Drug Channels delivers timely analysis and provocative opinions from Adam J. Fein, Ph.D., the country's foremost expert on pharmaceutical economics and the drug distribution system. Drug Channels reaches an engaged, loyal and growing audience of more than 100,000 subscribers and followers. Learn more...

Monday, April 21, 2025

Visit Drug Channels in Booth #1601 at #Asembia25 for a Special “Ask Adam Anything” (#AAA) Session

Next week, the Drug Channels Institute (DCI) team will be heading to Asembia’s AXS25 Summit at the always fabulous Wynn Las Vegas.

Thanks to our friends at HMP Global, we’re thrilled to have our very own DCI booth once again!

As you might expect, we'll be showing up in true Drug Channels style. Be sure to swing by booth #1601 for fun, flair, and pharma-frivolity:
  • Ask Adam Anything (#AAA). Join DCI president Adam J. Fein, Ph.D., for a special live session during the opening reception on Monday, April 28, at 4:00 p.m. Bring your phone—selfies encouraged!
  • Spin the Drug Channels Wheel O’ Fun and win fabulous prizes!
  • Meet Jeana Dollear, the behind-the-scenes dynamo who keeps everything running smoothly.
  • Enjoy cupcakes and conversation!
DCI’s booth is conveniently located in the middle of the hall. Check out the handy map below for directions:

[Click to Enlarge]

And remember: What happens in Booth #1601, stays in Booth #1601. 😉

Thursday, April 17, 2025

The AI Advantage: When and Where to Apply It in Your Patient Support Program

Today’s guest post comes from William Grambley, Chief Product Officer at AssistRx.

William discusses four specific use cases for how AI can create efficiencies and improve patient support programs for both healthcare providers and patients. He provides three considerations that life sciences organizations should evaluate when adopting AI in their patient support programs.

To learn more: Read on for William’s insights.

Wednesday, April 16, 2025

The Top 15 Specialty Pharmacies of 2024: How PBMs, Health Systems, and Independents Are Shaping the Market

Drug Channels Institute’s (DCI’s) latest analysis reveals that PBM-affiliated specialty pharmacies continue to dominate the dispensing of specialty drugs.

DCI has identified nearly 1,900 dispensing locations with specialty pharmacy accreditation. Below, we share DCI’s latest analysis of the top 15 specialty pharmacies, including updated market shares and revenue estimates.

As in prior years, pharmacies linked to the three largest pharmacy benefit managers (PBMs) accounted for two-thirds of prescription revenues from pharmacy-dispensed specialty drugs. We also explore how these pharmacies contribute to PBMs’ profitability—and spotlight the growing influence of provider- and health system-owned dispensing channels.

Once again, “specialty” mostly means affiliated with a PBM.

What do you think? Click here to share your thoughts with the Drug Channels LinkedIn community.

Tuesday, April 15, 2025

Master the Hidden Economics of Pharmaceuticals—In Under an Hour—with DCI's New eLearning Modules

In today’s fast-moving pharmaceutical marketplace, insight is everything. Whether you're building trust with customers, launching new products, or guiding internal teams, understanding the economic forces that shape drug distribution, reimbursement, and pricing is essential.

At Drug Channels Institute (DCI), we know how critical this knowledge is—and how hard it can be to find credible, up-to-date training that fits into a busy professional’s schedule. That’s why we created our DCI eLearning Modules: a suite of six interactive, expertly narrated courses that deliver must-know insights in 45 minutes or less.



Why Professionals Choose DCI eLearning

These modules were built from the ground up for pharmaceutical professionals—from seasoned experts to newcomers looking to understand the industry's complex web of relationships. Each course distills our signature Drug Channels expertise into engaging, bite-sized lessons that are ideal for:
  • Sales and field teams: seeking clearer context for their customer conversations
  • Market access, training, and internal strategy groups: who need to understand payer and channel dynamics
  • Any professional: ready to level up their understanding of pharmaceutical economics
Each module features:
  • Interactive graphics and animations for improved retention
  • Expert voice-over narration to guide you through complex topics
  • References to key DCI reports for optional deep dives
  • iPad compatibility for learning on the go
The modules are available only via a site-wide license, giving your entire organization access through your internal learning platform. We also offer licenses to our secure hosted learning environment—no internal setup required! (Sorry, individual licenses are not currently available.)

