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...
Today’s guest post comes from Lara Loveman, VP of Pharma Solutions at Outcomes.
Lara discusses how shifting market forces and evolving reimbursement models are reshaping pharmaceutical marketing strategies. She suggests that pharmacist-led interventions—particularly in chronic disease management—can both protect pharmaceutical investment and drive better health outcomes.
On Monday, Cigna announced that it would be abandoning traditional manufacturer rebates and moving to a new, “rebate-free” approach—essentially a point-of-sale (POS) rebate model paired with a cost-plus pharmacy reimbursement framework. Here’s the press release.
Moving manufacturers’ rebates and discounts to the point of dispensing is a big win for patients, who can share in the savings that pharmacy benefit managers (PBMs) negotiate with drugmakers. It's a practical, patient-friendly step toward shrinking the gross-to-net bubble that has inflated out-of-pocket costs for years.
Yet as always, the fine print matters. Below are three crucial considerations that reveal why this move might be less revolutionary than it first appears—and why it may not be widely adopted by plan sponsors. Perhaps these will spark some questions for Cigna's management about the company's increasingly opaque profit model during tomorrow’s third-quarter earning call.
This isn’t the first time that Express Scripts has tried to alter how its plan sponsors manage their pharmacy benefits. After reading the analysis below, you can decide whether this latest attempt is true reform—or the triumph of hope over experience.
Eeek! It’s time for the Drug Channels Halloween roundup of terrifying tales from the dark corners of the healthcare system. Gather your favorite demon hunters and help maintain the Honmoon. This month’s tricks and treats include:
Today’s guest post comes from Mark Thierer, Chief Executive Officer of EVERSANA.
Mark explains how combining direct-to-patient and direct-to-payer strategies can improve transparency, streamline access, and better align key stakeholders. He introduces EVERSANA DIRECT, the company’s new approach to market access.
In recent years, these companies have spent more than $16 billion to acquire management service organizations (MSOs) that oversee physician practices in such specialties as gastroenterology, oncology, ophthalmology, and urology.
Below, we highlight the largest MSO transactions and explore five ways wholesalers benefit from ownership in their downstream physician customers. Ultimately, these strategies may allow wholesalers to exert unprecedented control over market access for provider-administered drugs—if they can figure out how to realize this power.
The stakes have never been higher. With seismic shifts in distribution models, health policy and market access strategies, falling behind on critical trends could mean losing your competitive edge. If you’re a trade, channel, market access or brand professional, Informa Connect’s Trade and Channel Strategies is your must-attend event to stay ahead of the curve.
Why attend? Informa Connect’s Trade and Channel Strategies celebrates two decades of excellence—Experts will explore the evolution of the landscape, unravel its complexities and showcase innovative pharmacy and distribution models shaped by shifting market dynamics. Walk away with actionable strategies to tackle the latest industry challenges.
Why now? The US marketplace is in upheaval, with disruptions at both the pharmacy counter and across the supply chain. Policy changes, market fluctuations and new entrants, like GLP-1 therapies are reshaping the landscape. Traditional models are being replaced by innovative alternatives, leaving companies struggling to adapt. This conference offers critical insights into these changes and equips you to thrive in this evolving environment.
What can you expect? The event features a stellar lineup of industry leaders, including Bill Roth of IntegriChain, who will deliver the keynote address, Navigating Disruption in Today’s Trade and Channel Marketplace. Other notable speakers include:
Christine Hummel, US Head, Trade & Channel Management, Sanofi
Ramita Tandon, Chief Biopharma Officer, Walgreens
Peter A. Arakelian, Head of Channel & Oncology Enterprise Accounts, EMD Serono
Martine Avello, Director, Channel and Distribution, BioMarin Pharmaceutical Inc
Thomas Scalone, Director, Trade Strategy and Operations, Bristol Myers Squibb
Stephanie Wirkes, Head of Distribution and Strategy Execution, Bayer
And more!
