Market Access

CMS’s Globe and Guard models extend MFN pricing into Medicare Part B and Part D, signaling a sweeping shift in US drug pricing policy.

At Trade & Channel Strategies, industry executives explored evolving channel models, serialization challenges, generics and biosimilars, and the strategies shaping pharma's future.

In today’s Pharma Pulse, the biopharma landscape enters a transformative phase as the US signs landmark PBM reforms into law, while Novartis braces for the largest patent expiration cycle in its history.

In today’s Pharma Pulse, HHS issues guidance for manufacturer-direct drug discounts, while clinical data warns of significant weight regain after stopping tirzepatide and semaglutide.

For the first time, CMS has released negotiated prices for high-cost drugs covered under both Medicare Part D and Part B, naming 15 new negotiation targets and signaling continued efforts to rein in prescription drug spending.

How direct-to-patient programming can transform the prescription journey for patients and manufacturers alike.

In today’s Pharma Pulse, the FDA and EMA synchronize on AI standards, a potential divide in pricing strategy occurs, and BoomRx launches a needle-free nanoemulsion for weight loss.

The company’s latest preview report projects a guarded rebound for biopharma, as investor confidence returns and M&A activity accelerates.

In today’s Pharma Pulse, Amazon Pharmacy launches Novo's first oral Wegovy pill with transparent cash pricing, Johnson & Johnson triples down on North Carolina manufacturing, and new clinical data links medical debt to rising eviction risks.

Novo Nordisk’s newly approved oral semaglutide is now available nationwide through Amazon Pharmacy with insurance and cash-pay options.

The pharma giant becomes the latest manufacturer to participate in the Trump Administration’s direct-to-patient pricing platform, aligning US drug costs with European benchmarks while reinforcing its domestic manufacturing investments.

Backed by Frazier Healthcare Partners and strengthened by the acquisition of eBlu Solutions, CareTria aims to accelerate patient access by combining provider technology, digital enrollment, and multi-modal fulfillment into a single end-to-end platform.

In the final part of his Pharma Commerce video interview, Philip Sclafani, PwC’s pharmaceutical and life sciences lead, points out that from biosimilars and site-of-care shifts to AI, value-based reimbursement, and potential legislative action, market deflators—not simple cost shifting—will determine whether affordability improves across employer-sponsored plans, Medicaid, and Medicare.

In the third part of his Pharma Commerce video interview, Philip Sclafani, PwC’s pharmaceutical and life sciences lead, explains as medical inflation persists and benefit designs strain under rising drug spend—especially GLP-1s—employers are reaching the limits of what they can absorb, accelerating cost-shifting and fragmenting how employees pay for care.

In the second part of his Pharma Commerce video interview, Philip Sclafani, PwC’s pharmaceutical and life sciences lead, points out that a Medicaid spending tightens and ACA subsidies lapse, reduced public coverage is driving spillover effects—shifting costs to hospitals, employers, and commercial drug pricing in an increasingly interconnected healthcare market.

In today’s Pharma Pulse, GoodRx slashes cash prices for the new Wegovy pill, a federal judge halts the 340B rebate pilot, and Sanofi doubles down on Earendil Labs’ AI platform for autoimmune breakthroughs.

In the first part of his Pharma Commerce video interview, Philip Sclafani, PwC’s pharmaceutical and life sciences lead, discusses how from GLP-1 adoption to specialty drugs, behavioral health utilization, and hospital consolidation, multiple forces are reshaping employer-sponsored healthcare costs—and pushing premiums and cost-sharing higher.

Nine more companies have joined the DTC government-run website, which is set to launch sometime next year.

In today’s Pharma Pulse, major pharma players commit to most-favored-nation pricing, as DHL bolsters West Coast logistics for temperature-sensitive drugs.

Bill Roth, general manager and managing partner of IntegriChain’s consulting business, previews his new six-part series by outlining how rising payer fragmentation, divergent cash and insurance models, and supply-chain constraints are reshaping brand strategy.

In a discussion on emerging channel strategies, Bill Roth, general manager and managing partner of IntegriChain’s consulting business, explains why DTP models must extend beyond simple cash-pay offerings—highlighting how packaging innovation, insurance-flow backups, and improved patient compliance could unlock new revenue, streamline access, and better reflect clinical outcomes.

Traditional market access practices are being transformed by an increasingly rocky landscape of rebate, discount, and direct-distribution practices, but artificial intelligence may clear the pathways to profitability.

CoverMyMeds’ Megan Wetzel unpacks the forces behind rising specialty spend, the real impact of access barriers, and how field reimbursement teams help providers guide patients through today’s fragmented system.

In today’s Pharma Pulse, SOBI strengthens its gout franchise by acquiring Arthrosi Therapeutics for up to $1.5 billion, securing the Phase III asset pozdeutinurad, and much more.

How pharma can productively coexist with PBMs—and still lower drug costs faster.