Analysis

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.

I am pleased to announce Drug Channels Institute’s new 2025-26 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors, available for purchase and immediate download.

• Download a free 25-page report overview—including key industry trends, “What's New,” Table of Contents, and List of Exhibits

• Review pricing/license options and download the full 2025-26 report

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.

You can pay online with all major credit cards (Visa, MasterCard, American Express, and Discover). Click here to contact us if you prefer to pay by corporate check or ACH.

INSIDE THE 2025-26 REPORT

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.

WHAT’S INSIDE AND WHAT’S NEW

• The most current financial and industry data on pharmaceutical distribution and the major companies. See pages 9 and 10 of the free report overview for details on the notable new material in this latest edition.

• 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
November 18-20, 2025 | The Bellevue Hotel, Philadelphia, PA, USA

Exclusive Discount For Readers:

Use promo code 25DGCH15 for 15% off* your registration.

Download the agenda here
Reserve your spot here

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
• Rohit Gupta, Senior Director, Commercial Finance, Crinetics
• Darpan Jhaveri, Senior Director - US Revenue and Inventory Accounting, Insmed Incorporated
• Robert Lucchesi, Director, FP&A Sales Reporting & Forecasting, Novo Nordisk
• Ranish Singhvi, VP, Finance, Accord Healthcare
• Eric Kimelblatt, Head of Market Access, Trade/Distribution, Patient Services, Stallergenes Greer
• Kinneret Klein, Executive Director, Commercial Financial Planning & Analysis, Biocryst
• Ryan Coelho, Director, Net Revenue Management, Zoetis
• Felecia Manning, Senior Director, Managed Markets Pricing & Government Programs, United Therapeutics Corporation
• Edward McAdam, Director, Government Pricing, Contracting Operations & Analytics, Indivior
• Chad Nagel, Senior Director, Revenue Accounting, Nuvalent
• Matthew Pellegrini, Sr. Director - Revenue Optimization Contracting & Compliance N.A., Teva Pharmaceuticals
• Shirley Rong, Pricing & Channel Forecasting Lead, UCB

See why the GTN Summit remains the top choice for your peers.

PLUS! Save 15%* when you reserve your place today using the VIP code 25DGCH15.

*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.

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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.

Click here to learn more about PHIL Direct, PHIL’s integrated DTP solution.

Read on for Deepak’s insights.

This week, I’m rerunning some popular posts while I put the finishing touches on DCI’s 2025-26 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors.

Click here to see the original post from June 2025.

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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.

The 2025 market data below illustrate just how far the 340B program’s operations have diverged from its original intent. As Senator Bill Cassidy recently noted, the 340B program “was never meant to be part of an earnings call. It was meant to be part of patient care.”

This week, I’m rerunning some popular posts while I put the finishing touches on DCI’s 2025-26 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors.

Click here to see the original post from July 2025.

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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.

So, journey with me to Bikini Bottom as we again delve into the murky waters of gross-to-net drug pricing. Click here to share your thoughts with the Drug Channels community.

This week, I’m rerunning some popular posts while I put the finishing touches on DCI’s 2025-26 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors.

Click here to see the original post from July 2025. ICYMI, Express Scripts will boot the reference products from its 2026 formulary, but will cling to its biosimilar pricing double standard.

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The 2025 launch of biosimilars to Johnson & Johnson’s Stelara (ustekinumab) marks another turning point in pharmacy benefit dynamics. But unlike the chaotic rollout of Humira biosimilars, pharmacy benefit managers (PBMs) came prepared.

Private label strategies, aggressive pricing, and exclusive formulary deals have transformed what might have been a slow-crawling biosimilar introduction into a full-on pricing war. As with Humira, the reality of biosimilar economics is far messier—and more revealing—than the policy narratives suggest.

In this post, I examine how the major PBMs—and some of the smaller ones—are handling Stelara biosimilars, what’s changed since the Humira experience, and why their strategies reflect the growing dominance of private-label rebating schemes.

As always, with great pricing power comes great responsibility. Excelsior!

Informa Connect’s PBM Contracting Summit
December 9-10, 2025 | Chicago, IL
(Pre-Summit Workshop on December 8th)

Drug Channels readers save 10% with code 25DRCH10*

Informa Connect's PBM Contracting Summit returns to Chicago this December! Join the industry as expert speakers navigate the complex PBM landscape, gaining unparalleled strategies to enhance patient care and effectively manage costs.

The 2025 event features:

• A regulatory snapshot, reviewing state mandates and federal enforcement
• Analysis on rebate transparency and next-generation PBM contracting
• A look inside the GLP-1 challenge, with a focus on balancing momentum with sustainable models
• Perspectives on alternative funding programs with a focus on risk, compliance and cost in managing high-cost therapies
• Expert analysis of AI and automation, focusing on prior auth, precision medicine and the future of pharmacy
• Examination of digital health disruption and the PBM model
• Overview of specialty pharmacy access
• Insights into the rise of disruptor PBMs, biosimilars and more
• Deep dives into the 340B firestorm, covering policy, pricing and practical fixes
• Coverage on redefining network adequacy while balancing access and geography
• An outlook into Medicaid for the year ahead
• An inside look into the patient voice within PBM contracting
• And more!
• PLUS! Attend a Pre-Summit Workshop on December 8th: GLP-1 Cost, Coverage, and Care - Continuum or Conundrum?

The PBM Contracting Summit remains essential to tackle the rising drug costs head-on–Spotlighting bold innovations in contracting, GLP-1 strategy, AI-powered solutions and federal & state driven regulatory change.

View the agenda for PBM Contracting 2025 to see the complete picture–the program, speakers, and more, and visit www.informaconnect.com/pbm-contracting for further details and to register.

Drug Channels readers will save 10% off when they use code 25DRCH10 and register prior to November 3, 2025.*

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rates or other offers. Other restrictions may apply.

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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 Jordan Armstrong, VP of Business Development at AssistRx.

Jordan examines the growing role of direct-to-consumer (DTC) access models in the pharmaceutical sector. He discusses recent regulatory developments, the potential benefits and risks for manufacturers, and key considerations for building sustainable DTC programs.

To learn more, register for AssistRx's October 21st webinar: The New Patient Support Program: Why Regulatory Shifts Require a Higher Caliber of Program Sophistication and How to Do It.

Read on for Jordan’s insights.

By Adam J. Fein, Ph.D.

Autumn is here! Curl up with your Labubu’s favorite pumpkin-spiced blog and savor these stories harvested from the great Drug Channels patch:

• Mark Cuban’s company trims third-party fat but insured patients sometimes pay more

• Express Scripts boots Stelara, but clings to its biosimilar pricing double standard

• Thanks, IRA! The Part D market keeps unravelling

• Fresh insights from two government reports on the 340B Drug Pricing Program

Plus: If you loved The Pitt, you'll love the sequel!

P.S. Join my 65,000+ LinkedIn followers for curated links to neat stuff, along with sharp and thoughtful commentary from the DCI community.

Drug Channels Leadership Forum 2026

Drug Channels Institute is proud to host the 2026 Drug Channels Leadership Forum, which will take place from March 16–18, 2026, in Miami. Check out the agenda and request your invitation to this invite-only gathering of senior leaders from across the drug channel ecosystem. You must request an invitation to be considered for attendance. We will begin sending invitations in mid-October.