Trade & Channel Strategies 2025: Inside Pharma’s Turning Point

In his keynote address, “Navigating Disruption in the Pharmaceutical Channels,” Bill Roth, general manager and managing partner of IntegriChain’s consulting business, described 2025 as a pivotal year for the industry—one defined not just by evolving product archetypes but by the unprecedented acceleration of regulatory change. Although he typically revises his macro framework only once every decade or more, Roth explained that the current environment has forced a significant shift in how he views pharma’s trajectory across generics, brands, specialty, orphan/rare, and cell and gene therapies.

What makes this moment unique, he argued, is the scale and speed of policy transformation. Major regulatory developments—including the Medicare MFP program, the introduction of the 340B rebate, changes to the MDRP, and updates to the physician fee schedule—are reshaping commercial strategies in real time. He noted that manufacturers are now making preemptive changes to pricing and contracting before regulations take effect, a behavior he described as virtually unheard of in past cycles.

Roth emphasized the importance of looking beyond the policies themselves to understand their downstream commercial effects. For example, he predicts significant WAC reductions across the market and a long-term decline in 340B value as new rules strip margin from the program. He also introduced a new concept—the “medical benefit bubble”—warning that once MFP values fold into ASP for medical benefit products in 2028, the resulting gap between WAC and ASP will likely force further WAC compression.

Another emerging area of disruption is the industry’s rapid shift toward direct-to-patient models. Roth highlighted ongoing debates about whether this movement is driven by genuine operational advantage or political and public-perception pressures. His goal for the keynote was to provide a broad, high-level map of these intersecting forces—an approach he believes resonated strongly with attendees.

He also commented on other topics that have piqued his interest; his new six-part series; and much more.