Today’s guest post comes from Jordan Armstrong, VP of Business Development at AssistRx.
Jordan examines the growing role of direct-to-consumer (DTC) access models in the pharmaceutical sector. He discusses recent regulatory developments, the potential benefits and risks for manufacturers, and key considerations for building sustainable DTC programs.
Drug Channels Institute is proud to host the 2026 Drug Channels Leadership Forum, which will take place from March 16–18, 2026, in Miami. Check out the agenda and request your invitation to this invite-only gathering of senior leaders from across the drug channel ecosystem. You must request an invitation to be considered for attendance. We will begin sending invitations in mid-October.
The healthcare landscape continues to evolve at an unprecedented pace, bringing new challenges and opportunities for patient access and affordability. As legislation shifts, market forces disrupt and cost-sharing programs grow increasingly complex, the need for innovative solutions has never been greater. Are you prepared to navigate this dynamic environment?
The Copay, Reimbursement and Access Congress is back November 18-20, 2025. Driven by real-time marketplace insights and led by the brightest minds in access and reimbursement, Copay 2025 is designed to equip you with the tools and strategies needed to enhance patient affordability, ensure program sustainability and stay ahead of regulatory changes.
Can’t-Miss Highlights:
14+ hours of content featuring 5+ sessions dedicated to deciphering copay legislation and 10+ sessions dedicated to copay operationalization.
Expert insights from top organizations like Sanofi, Geron, Pfizer, Kyowa Kirin, Novartis, J&J, Teva, Nuvation Bio, Celltrion, Exelixis and more.
Illuminating case studies on Mastering Copay Communication, Integrating Field Teams, Navigating Specialty Pharmacy in Rare Disease and Redesigning Insurance to Better Meet Patient Need
Enforcement perspectives on trends and actions within the copay and patient services space
7+ hours of networking to build powerful partnerships, expand your professional network and give your organization a competitive edge
Why Attend?
In today’s healthcare climate, balancing patient access with business objectives is a delicate task. The Congress will address critical questions that access professionals face:
How can programs remain sustainable, innovative and profitable while better supporting patients?
Is your patient support program’s restructuring in response to copay legislation delivering the desired results? Do MFP negotiations and copay smoothing initiatives call for further adjustments?
How will upcoming health policy changes impact patient affordability and commercialization strategies?
Join industry leaders, peers and solution providers to crack the copay code–Benchmark best practices, gain actionable insights, connect with industry trailblazers and drive patient access and affordability forward at Copay 2025.
“The Copay, Reimbursement and Access Congress was a great learning experience that allowed exchanging thought leadership, networking and brainstorming sessions. Audience was enthusiastic and engaged and these after-event sessions were true gems in surfacing interesting ideas.”
*Cannot be combined with other offers, promotions or applied to an existing registration. Other restrictions may apply.
The content of Sponsored Posts does not necessarily reflect the views of HMP Omnimedia, LLC, Drug Channels Institute, its parent company, or any of its employees. To find out how you can publish an event post on Drug Channels, please contact Paula Fein(paula@DrugChannels.net).
Today’s guest post is from Laura Jensen, Chief Commercial Officer and President of Pharma Solutions at GoodRx.
Laura shares her perspective on how direct-to-consumer (DTC) strategies are evolving and the role that platforms like GoodRx can play in improving access.
Over the summer, the boffins at the Centers for Medicare & Medicaid Services (CMS) released the latest projections for U.S. spending on healthcare. (See links below.) These data provide the latest official and apolitical look at the future of U.S. healthcare spending.
The top line projections highlight the government’s official view that prescription drugs dispensed by retail and mail pharmacies will have a modest impact on U.S. healthcare costs.
However, there are some notable changes from the previous forecast. CMS now expects that the Inflation Reduction Act’s changes to the Medicare Part D program will have a greater impact than previously projected, while private insurers will find drug costs creeping higher.
Below, we outline the four major takeaways from the latest projections, which continue to show that taxpayers—primarily via Medicare and Medicaid—will continue to dominate the employer-sponsored insurance market. And like it or not, vertically integrated insurers, PBMs, specialty pharmacies, and providers will continue to prosper.