Program highlights:
Navigate Regulatory Changes: Stay on top of DSCSA serialization, IRA impacts and PBM reforms that are reshaping the industry
Master Distribution Models: Explore the direct-to-patient revolution, limited distribution networks and innovative cold chain solutions for specialty pharmaceuticals
Optimize Market Access: Learn strategies to balance GTN optimization, payer negotiations and patient affordability
Leverage Technology: Discover how AI, digital tools and analytics are transforming trade strategies
What attendees are saying: “For those of us responsible for navigating and developing specific strategy around this ever-changing marketplace in distribution channel management, this was a bullseye.”
“Most valuable conference of the year to understand pharmacy and distribution related topics. There is no second.”
“One of the best conferences I have ever attended. The speaker selection and topic covered from a strategic and tactical approach were extremely relevant to our business.”
Exclusive Offer—Download the agenda and register today–Use your exclusive promo 25DC10 to save 10%*
*Cannot be combined with other offers, promotions or applied to existing registration. Other restrictions may apply.
The content of Sponsored Posts does not necessarily reflect the views of HMP Omnimedia, LLC, Drug Channels Institute, its parent company, or any of its employees. To find out how you can publish an event post on Drug Channels, please contact Paula Fein(paula@DrugChannels.net).
Today’s guest post comes from from Chad Zerangue, Founder of InfuseFlow and Senior Director, Enterprise Provider Sales at CareMetx.
Chad explains how barriers to access for infused therapies—including site-of-care changes and financial clearance delays—often cause patients to disengage before receiving the first dose. He shares one patient’s story illustrating the need for a strong patient services partner with coordinated systems and digital handoffs.
Special launch pricing is available through October 27, 2025.
This report—our sixteenth edition—remains the most comprehensive, data-driven resource for understanding and analyzing the large and growing U.S. pharmaceutical distribution industry.
With 9 chapters, more than 400 pages, 187 exhibits, and over 850 endnotes, this report is unmatched in scope and depth. There’s simply no other resource like it.
Order today to secure your copy of this fully updated, revised, and expanded 2025-26 edition at special discounted prices.
The 2025-26 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors remains the most comprehensive, fact-based tool for understanding and analyzing the large and growing U.S. pharmaceutical distribution industry. Widely regarded as the industry standard, this encyclopedic resource offers a definitive guide to wholesale distribution’s role in the complex web of U.S. prescription drug channels.
The chart below illustrates the vertical integration and broad reach of the three largest companies in U.S. pharmaceutical distribution. The numbers in the chart correspond to the report chapter that explains and analyzes the specific business segment.
Updated analyses of strategies, market positions, and executive compensation for the Big Three—Cencora, Cardinal Health, and McKesson. We review each company’s business segments and underlying business profitability, based upon our proprietary economic models. This allows you to assess differences among the public companies’ organizational structure and financial performance.
Self-contained chapters that do not need to be read in order. (Really!) There are loads of internal hyperlinks to help you navigate the document and customize it to your specific interests and priorities.
The option to download an additional PowerPoint file with images of all 178 exhibits. This popular option helps you share the insights and data with others in your organization. (The exhibits appear within the text for all license versions.)
760 (!) endnotes, most of which have direct hyperlinks to original source materials for deeper learning.
No SpongeBob Squarepants, corny jokes, or pop culture references, all of which have been reluctantly removed.
Thank you for your continued interest in our research. Please email me (afein@drugchannels.net) with any questions before purchasing.
We look forward to sharing this year’s insights with you.
Informa Connect's Pharma/Biotech GTN Summit returns on November 18-20, 2025, in Philadelphia, PA, bringing together hundreds of senior finance, gross-to-net and accounting professionals from across the life sciences industry to tackle the complexities of gross-to-net management.
