Analysis

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.


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.

Informa Connect's Access USA
March 18-20, 2025, Pre-Event Workshops on March 17
Drug Channels readers save 10%* on their registration with code 25AUSA10

Three events. One roof. The future of patient access.
There’s a lot to discuss, and Access USA is ready to deliver: policy updates, PBM reform, commercialization strategies and more!

Access USA unites PAP – Patient Assistance & Access Programs, Hub and Specialty Pharmacy Models East and Rare Disease Summit: three influential access conferences under one roof for collaborative discussions and opportunities to establish powerful partnerships.

Meet with hundreds of key stakeholders across the access landscape and benchmark with, learn from and network with leaders paving the way in patient access. Choose your preferred event and prepare to walk away inspired and armed with the knowledge necessary to drive change forward.

Which event is for you?

PAP 2025
Download Agenda
This forum gathers experts to share strategies for program optimization, navigate policy change and adapt to market dynamics to transform patient outcomes and maximize medication access. Benchmark your PAP program against leaders in industry and explore best practices to empower patients, champion affordability and accelerate access.

Hub and Specialty Pharmacy Models
Download Agenda
As the patient services landscape undergoes massive transformation, unite with industry to talk hub optimization and sustainability. In a time where flexibility in your hub program is a must, ensure you have all the tools to remain agile in this fluctuating landscape. This event is your insider playbook to driving efficiency in hub operations for improved access and adherence.

Rare Disease Summit
Download Agenda
While the industry has seen heightened focus surrounding rare drug development, we’ve only scratched the surface. Connect with key stakeholders to drive therapeutic progress, propel commercial strategies and inspire impactful advocacy. Generate solution-focused approaches surrounding access, commercialization, funding, partnering and more, as you unify in areas of unmet medical need at this inspiring summit.

What attendees are saying:

"Excellent conference! Content is always up-to-date and relevant… I attend yearly and always learn about topics impacting our industry."

"Valuable insights related to access and coverage relative to the impact of government policies and regulations… a window into the critical factors that impact manufacturers, supporting vendors and patient advocacy organizations."

"This event was exactly what I needed... the ability to connect with others on a more granular level guarantees that you will have some much-needed takeaways to share as well as networking with industry leaders!"

Use code 25AUSA10 on your preferred event to save 10%*!

*Cannot be combined with other offers or used toward a current registration. 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 Chris Apolito, Chief Strategy Officer, and Karina Castagna, Senior Vice President, Commercial Strategy at Mercalis.

Chris and Karina describe four ways that artificial intelligence (AI) can improve patient access, affordability, and adherence.

To learn more, join Mercalis for a complimentary webinar on March 13, 2025: Modernizing Patient Support: Harnessing Advanced Automation, Artificial Intelligence and Machine Learning to Improve Efficiency and Performance of PSPs.

Read on for Chris and Karina’s insights.

Get ready to climb a Crisco-covered light pole! DCI’s hometown Philadelphia Eagles are going to Super Bowl LIX! Go E-L-G-S-E-S! (No, that's not a typo.)

Before you overturn any cars, please enjoy this month’s playbook of articles, intercepted for you from the Drug Channels gridiron:

• Touchdown! How Mark Cuban would quarterback the U.S. healthcare system

• Trick Play: Patients and plans get sacked by a gross spending-to-net bubble

• Defensive line: A comeback for pharmacy students

• Offensive line: Apexus dances in the end zone, while a 340B hospital tackles a patient

Plus, Super Antonio runs downfield in the Mushroom Kingdom.

P.S. I recently passed 60,000 LinkedIn followers. If you haven’t done so already, follow along for my daily links to neat stuff along with thoughtful and provocative commentary from the DCI community.

Today’s guest post comes from Scott Genone, Chief Product Officer at CareMetx.

Scott shares key takaways from CareMetx’s recent survey of over 100 industry leaders. He outlines four trends that will define the future of patient services.

To view the full survey results, download The 2025 Patient Services Report: Provider Engagement is Make or Break for Success.

Read on for Scott’s insights.

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.

Informa Connect's Patient Assistance & Access Programs (PAP)
March 18-20, 2025 | Sheraton Philadelphia Downtown PA
Pre-Conference Workshops on March 17, 2025

Drug Channels readers save 10% on their registration with
code 25DC10

When it comes to patient affordability, it’s difficult to imagine a more complex time for our industry. Navigating policy updates, disarming AFPs, considering compliance risks – There are countless barriers to medication access and it remains our responsibility as an industry to ensure patients have access to the life-changing therapies they need.

How are we ensuring our programs are helping those who need it most? How does PAP 2025 help us reach this goal?