The Patient Support Services Congress returns on November 20-21, 2025, at the Hilton East Brunswick, bringing together industry leaders to address the evolving landscape of patient support programs in pharmaceuticals and healthcare.
Exclusive Discount for Readers
Use promo code 25DC10 to save 10% off* your registration.
This year’s congress focuses on innovative approaches to patient support amid rapid technological advancement and regulatory changes. The meticulously crafted agenda delivers a perfect blend of policy updates, strategic insights, and technical expertise for professionals looking to revolutionize their patient support initiatives.
Key Highlights for 2025:
AI Integration in Patient Services: Explore the transformative potential of AI in patient support programs while balancing cutting-edge technology with personalized care
Direct-to-Patient Distribution Models: Learn strategies for overcoming logistical challenges and integrating direct-to-patient channels within existing support programs
Data Privacy and Compliance: Navigate the complexities of obtaining valid patient consent for data usage and address challenges in managing patient data rights
Digital Therapeutics: Discover regulatory landscapes and approval processes for digital therapeutics and their seamless integration into patient support programs
Accumulators and Maximizers: Join a closed-door summit to brainstorm with industry peers on mitigating risk from accumulators, maximizers, and alternative funding programs
Distinguished Speakers Include:
Kristin Manzolillo, Senior Director and Team Lead, US Oncology Patient Solutions Strategy, Pfizer
Jeffrey Vernice, Director, Patient Excellence, Boehringer Ingelheim Pharmaceuticals, Inc.
Brian Campbell, Vice President and General Manager, US, Orchard Therapeutics, A Kyowa Kirin Company
Suzanne Marinakos, Senior Director, Patient Solutions & Field Reimbursement, Novo Nordisk
Charles Husser, Federal Affairs Manager, Department of Advocacy and Access, Arthritis Foundation
And so many more!
The congress offers diverse session formats including expert panels, spotlight sessions, interactive benchmarking, and dedicated case studies. Strategically timed networking breaks and a vibrant evening reception provide ample opportunities to connect with peers and industry leaders.
This is the only event on the market uniting both compliance and operational teams, making it an essential gathering for anyone involved in patient support services.
Register today for this immersive event experience that will leave you energized, inspired, and equipped with strategies to enhance your patient support programs. View the agenda today and join us this November!
Drug Channels readers—Save 10% off the current registration rate with promo code 25DC10*. Register today.
*Offer applies to current rates only and may not be combined with other offers, category rates, promotions or applied to an existing registration. Offer not valid on workshop only or academic/non-profit registrations.
The content of Sponsored Posts does not necessarily reflect the views of HMP Omnimedia, LLC, Drug Channels Institute, its parent company, or any of its employees. To find out how you can publish an event post on Drug Channels, please contact Paula Fein(paula@DrugChannels.net).
Today’s guest post comes from Carolyn Zele, Advisor, Solution Consulting at MMIT.
Carolyn explores how access to BIN/PCN/Group (BPG) data—the three key identifiers on pharmacy benefit cards—can shape the benefit verification process for patient support services programs. By linking this data to claims systems and APIs, companies may be able to accelerate verification, reduce regulatory complexity, and better align financial assistance with patient needs.
With 9 chapters, 400+ pages, 187 exhibits, and 850+ endnotes, this report is unmatched in scope and depth. There is no other resource like it.
Preorder today to secure this fully updated, revised, and expanded 2025-26 edition at special discounted prices. Preorders ensure early access. You’ll receive the report before its October 14 release date.
Special preorder and launch pricing discounts will be valid through October 27, 2025. Act now to maximize savings.
The chart below highlights the three largest companies’ vertical alignment and diverse roles within the U.S. healthcare system. The numbers in the chart indicate the report chapter that corresponds to, explains, and analyzes each business.
[Click to Enlarge]
The 2025-26 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors remains the most comprehensive, fact-based tool for understanding and analyzing the large and growing U.S. pharmaceutical distribution industry. Widely regarded as the industry standard, this encyclopedic resource offers a definitive guide to wholesale distribution’s role in the complex web of U.S. prescription drug channels.
