Managed Healthcare Executive January 1, 2026
Key Takeaways
- Radiopharmaceuticals are gaining traction in oncology, with regulatory changes and high costs challenging payers and PBMs. The market is projected to double by 2033.
- Lipid-lowering drugs will see renewed interest, and biosimilars may become more accessible as regulatory requirements for approval and interchangeability are likely to be removed.
- Drug pricing debates will intensify, with potential shifts toward outcomes-based pricing models driven by rising healthcare costs and value-based assessments.
- PBMs are evolving their pricing strategies, moving away from traditional models to increase transparency and align with actual acquisition costs, driven by legislative scrutiny and market disrupters.
- Payers may disaggregate traditional PBM functions to gain control over costs and member experience, driven by frustration with opaque economics and accelerating...
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