BlinkRx Insights: Beyond the Hub - Rethinking the Prescription Journey

Today's guest post comes from Geoffrey Chaiken and Matthew Chaiken, Co-founders of BlinkRx.

Geoffrey and Matthew examine how efforts to improve patient access have contributed to an increasingly fragmented prescription journey. They suggest that a more integrated approach can reduce complexity, improve visibility and control for manufacturers, and create a simpler path to therapy for patients.

To learn more about the BlinkRx Prescription Journey Management Platform, visit BlinkRx.

Read on for Geoffrey and Matthew's insights.

The Private Label Biosimilar Paradox in Medicare Part D

By Tyler Novotny and Bryce Platt

PBM-affiliated private label biosimilars would seem to have a built-in formulary advantage. But for ustekinumab, that advantage has not carried over to Medicare Part D.

A recent JAMA Network Open study identified 12 ustekinumab products available for formulary coverage in early 2026. Yet the average Part D plan covered only 2.3 biosimilars. Even more surprising, PBM affiliated private label products were largely missing from formularies connected to their corporate siblings.

CVS Health’s Cordavis labeled Pyzchiva received no Part D coverage. Optum Rx’s Nuvaila labeled Wezlana appeared in just 0.4% of UnitedHealth plans.

The results run against the conventional logic of vertical integration. If a PBM can influence formulary placement, why not direct volume toward its own product like in commercial formularies? The answer lies in the Inflation Reduction Act’s (IRA) Part D redesign, which made the economics of an affiliated private label biosimilar potentially less attractive in Medicare than in the commercial market.

Below, we follow the incentives that help explain why PBM-affiliated biosimilars remain largely absent from Medicare Part D formularies.