What You’ll Learn: A Snapshot of Each Module

1. Follow the Dollar: How Funds Flow in the Distribution and Reimbursement Channels
This foundational course breaks down the financial and product flows in U.S. pharmaceutical distribution. You'll learn how money and medicines move between manufacturers, wholesalers, pharmacies, PBMs, and payers—and how each relationship affects costs and outcomes.

2. The Economics of Retail, Mail, and Specialty Pharmacies
Gain a clear-eyed view of how different pharmacy channels generate revenue and manage costs. Understand reimbursement dynamics, cost estimation methods, and how profitability varies across drug types and dispensing models.

3. The Business of Specialty Pharmacy
Specialty drugs are revolutionizing care—and reshaping the pharmacy business. This module explores how these products are distributed, covered by insurance, and supported through value-added services.

4. The Economics of Provider-Administered Specialty Drugs
Navigate the unique dynamics of provider-administered drugs, from buy-and-bill systems to ASP reimbursement. Understand how coverage types, care sites, and financial relationships affect access and profitability.

5. Understanding Pharmacy Benefit Managers
PBMs wield enormous influence—but many professionals may not fully understand their true impact. Learn how PBMs operate, where they make money, and how they interact with manufacturers, payers, and pharmacies.

6. Pharmaceutical Wholesalers: Business Strategies and Financial Economics
Take a deep dive into how wholesalers operate, generate profits, and provide critical services. You’ll come away understanding the difference between full-line wholesalers and specialty distributors—and why that matters for your strategy.




Bottom line: If you or your team work in any part of the pharmaceutical value chain, DCI’s eLearning modules will make you smarter, faster. They’re the shortest path to mastering the industry's most important (and most misunderstood) topics.

Visit our eLearning page to get started.

Click here if you can't see the video below.



Friday, April 11, 2025

The Hidden Costs of Data Silos: How Pharma Manufacturers Can Stop Revenue Leaks and Strengthen Security

Today’s guest post comes from Jim Hundemer, Chief Information Security Officer (CISO), and Sudhakar Velamoor, Chief Technology Officer (CTO), of Kalderos.

Jim and Sudhakar discuss some of the complex challenges manufacturers face as they deal with outdated data systems, information silos, misapplied discounts, and growing cyber security threats. They argue that these challenges will lead to lost revenue, third-party security breaches, and diminished patient care.

To learn more, register for Kalderos’ April 23, 2025 webinar: The Hidden Costs of Data Silos: Why Data Security & Architecture are Critical.

Read on for Jim and Sudhakar’s insights.

Wednesday, April 09, 2025

Mapping the Vertical Integration of Insurers, PBMs, Specialty Pharmacies, and Providers: DCI’s 2025 Update and Competitive Outlook

It's time for Drug Channels’ annual update of vertical integration among insurers, PBMs, specialty pharmacies, and healthcare services within U.S. drug channels. As you can see below, we have revised, renovated, and refurbished our infamous illustration of the major vertical business relationships among the largest companies.

Proponents of these vertical integration arrangements argue that they create opportunities to mine healthcare costs. However, these organizations remain highly controversial, due to the potential for anti-competitive behavior. We summarize some of the key issues below.

While some major companies have narrowed their focus or unwound previous integration efforts, ongoing consolidation and selective deconsolidation will continue to reshape the healthcare biome by trying to build something epic, block by block.

What do you think? Click here to share your thoughts with the Drug Channels LinkedIn community.

Friday, April 04, 2025

Inflation-Adjusted U.S. Brand-Name Drug Prices Fell for the Seventh Consecutive Year as a New Era of Drug Pricing Dawns (rerun)

This week, I’m rerunning some popular posts while I prepare for today’s live video webinar: PBM Industry Update: Trends, Challenges, and What’s Ahead.

Click here to see the original post from January 2025.


It's time for Drug Channels’ annual examination of U.S. brand-name drug pricing.

For 2024, average brand-name drugs’ list prices grew by only 2.3%. What’s more, after adjusting for overall inflation, brand-name drug net prices dropped for an unprecedented seventh consecutive year. Details and additional commentary below.

