Why Waltz Health, Fresenius Kabi Are Taking Biosimilars Direct

Waltz Health and Fresenius Kabi are giving employers and payers a direct contracting channel for three biosimilars through the Waltz Connect platform, sidestepping rebate structures that typically govern specialty drug access.¹

The partnership was announced as payers face growing pressure to manage specialty drug costs. In an email statement to Pharmaceutical Commerce, Jeff Park, president of Waltz Health, said "Employers and payers are looking for new approaches because specialty drugs are a growing share of pharmacy spend, while the economics behind what they ultimately pay can be difficult to see and manage.”²

"A large rebate does not necessarily mean the lowest net cost, particularly as more biosimilars and lower-cost alternatives enter the market,” he added.

What Is Included in the Waltz Health-Fresenius Kabi Agreement?

The agreement covers adalimumab-aacf, a biosimilar to Humira (AbbVie); Otulfi (ustekinumab-aauz), a biosimilar to Stelara (Johnson & Johnson); and Tyenne (tocilizumab-aazg), a biosimilar to Actemra (Genentech). The three products span rheumatology, dermatology and gastroenterology, three major inflammatory disease categories where Waltz Health and Fresenius Kabi said the pricing model is designed to help commercial plans manage the cost of care.¹

Plan members will access the biosimilars at a defined price per unit, with Waltz Health applying a flat, previously disclosed fee. Final member cost will vary by pharmacy fees and each plan sponsor's benefit design, according to Waltz Health.¹

How Does the Direct-to-Payer Model Work?

Under Waltz Health's Direct-to-Payer program, employers and other plan sponsors contract directly with Waltz Health to offer eligible medications to covered members at pre-negotiated, transparent prices, without relying on the traditional rebate structures that route through PBMs. Eligibility and pricing are verified through the Waltz Connect platform before fulfillment.¹

Prescriptions will be filled through a dedicated specialty pharmacy operated by EVERSANA, Waltz Health's parent company, and delivered directly to patients' homes. The model bypasses traditional wholesaler distribution and rebate-driven PBM channels, reducing intermediary cost, while maintaining the clinical support typically associated with specialty pharmacy, according to the companies.

The expansion builds on Waltz Health's earlier rollout of direct-to-payer access for anti-obesity GLP-1 medications, marking the platform's first extension into biosimilars.

Why Is Direct-to-Payer Contracting Gaining Traction Now?

Direct-to-payer arrangements for high-cost drugs, first popularized through GLP-1 programs from manufacturers including Eli Lilly and Novo Nordisk, have expanded as plan sponsors look to "evaluate alternative pricing structures for medications that have historically been difficult to cover due to cost volatility and complex rebate dynamics," according to a January 2026 analysis from law firm Morgan Lewis. Traditional PBM arrangements "have long relied on rebate-driven economics, often with limited transparency into true net cost," the analysis noted, while direct models offer "simpler, more transparent pricing, clearer terms, and defined clinical rules."³

"We believe direct manufacturer arrangements will become an increasingly important part of the solution because they can establish clear, upfront economics and give plan sponsors more control over how they access the lowest-cost therapy," Park said in his statement to Pharmaceutical Commerce.² "But getting a good price is only the first step. The real opportunity is connecting that price to the benefit, identifying the right pharmacy, routing the prescription appropriately, and supporting the patient through fulfillment."

What Are the Commercial and Market Access Implications for Manufacturers?

For manufacturers, the deal illustrates a channel strategy built on a flat transparent price negotiated directly with plan sponsors, fulfilled through an aligned specialty pharmacy rather than traditional wholesaler and PBM distribution. Fresenius Kabi frames the move as part of a broader push to expand access to biological therapies through commercial partnerships outside conventional channels.

"That is where we see the market heading: not simply direct contracting, but intelligent orchestration of specialty medications around the lowest net cost and the best path for the patient," Park said.2 "The models that can do that at scale should create more competition, greater transparency and a simpler experience for employers, payers and patients."

As direct-to-employer contracting extends from GLP-1s into biosimilars, the Waltz Health-Fresenius Kabi agreement points to a broader test of whether manufacturers and platforms can build durable commercial channels circumventing PBM rebate structures.

References

1. Waltz Health and Fresenius Kabi. "Waltz Health and Fresenius Kabi Expand Direct Access to Biosimilars Through Waltz Connect Platform." Press release, September 29, 2026.
2. Park, Jeff. President, Waltz Health. Email statement to Pharmaceutical Commerce, September 29, 2026.
3. Fattahian, Saghi, and Lindsay M. Goodman. "Straight to the Source: What Direct Drug Models Mean for Employer Plan Sponsors in 2026." Morgan Lewis LawFlash, January 13, 2026. https://www.morganlewis.com/pubs/2026/01/straight-to-the-source-what-direct-drug-models-mean-for-employer-plan-sponsors-in-2026