Our 2025-26 edition contains the most current financial and industry data about the distribution of pharmaceuticals and the major companies that handle these products. As always, we have updated all market and industry data with the most current information available. The report also updates our annual analyses of the strategies, market positions, and executive compensation of the three largest companies: Cencora, Cardinal Health, and McKesson.
We review each wholesaler’s business segments and underlying business profitability, based upon our proprietary economic models. This information allows you to assess differences among the public wholesalers’ business organizations, strategies, and financial performance. Where appropriate, financial data have been restated based on updated disclosures.
Thank you for your continued interest in our research. Please email me (afein@drugchannels.net) with any questions before purchasing. We look forward to sharing this year’s insights with you.
Pharmacy services administrative organizations (PSAOs), which operate between pharmacy benefit managers (PBMs) and smaller pharmacies, are among the most mysterious—and misunderstood—intermediaries in our complex U.S. drug channel.
Adding to the mystery: the largest PSAOs are owned by the three multi-billion dollar, public companies that also dominate pharmaceutical distribution—Cencora, Cardinal Health, and McKesson. These companies sit atop the Fortune 500 list and distribute more than 96% of prescription pharmaceuticals in the U.S.
Below, we draw on data from our forthcoming 2025-26 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors to profile the largest PSAOs and highlight crucial business trends affecting each company. We also examine how wholesalers are leveraging PSAOs as part of a broader vertical integration strategy that is building significant positions in businesses beyond drug distribution.
So, buckle up and let’s take a trip through the tollbooth to visit yet another overlooked—but powerful—corner of the drug channel.
Today’s guest post comes from Gerard Rivera, CEO and Co-Founder of RIS Rx.
Gerard explores how pharma companies lose billions each year through copay program inefficiencies, accumulators, maximizers, and other forms of systemic leakage. He introduces RIS Rx, a healthcare technology company whose platform helps manufacturers mitigate gross-to-net (GTN) revenue leakage while supporting patient access and outcomes.
Today’s guest post comes from Bansi Nagji, Chief Executive Officer at PANTHERx Rare.
Bansi explores how the emerging model of “Rare Pharmacy” addresses the challenges rare diseases pose to patients, caregivers, and the healthcare system. His perspective highlights the role of hyper-personalization, empathy, and data in improving outcomes for individuals with rare and orphan conditions, while also pointing to lessons that may extend across the broader healthcare landscape.
We’re thrilled to announce the full agenda for the 2026 Drug Channels Leadership Forum (DCLF)—taking place from March 16–18, 2026, at the Turnberry Resort & Spa in Miami. Once again, Drug Channels Institute (DCI) is proud to host this invite-only gathering of senior leaders across the drug channel ecosystem. You must request an invitation to be considered for attendance. We will begin sending invitations in mid-October.
Our 2026 lineup brings together a diverse range of C-suite leaders and policy influencers, ensuring every session delivers candid, high-value insights.
WHO SHOULD ATTEND
DCLF is a strategic, invite-only gathering for leaders from across the healthcare and pharmaceutical landscape, including:
Pharmaceutical manufacturers
PBMs, health plans, employers, and plan sponsors
Health systems and physician practices
Pharmacies and wholesalers
Policymakers
WHAT TO EXPECT
Expect another year of bold, candid discussions—not just presentations. We’ve enhanced the 2026 agenda with new formats and even more opportunities for direct, high-impact exchanges among attendees.
At DCLF, there are no exhibit halls, no press, no recordings, and no distractions—just substance and strategy.
You can expect:
Provocative panels with C-suite executives
Off-the-record insights and open Q&A sessions
Direct, high-impact exchanges among leaders
If you want to be in the room where it happens, there’s no substitute for being there in person.
SPONSORSHIP OPPORTUNITIES
To maintain the event’s strategic focus, attendance from industry suppliers (e.g., technology, consulting, financial services, etc.) is available only through sponsorship.
Each sponsorship level provides a limited number of attendee badges, ensuring the right mix of participants.
Invitations will begin going out in mid-October 2025. You must request an invitation to be considered for attendance. Don’t wait—our curated guest list fills up fast.