As I predicted two years ago, the combined impact of changes to Medicaid rebates, the Inflation Reduction Act (IRA), and novel formulary access strategies have led multiple manufacturers to pop the gross-to-net bubble for high-list/high-rebate products. Consider the 18 products with list-price cuts shown below.  Other drugmakers have reduced the rate of price increases, thereby inflating the bubble more slowly.

Employers, health plans, and pharmacy benefit managers (PBMs) determine the extent to which patients with insurance share in this ongoing deflation. But signs of change to the conventional approaches are undeniable.

New channel models—including smaller PBMs, cost-plus pharmacies, patient-paid discount card prescriptions, and manufacturers’ direct-to-patient businesses—are creating novel paths for drugs that can be sold without gross-to-net bubble distortions.

The bubble won’t vanish overnight. But for the first time in years, I can foresee a time when SpongeBob SquarePants will move on from Drug Channels.

Thursday, April 03, 2025

Vertical Integration Redux: How Pharmaceutical Wholesalers Are Transforming the Buy-and-Bill Market (rerun)

This week, I’m rerunning some popular posts while I prepare for tomorrow’s live video webinar: PBM Industry Update: Trends, Challenges, and What’s Ahead.

Click here to see the original post from February 2025.


ICYMI, the largest three pharmaceutical wholesalers—Cardinal Health, Cencora, and McKesson—are using vertical integration to build significant market positions in businesses beyond drug distribution.

In the video clip below, I review the vertical integration status of the largest three pharmaceutical wholesalers, illustrated in the chart below.

[Click to Enlarge]

I also:
  • Explain how wholesalers have strengthened their position in buy-and-bill channels for provider-administered drugs through vertical integration with their downstream customers.
  • Discuss how and why private equity roll-up activity has provided wholesalers with strategic opportunities to acquire ownership stakes in practice management companies.
  • Outline the market access implications for provider-administered biosimilars in the buy-and-bill market.
This video was excerpted from my recent Drug Channels Outlook 2025 webinar. Click here if you can’t see the video below.


For more on the forces of change affecting drug distribution and the buy-and-bill market, see Chapter 6 of DCI’s recent 2024-25 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors.

Wednesday, April 02, 2025

Four Revelations from Minnesota’s First 340B Transparency Report (rerun)

This week, I’m rerunning some popular posts while I prepare for Friday’s live video webinar: PBM Industry Update: Trends, Challenges, and What’s Ahead.

Click here to see the original post from December 2024.


It’s time to pay attention to the money behind the 340B curtain.

Minnesota just released the industry‘s first ever mandated financial report on the 340B Drug Pricing Program. Below, I do a wicked deep dive into the data and highlight crucial implications about spending, profits, pharmacies, plans, patients, program integrity, and more.

There are important limitations to these data. But Minnesota’s report marks a valuable first step on the yellow brick road to the wonderful world of transparency. I suspect similar reports are gonna be popular.

Tuesday, April 01, 2025

The Big Three PBMs’ 2025 Formulary Exclusions: Humira, Stelara, Private Labels, and the Shaky Future for Pharmacy Biosimilars (rerun)

This week, I’m rerunning some popular posts while I prepare for Friday’s live video webinar: PBM Industry Update: Trends, Challenges, and What’s Ahead.

Click here to see the original post from January 2025.


For 2025, the three largest pharmacy benefit managers (PBMs)—Caremark (CVS Health), Express Scripts (Cigna), and Optum Rx (United Health Group)—have again each excluded hundreds of drugs from their standard formularies. You can find our updated counting below.

As you’ll see below, the combination of formulary exclusion and private labels is creating an increasingly confusing and crowded biosimilar marketplace.

For 2025, the Big Three PBMs shifted national formularies to favor their private-label biosimilars over Humira and its many biosimilar competitors. In fact, nearly all marketed Humira biosimilars are excluded from the larger PBMs’ 2025 formularies. Meanwhile, Stelara—this year’s big pharmacy benefit biosimilar launch—remains on the PBMs’ formularies, but will share space with PBMs’ private label products.

Like it or not, PBMs’ financial benefits from their private-label product align with the benefits to plan sponsors and patients. But the PBMs’ strategies, combined with the warped incentives baked into the Inflation Reduction Act, raise questions about the viability of the biosimilar marketplace.

What do you think? I encourage you to share your thoughts with the Drug Channels community on LinkedIn.