Analysis

Today’s guest post is from Divya Iyer, SVP of Go-to-Market Strategy at GoodRx.

Divya shares new GoodRx data showing that out-of-pocket costs at the pharmacy counter remain a primary barrier to medication adherence. Despite the availability of manufacturer-sponsored support programs, many patients still abandon their prescriptions due to high costs.

During my PBM Industry Update: Trends, Challenges, and What’s Ahead video webinar, I explored the latest trends, emerging data, and strategic shifts transforming the pharmacy benefit management (PBM) industry.

In the video clip below, I explain how PBM compensation models continue to evolve:

• Traditional profit sources, such as mail dispensing of nonspecialty drugs and retained rebates, have become less significant.

• Retail network spreads now account for a small portion of large PBMs’ overall profits.

• Specialty dispensing profits, manufacturer administrative fees, and revenues from group purchasing organizations (GPOs) have emerged as major contributors to PBM profitability.

Can’t see the video? Click here to watch the PBM compensation models clip.

Understanding how PBMs generate profits is key to navigating the evolving drug channel landscape. Watch the full webinar replay and download the complete slide deck to explore these dynamics in more depth.

For a more comprehensive analysis of the forces transforming PBMs, see DCI’s 2025 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers.

Today’s guest post comes from Mike Cohn, Vice President, Network Operations at CoverMyMeds.

Mike shares key takeaways on patient access and affordability from CoverMyMeds’ 2025 Medication Access Report. He focuses on the systemic fragmentation that exists across payers, providers, and pharmacies. Mike explains how these silos delay treatment and lead to increased out-of-pocket costs.

To learn how a more connected, patient-centered solution can bridge silos and align clinical and financial realities, register for CoverMyMeds’ free June 12th webinar: Dimensionalization of the Patient Journey.

Read on for Mike’s insights.

Two weeks ago, Senator Bill Cassidy—now chair of the Senate Committee on Health, Education, Labor, and Pensions (HELP)—dropped a must-read, eyebrow-raising report on the out-of-control 340B Drug Pricing Program. (Link below.)

The report reveals previously confidential information showing how billions are funneled to health systems and pharmacies—with manufacturers unable to follow the flow.

Below, we use these new disclosures to illustrate the 340B program’s hidden prescription economics for 340B contract specialty pharmacies operated by CVS Health and Walgreens Boots Alliance.

As you can see, the program’s participants earn substantial margins, while plans and third-party payers foot the bill.

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

Participate in Claritas Rx's upcoming webinar to learn innovative strategies designed to increase your fill rates by 20% and enhance patient adherence. The webinar seeks to elevate your operational efficiency and improve patient care standards.

Join Claritas Rx experts as they lead you through methods intended to optimize patient care coordination, featuring an in-depth real-world case study that demonstrates the impact of these approaches. You will also acquire insights into streamlining patient journey processes with AI.

During this webinar, you will learn:

• Key strategies to boost fill rates by 20% and improve patient adherence in specialty pharma operations
• How to leverage advanced AI solutions to transform and streamline your patient journey processes
• Insights on elevating care standards and maximizing outcomes for success in specialty pharma

Register today to take the lead in achieving success in specialty pharma.

When: May 15, 2025, at 1:00 p.m. ET (10:00 a.m. PT)

Today’s guest post comes from Kristine McGaughey, Vice President, Implementation at ConnectiveRx and Sam Blake, SVP, Hub Product at ConnectiveRx.

Sam and Kristine discuss the importance of the first 24 hours of a patient’s engagement with a hub services program. They outline five reasons why two components—patient enrollment and successful benefits verification—dictate the effectiveness of a patient support program.

To learn more, register for ConnectiveRx’s free June 3 webinar: Unlocking the Gate: The Critical First 24 Hours of Patient Hub Engagement.

Read on for Kristine and Sam’s insights.

Spring has officially arrived at Drug Channels' worldwide headquarters in beautiful downtown Philadelphia. (Photo proof at right.) So, scurry over to this month’s curated crop of noteworthy news:

• Amazon Pharmacy is still coming for retail pharmacy

• Express Scripts revives its long-lost drug trend report

• Prior authorization gold cards: Progress or peril?

Plus, MPPP or not MPPP? That is the question.