Today’s guest post comes from George Moore, Chief Information Technology Officer at CareMetx.
While banks and logistics companies update data instantly, patient services often rely on delayed, batch-based systems. George examines the challenges of this model and the potential for real-time synchronization to improve coordination and accelerate access to therapy.
Today’s guest post comes from Josh Marsh, Vice President and General Manager, Sonexus™ Access and Patient Support at Cardinal Health.
Josh examines the central role that hubs play in connecting patients, providers, and other stakeholders. He shares how hubs, by gathering and interpreting real-world insights, can help improve access, adherence, and the overall patient experience.
Today’s guest post comes from Jim Sheninger, Senior Vice President, Supply Chain at SmithRx.
Jim reviews the evolution of pharmacy benefit managers (PBMs) within the drug channel and discusses the challenges that the industry's current dynamics create for plan sponsors, patients, and pharmacies. He then outlines SmithRx’s approach to addressing these issues.
Our news-laden summer is ending. Time to pack away your bathing suit, send the kids back to school, and cherish these curated curiosities that I combed from the Drug Channels coastline:
Today’s guest post comes from Angie Franks, CEO at Kalderos.
Angie examines how data fragmentation contributes to inefficiencies in drug discount programs and the broader gross-to-net bubble—the widening difference between a drug’s revenue at list prices and what manufacturers actually receive. Angie outlines how better access to consistent, claims-level data could help reduce waste, improve program integrity, and enhance collaboration among stakeholders in the drug channel.
During my recent video webinar—What’s Next for Retail Pharmacy: Data, Debate, and Disruption—Antonio Ciaccia of 46brooklyn Research joined me to explore the data, trends, and strategic shifts driving a major shakeout in the retail pharmacy sector.
In the short video excerpt below, I break down five key economic forces putting intense pressure on U.S. drugstores. This clip offers just a glimpse of our broader conversation, which also covered PBMs, wholesalers, the evolving competitive landscape, and more.
Today’s guest post comes from Chris Dowd, Senior VP of Market Development at ConnectiveRx.
Chris revisits his November 2024 forecasts to assess how they’ve held up through mid-2025, giving them an overall grade of A-. He examines which trends played out as expected, where the landscape shifted more dramatically, and how these developments are reshaping patient access strategies.
After multiple years of mandated disclosure of negotiated hospital-insurer rates, those of us who follow the buy-and-bill channel might have expected transparency to reduce drug price variability, lower hospital markups, and accelerate adoption of lower-cost biosimilars.
Alas, that’s not what the latest data reveal.
DCI’s analysis of four national commercial insurers—Aetna, Anthem, Cigna, and UnitedHealthcare—and 26 hospitals found that:
Hospitals still earn significant markups over average sale price (ASP). 340B hospitals earn even more.
Insurers pay wildly varying amounts for the same drug.
Some hospitals get paid significantly more than others for the same drug.
Insurers can pay more for a lower-cost biosimilar than for the higher-cost reference product.
While provider-administered biosimilars are significantly cheaper than their reference products, hospitals and insurers are still making them expensive for plan sponsors. Meanwhile, patients with coinsurance and deductibles are paying higher out-of-pocket costs.
Transparency was supposed to clean things up—but someone forgot to bring the mop.
Today’s guest post comes from Stacey Little, Chief Growth Officer at AssistRx.
In this guest post, Stacey explores how artificial intelligence (AI) is helping life sciences organizations move beyond fragmented support models to deliver more integrated and personalized patient engagement. She outlines three distinct approaches to structuring patient support programs and discusses how AI-driven tools—such as AllazoHealth—can help tailor interventions across the entire treatment journey.
This week, I’m rerunning some popular posts while I put the finishing touches on DCI’s 2025-26 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. 
This week, I’m rerunning some popular posts while I put the finishing touches on DCI’s 2025-26 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. 
This week, I’m rerunning some popular posts while I put the finishing touches on DCI’s 2025-26 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. 
On October 14, 2025, Drug Channels Institute will release our 2025-26 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. This report—our sixteenth edition—is the most comprehensive, fact-based tool for understanding and analyzing the large and growing U.S. pharmaceutical distribution industry.
