When Access Tightens, Prior Authorization Execution Becomes the Differentiator

Today's guest post comes from Megan Wetzel, Vice President of Product, Access and Affordability at CoverMyMeds.

Megan examines how prior authorization execution has become a strategic differentiator for biopharma brands as formulary changes and expanding utilization management put more pressure on access. She argues that building consistent, scalable prior auth execution can reduce therapy delays, improve determination time, and strengthen brand performance across the product lifecycle.

To learn more about CoverMyMeds' prior authorization solution, download their case study: From Decline to Growth: How One Brand Expanded Access in Late Lifecycle.

Read on for Megan's insights.

The Hidden Cost of 340B for Employers and Health Plans

By Adam J. Fein, Ph.D.

For years, the controversy surrounding the 340B Drug Pricing Program has centered on hospitals, manufacturers, and contract pharmacies.

But employers and health plans have become major participants in the program's economics—even though many don't realize it.

The short video below—excerpted from DCI’s recent 340B in 2026: Market Shifts, Policy Battles, and What They Mean for Stakeholders webinar—explains why.

In eight minutes, I discuss:

• How retrospective identification of contract pharmacy claims can eliminate manufacturer rebates for commercial plans while increasing plan costs

• What PBMs’ growing role in the 340B contract pharmacy market means for pharmacy benefits

• Why the economics differ from what many employers believe is happening at the pharmacy counter

• What newly reported Minnesota data reveal about who ultimately funds hospitals' 340B net profits

Whether you support or oppose the current structure of 340B, it is becoming harder to ignore that the debate is expanding beyond manufacturers and hospitals. Employers, health plans, and policymakers are beginning to ask who ultimately finances the program—and what those economics mean for benefit costs and premiums.

Click here to share your thoughts with the Drug Channels community on LinkedIn.

Can’t see the video? Click here to watch the 340B clip.