Market Access

In the first part of his Pharma Commerce video interview, John Stanford, Incubate’s executive director, explains how third round of CMS drug selections brings physician-administered medicines under price controls for the first time, intensifying debate over provider reimbursement and investment in small-molecule therapies.

A 2026 industry survey finds mounting pressure from PBMs, federal pricing reforms, and compliance scrutiny, as manufacturers increase automation and AI investment to manage expanding gross-to-net exposure.

While the Inflation Reduction Act introduces a $2,100 out-of-pocket cap and payment smoothing options for Medicare Part D beneficiaries, low awareness and persistent health literacy gaps threaten to limit their real-world impact—highlighting the need for coordinated action across providers, pharmacies, industry, and advocacy groups.

The GLP-1 landscape continues to evolve in both delivery formats and affordability.

In today’s Pharma Pulse, bipartisan lawmakers target PBM vertical integration, while pharma giants race to secure tariff-exempt pricing deals.

Companies not included in the initial round are now pursuing their own agreements amid concerns over levies, Medicare pilot programs, and future price-setting policies.

In today’s Pharma Pulse, a telehealth giant retreats from the weight loss pill conflict, while safety-net hospitals secure a major legal victory against 340B reform.

SQ Innovation’s at-home furosemide injection for heart failure–related edema is now available through two of the Big Three drug wholesalers and covered under a Medicaid rebate agreement, expanding access for hospitals, pharmacies, and eligible patients.

These hubs can streamline access, reduce friction across reimbursement and logistics, and improve outcomes, as the CGT pipeline expands and patient demand accelerates.

TrumpRx is meant to reduce drug costs, but Americans are wondering how it works and what impact it will have.

In today’s Pharma Pulse, TrumpRx officially goes live, while Novo Nordisk prepares to take the oral version of Wegovy to the biggest stage in advertising.

The new platform offers coupon-driven discounts on dozens of high-cost brand name drugs, while raising new questions about eligibility, access, and how savings are applied.

The commercial PBM model is confronting structural strain as market forces—not regulation—begin to expose the fragility of high-rebate pricing economics.

A four-pillar strategy to help ensure both, as copay programs face mounting payer pressure and misuse in 2026.

In today’s Pharma Pulse, the FTC secures a multi-billion-dollar settlement against the "rebate trap," while Congress provides long-term certainty for the digital health revolution.

Policy shifts bring meaningful improvements for some—but looming coverage losses and rising premiums threaten to erase those gains.

A landmark FTC settlement requires Express Scripts to overhaul formulary and rebate practices, boosting price transparency in the process.

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.