PAP 2025 will unite stakeholders from across the industry for vital collaboration focused on transforming patient outcomes. The experts are coming together to define best practices for PAP programs and answer top-of-mind questions for access professionals, including:

What can we do to catch, block and disarm AFPs?
How are we improving health equity to bridge the gaps in healthcare?
Are we effectively showcasing resources to empower patients?
What is the potential impact of the new administration on health policy?

Event highlights:

• Customizable Content: Benefit from add-on workshops, dedicated tracks, breakout discussions and more to customize your experience and strategize on your specific needs.
• Expert-Led Sessions: Uniting manufacturers, foundations, clinics and more, benchmark your program with leaders to see how you can improve your program to accelerate access.
• Actionable Takeaways: Uncover tangible solutions for your organization to streamline programs, optimize operations and improve patient outcomes.
• Networking: Robust networking opportunities with an expected 700+ access professionals to expand your network and establish powerful partnerships.

Featured speakers:

• Judd Caulfield, Takeda Pharmaceuticals – Expert in healthcare policy, sharing insights on upcoming regulatory changes, IRA response and the impact on access programs.
• Shanelle Gabriel, Starting Something Productions, Inc – Well-versed in advocacy work, sharing a powerful patient journey of resilience, creativity and the role of art in patient engagement.
• Rachel Thorpe, Otsuka Patient Assistance Foundation – Thought-leader in PAP innovation, diving into methods for patient empowerment.
• Liz Austin, Genentech – A veteran in patient assistance, discussing strategies to safeguard and preserve patient access amid the era of PBM reform.
• Jacob Foster, Criminal Division, U.S. Department of Justice – On the front lines of policy changes and enforcement, sharing the most recent and impactful cases related to patient assistance and where they are heading next.
• And many more!

Download your agenda and register today – Use exclusive promo 25DC10 to save 10%* when booking!

*Cannot be combined with other offers, promotions or applied to an existing registration. 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 is from Dorothy Gemmell, Chief Commercial Officer and President, Manufacturer Solutions, at GoodRx.

Dorothy highlights five trends to watch in 2025. She then describes how GoodRx's Cash Point-of-Sale Solution can help brands improve gross-to-net (GTN) while also making medications more affordable for patients.

Click here to download the latest GoodRx data on copay, cash, and patient services programs.

Read on for Dorothy’s insights.

During my recent Drug Channels Outlook 2025 video webinar, I tackled a wide range of crucial topics—including the controversial 340B Drug Pricing Program. As I explain in this video excerpt, we may finally see reform of this rapidly expanding program.

What’s more, implementing the Inflation Reduction Act will disrupt the current operations of the 340B program—and could shift program oversight from Health Resources and Services Administration to the Centers for Medicare & Medicaid Services.

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


Here are some Drug Channels articles with relevant background for the video:

• The 340B Program Reached $66 Billion in 2023—Up 23% vs. 2022: Analyzing the Numbers and HRSA’s Curious Actions

• Follow the 340B Prescription Dollar: How PBMs Profit from 340B Contract Pharmacies

• Hospitals Are Relying More on PBMs to Manage Manufacturers' 340B Contract Pharmacy Restrictions: DCI's 2024 Market Analysis

• Four Revelations from Minnesota’s First 340B Transparency Report

The inaugural Drug Channels Leadership Forum (DCLF) is coming soon! This exclusive event will be held from March 17 to 19, 2025, at the Turnberry Resort and Spa in Miami.

Our first event will provide attendees with an opportunity to explore the most pressing strategic issues and crucial uncertainties that will impact all participants across U.S. drug channels.

Speakers and panelists include top industry executives and subject matter experts from throughout the drug channel. Registered attendees include senior executives from pharmaceutical manufacturers, pharmacy benefit managers, health systems, physician practices, pharmacies, wholesalers, and more.

To maximize the value of networking and learning, the event will have a limited number of senior-level participants. We have a small number of spots still available for qualified individuals. You must submit a request to be considered for an invitation to attend.

• View the full Drug Channels Leadership Forum agenda. It’s filled with senior industry executives who will participate in fireside chats with me as well as topical panel discussions moderated by a diverse set of subject matter experts.

• Click here to request an invitation to attend. DCI will carefully review all submissions to include participants from a broad range of organizations. We are extending invitations on a rolling basis. Once you receive your invitation, you will have 15 business days to accept and complete the registration by paying the registration fee.

Please note that the DCLF is strictly limiting the number of attendees from technology companies, business services, financial firms, and other industry vendors. Vendors are only able to participate as part of a sponsorship. Click here to learn more about available sponsorship opportunities. There will be no exhibit hall and no media.

Everyone here at Drug Channels Institute (DCI) is excited to bring this novel event to the drug channels community. Visit the event website for more information on the registration process and our policies.

Below, I have reproduced our original press release. I hope you can join us!