P.S. Join nearly 63,000 of your peers who follow me on LinkedIn for daily insights, links to neat stuff, and sharp commentary from the ever-engaged DCI community.

Live from Asembia’s AXS25 Summit: The DCI team is on-site! Swing by booth #1601 at 4 p.m. today for our “Ask Adam Anything” (#AAA) session.

Today’s guest post comes from Scott Hughes, Vice President of Strategy of CareMetx.

In this latest analysis from CareMetx, Scott explores how the Inflation Reduction Act (IRA) is reshaping Medicare patients’ access to critical medications across three high-impact therapeutic areas: immunology, oncology, and endocrinology. Drawing on fresh 2025 plan data, he highlights the emerging barriers faced by patients, the shifting demands on providers, and the strategic implications for drug manufacturers.

To learn more, download CareMetx’s complete analysis: The IRA Disruption Report: A Strategic Look at Patient Access Changes.
 
Read on for Scott’s insights.

After a blockbuster inaugural event and tremendous feedback from attendees, we’re excited to announce that the Drug Channels Leadership Forum (DCLF) returns on March 16–18, 2026, at the Turnberry Resort & Spa in Miami. This one-of-a-kind, off-the-record event convenes senior leaders across the drug channel to address today’s most pressing industry issues.

“I’d recommend the DCLF to anyone in the drug industry in the US. It's a great opportunity to bring together all constituents and members and have a frank sharing of ideas.”
— Timothy Folts, Finance Director of Gross-to-Net Strategy, GSK

WHO SHOULD ATTEND

DCLF is an invite-only, strategic gathering for leaders across the drug channel ecosystem, including:

• Pharmaceutical manufacturers
• PBMs, health plans, and employers
• Health systems and physician practices
• Pharmacies and wholesalers
• Policymakers

“The thing that I think sets it apart is the fact that there are so many different parts of the industry that are represented here.”
— Jeanine Robertson, Director of Pharmacy Network Relations, Liviniti

WHAT TO EXPECT

Expect bold, candid discussions—not just presentations. We’re enhancing the 2026 agenda with new formats and even more opportunities for direct, high-impact exchanges among attendees.

Here’s a glimpse of what made the 2025 event such a success:

• Provocative panels with C-suite executives
• Off-the-record insights and open Q&A sessions
• No exhibit hall, no press, no distractions—just substance

“Sometimes you go to events like this and the chat on stage is completely pre-scripted. But we're not seeing that today, which has really added a robustness and flavor to the overall discussion.”
— Jason Dombi, Senior Vice President of Strategic Solutions, Cencora

WATCH HIGHLIGHTS FROM DCLF 2025

Relive the #DCLF2025 energy and hear testimonials directly from participants.

SPONSORSHIP OPPORTUNITIES

We limit attendance from industry suppliers (e.g., tech, consulting, financial services) to maintain the event’s strategic focus.

Attendance for suppliers is only available through sponsorship. The number of badges provided depends on your selected sponsorship level.

“The networking opportunities at DCLF have been impressive.”
— Angie Franks, CEO, Kalderos

A CONFIDENTIAL, INVITE-ONLY EXPERIENCE

To foster open dialogue and protect attendee confidentiality, DCLF is a private event:

• No media or press
• No recording or reporting
• No exhibit hall

If you want to be in the room where it happens, you need to be there in person.

GET STARTED

Invitations will begin going out in October 2025. Don’t wait—our curated guest list fills up fast.

Have questions? Interested in sponsorship? Please contact us or visit us at booth #1601 at Asembia.

Last week, we examined the growing concentration of specialty drug dispensing revenues among the largest pharmacies. See The Top 15 Specialty Pharmacies of 2024: How PBMs, Health Systems, and Independents Are Shaping the Market.

Today, we dive deeper. Drawing from DCI’s new 2025 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers, we explore how pharmaceutical manufacturers structure their specialty pharmacy networks—and how smaller, independent pharmacies have emerged as dominant players in exclusive networks.

In DCI’s latest analysis, we find specialty pharmacies affiliated with the largest PBMs still play an outsized role in limited networks. But like a certain striped-hatted cat, smaller pharmacies unaffiliated with PBMs show up where few expect them. They dominate exclusive networks and maybe even cleaning up any messes left by Things 1, 2, and 3.

Read on for DCI’s updated profile of specialty networks—and consider why smaller players are showing the good tricks that they know.