On The Radar – 21st Edition
By
ASCO is calling for tighter oversight and clearer reporting within the 340B Drug Pricing Program, arguing that hospitals should better demonstrate how program savings directly benefit vulnerable oncology patients.
➡ Why it matters: Transparency expectations are expanding across every corner of healthcare, including long-standing federal pricing programs.
Employers continue identifying GLP-1 medications as one of the largest drivers of rising healthcare costs in 2026, prompting stricter utilization management and value-based coverage strategies.
➡ Why it matters: GLP-1s are rapidly reshaping employer pharmacy benefit strategies and long-term budget planning.
Local pharmacies are struggling as PBM reimbursement rates fail to keep pace with rising drug acquisition costs, threatening closures in underserved communities.
➡ Why it matters: Reduced pharmacy access could worsen care gaps and create more “pharmacy deserts” nationwide.
The generic and biosimilar market is projected to surge over the next decade as blockbuster drug patents expire and healthcare systems prioritize affordability.
➡Why it matters: Generics and biosimilars may become one of the biggest tools for controlling long-term specialty drug spend.
A new national poll found strong bipartisan support for greater drug pricing transparency, PBM reform, and efforts to curb patent extension tactics.
➡Why it matters: Healthcare affordability continues gaining momentum as a major public and political issue.
Compounded GLP-1s, oral therapies, and future biosimilars are gaining traction as employers and providers search for lower-cost treatment options.
➡Why it matters: Alternative access models could improve affordability but also raise new safety and oversight concerns.
U.S. prescription drug spending is projected to surpass $1 trillion as specialty medications and GLP-1 demand continue climbing.
➡ Why it matters: Drug affordability pressures are accelerating the push for pharmacy benefit reform and transparency.
Federal and state lawmakers continue advancing PBM reform efforts focused on spread pricing restrictions, rebate transparency, and fiduciary accountability.
➡ Why it matters: The shift toward transparent, fee-based pharmacy models continues gaining traction.
Growing concerns over direct-to-consumer pharmaceutical advertising are fueling increased legal and regulatory attention, particularly around GLP-1 marketing.
➡ Why it matters: Aggressive drug marketing campaigns may carry growing financial and legal consequences.
Employers and consultants are increasingly adopting direct contracting, transparent pharmacy models, and reference-based pricing to regain control over healthcare spend.
➡ Why it matters: Benefit leaders are becoming active healthcare purchasers instead of passive plan administrators.
More employers are moving toward pass-through PBM structures that eliminate spread pricing and align compensation through flat administrative fees.
➡ Why it matters: Organizations are demanding clearer visibility into where pharmacy dollars actually go.
Final Thoughts
Healthcare affordability pressures continue intensifying across employers, pharmacies, manufacturers, and patients alike. As transparency expectations rise, organizations are increasingly moving away from opaque healthcare models in favor of strategies built around accountability, visibility, and long-term sustainability.
We’ll be back in two weeks with more news you need to know. If you’d like a custom analysis or want to explore SHARx program options for your clients, contact us!
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