This year’s CPE-accredited event will deliver cutting-edge insights, proven methodologies, and practical tools to optimize gross-to-net processes and enhance forecasting accuracy. With a sharp focus on policy updates, technology integration,and cross-functional collaboration, the agenda will help you keep pace with the fast-evolving US life sciences landscape and its unique complexities, providing the ultimate forum for model-sharing, benchmarking best practices and inspiring innovation within your team.
Featured Thought Leaders Include:
Brett Nussbaum, Director of Gross to Net Accounting, Novartis
Trevor Ackerman, VP, Global Tax, Amneal Pharmaceuticals
Chris Rocco, Head of US Market Access Data, Reporting and Analytics, GSK
Prakash Chainani, VP - Finance, HR & IT, Lifestar Pharma LLC (a Mankind Group Company)
Bal Ram Chopra, Senior VP, Finance, US Operations, Indivior
Rosalind Davis, Director, Government Pricing and Contracts, CSL Vifor
Timothy Kocses, Executive Director, US Commercial Controller, Bristol Myers Squibb
Dominic Fatigati, Finance Director, Market Access, US Oncology, AstraZeneca
James Engel, Controller, Finance, Collegium Pharmaceuticals
*Offer exclusively for life sciences manufacturers only. Offer applies to the current rate and maybe not be applied to existing registrations; additional terms may apply, see website for full details.
The content of Sponsored Posts does not necessarily reflect the views of HMP Omnimedia, LLC, Drug Channels Institute, its parent company, or any of its employees. To find out how you can publish an event post on Drug Channels, please contact Paula Fein(paula@DrugChannels.net).
Today’s guest post comes from Deepak Thomas, Founder and CEO of PHIL.
Deepak explores how demographic shifts and digital expectations are reshaping patient engagement. He argues that to stay competitive, pharmaceutical manufacturers must adopt integrated direct-to-patient (DTP) platforms that streamline access, support insurance coverage, and deliver sustainable commercial impact.
The 340B Drug Pricing Program has emerged as a growing source of profits for pharmacies and pharmacy benefit managers (PBMs).
Drug Channels Institute’s latest exclusive analysis of the 2025 market reveals a highly concentrated market structure increasingly dominated by a handful of major players:
About 32,000 pharmacy locations—nearly 60% of the entire U.S. pharmacy industry—function as contract pharmacies for the hospitals and federal grantees that participate in the 340B program.
The 340B contract pharmacy has become increasingly concentrated with five multi-billion-dollar, for-profit, publicly traded pharmacy chains and pharmacy benefit managers (PBMs)—Cigna (via Express Scripts), CVS Health, UnitedHealth Group (via Optum Rx), Walgreens, and Walmart.
It’s time for Drug Channels’ annual update on drug pricing trends at the largest pharmaceutical manufacturers.
This year’s review includes the following nine companies: Bristol Myers Squibb, Eli Lilly and Company, Genentech, GlaxoSmithKline, Johnson & Johnson, Sanofi, Takeda, Teva, and UCB. You can find links to each company’s data below.
These data highlight divergent trends reshaping the gross-to-net bubble:
Rebates, discounts, and other fees reduced the selling prices of brand-name drugs at the biggest drugmakers to less than half of their list prices.
When accounting for all list price reductions, average brand-name drug prices declined at three manufacturers and increased at six others.
Gross-to-net difference in price changes ranged from −12.8% to +6.3%, reflecting significant differences in the manufacturers’ portfolio mix and pricing strategies.
As I noted in last week’s gross-to-net bubble analysis, manufacturers’ evolving market access strategies increasingly aim to offset—or circumvent—growing pricing pressure from both commercial and government payers. Drug pricing flat earthers (#DPFE) will be challenged by falling net prices, while policy wonks will be amazed at the unintended consequences unleashed by our crazy system.
This week, I’m rerunning some popular posts while I put the finishing touches on DCI’s 
This week, I’m rerunning some popular posts while I put the finishing touches on DCI’s 