𝐖𝐡𝐲 𝐃𝐨 𝐌𝐚𝐧𝐲 𝐄𝐦𝐩𝐥𝐨𝐲𝐞𝐫𝐬 𝐒𝐚𝐲 𝐓𝐡𝐞𝐲 𝐃𝐨𝐧’𝐭 𝐑𝐞𝐜𝐞𝐢𝐯𝐞 100% 𝐨𝐟 𝐓𝐡𝐞𝐢𝐫 𝐏𝐁𝐌 𝐑𝐞𝐛𝐚𝐭𝐞𝐬? A persistent puzzle in the pharmacy benefit world surfaced again in @psgconsults latest benefit design reports. PBMs frequently state that they pass through 95% of manufacturer rebates to their employer clients. Yet employer surveys tell a different story. According to PSG: 📊 Traditional drugs • 66% of employers report receiving 100% of rebates • 34% use other arrangements 📊 Specialty drugs • Only 54% report receiving 100% of rebates • Nearly half use alternative rebate structures What's striking is that we've seen similar results for many years. So what's behind the disconnect? • Are employers defining "100% of rebates" differently than PBMs? • Do guaranteed rebate arrangements create confusion about what is actually being passed through? • Will the Consolidated Appropriations Act's transparency requirements narrow this perception gap? Or is something else going on? 🤔 Download the complete reports: 📘 Trends in Drug Benefit Design Report drugch.nl/4v57nsc 📘 Trends in Specialty Drug Benefits Report drugch.nl/4vM8zRw #PBM #DrugChannels #DrugBenefits #HealthBenefits #SpecialtyPharmacy #EmployerBenefits #HealthcareTransparency

𝐓𝐡𝐞 𝐓𝐨𝐩 15 𝐒𝐩𝐞𝐜𝐢𝐚𝐥𝐭𝐲 𝐏𝐡𝐚𝐫𝐦𝐚𝐜𝐢𝐞𝐬 𝐨𝐟 2025: 𝐏𝐁𝐌-𝐀𝐟𝐟𝐢𝐥𝐢𝐚𝐭𝐞𝐝 𝐏𝐡𝐚𝐫𝐦𝐚𝐜𝐢𝐞𝐬 𝐃𝐨𝐦𝐢𝐧𝐚𝐭𝐞 𝐖𝐡𝐢𝐥𝐞 𝐇𝐞𝐚𝐥𝐭𝐡 𝐒𝐲𝐬𝐭𝐞𝐦𝐬 𝐚𝐧𝐝 𝐈𝐧𝐝𝐞𝐩𝐞𝐧𝐝𝐞𝐧𝐭𝐬 𝐆𝐚𝐢𝐧 𝐆𝐫𝐨𝐮𝐧𝐝 (rerun) Three companies now account for two-thirds of specialty pharmacy revenues. Drug Channels Institute’s latest analysis shows that PBM-affiliated specialty pharmacies remain firmly in control—but the market is shifting at the margins: • Health systems are expanding rapidly • A handful of independents are outperforming • Traditional retail players are losing share What’s driving these changes—and where is the market headed next? We break it all down here 👇 drugch.nl/4uliNqM #SpecialtyPharmacy #PBM #Healthcare #DrugChannels #Pharmacy

𝐌𝐚𝐩𝐩𝐢𝐧𝐠 𝐕𝐞𝐫𝐭𝐢𝐜𝐚𝐥 𝐈𝐧𝐭𝐞𝐠𝐫𝐚𝐭𝐢𝐨𝐧 𝐢𝐧 𝐔.𝐒. 𝐃𝐫𝐮𝐠 𝐂𝐡𝐚𝐧𝐧𝐞𝐥𝐬: 𝐃𝐂𝐈’𝐬 2026 𝐔𝐩𝐝𝐚𝐭𝐞 The biggest companies in the U.S. drug channel have spent years building sprawling, vertically integrated empires. But some are starting to unwind them. DCI’s latest update maps the shifting connections across insurers, PBMs, specialty pharmacies, and healthcare services—and reveals who’s still doubling down and who is changing course. 👉 Where integration is expanding 👉 Where it’s quietly retreating 👉 How these shifts affect access, dispensing, and profits See the full analysis (and the complete chart): 👇 drugch.nl/4vvCg8Z

𝐓𝐡𝐞 𝐓𝐨𝐩 𝐏𝐡𝐚𝐫𝐦𝐚𝐜𝐲 𝐁𝐞𝐧𝐞𝐟𝐢𝐭 𝐌𝐚𝐧𝐚𝐠𝐞𝐫𝐬 𝐨𝐟 2025: 𝐌𝐚𝐫𝐤𝐞𝐭 𝐒𝐡𝐚𝐫𝐞 𝐚𝐧𝐝 𝐊𝐞𝐲 𝐈𝐧𝐝𝐮𝐬𝐭𝐫𝐲 𝐃𝐞𝐯𝐞𝐥𝐨𝐩𝐦𝐞𝐧𝐭𝐬 (rerun) For 2025, 80% of all equivalent prescription claims were processed by just three companies: • CVS Caremark (CVS Health) • Express Scripts Pharmacy Benefit Services (The Cigna Group) • Optum Rx (UnitedHealth Group) The Big Three still dominate, but the story is more complicated than the headline. Independent PBMs are gaining traction. But even when they win, the Big Three may still profit. Meanwhile, the emerging Net Pricing Drug Channel #NPDC is reshaping how the large PBMs generate profits, structure contracts, and justify their role. Read DCI's full analysis 👇 drugch.nl/4vvAnsX

𝐓𝐡𝐞 𝐓𝐨𝐩 15 𝐔.𝐒. 𝐏𝐡𝐚𝐫𝐦𝐚𝐜𝐢𝐞𝐬 𝐨𝐟 2025: 𝐌𝐚𝐫𝐤𝐞𝐭 𝐒𝐡𝐚𝐫𝐞𝐬 𝐚𝐧𝐝 𝐑𝐞𝐯𝐞𝐧𝐮𝐞𝐬 𝐚𝐭 𝐭𝐡𝐞 𝐁𝐢𝐠𝐠𝐞𝐬𝐭 𝐂𝐡𝐚𝐢𝐧𝐬, 𝐏𝐁𝐌𝐬, 𝐚𝐧𝐝 𝐒𝐩𝐞𝐜𝐢𝐚𝐥𝐭𝐲 𝐏𝐡𝐚𝐫𝐦𝐚𝐜𝐢𝐞𝐬 (rerun) From Drug Channels Institute's 2026 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers: • Total prescription dispensing revenues reached $751 billion in 2025, up 10% vs. 2024. • The top 15 organizations captured nearly three-quarters of total revenues. • The four largest players account for more than half of the U.S. market. • GLP-1 drugs continue to reshape revenue mix and competitive positioning. • Vertically integrated insurer-PBM-pharmacy models are strengthening their dominance. The chart shows who made the list—and how specialty and mail pharmacy revenues are driving the story. Read the full breakdown 👇 drugch.nl/43nb1Sd #pharmacy #PBM #healthcare #drugpricing #specialtypharmacy #healthpolicy

From @RISRxInc: 𝐏𝐡𝐚𝐫𝐦𝐚𝐜𝐲 𝐂𝐨𝐩𝐚𝐲 𝐌𝐢𝐬𝐮𝐬𝐞: 𝐓𝐡𝐞 𝐌𝐮𝐥𝐭𝐢-𝐁𝐢𝐥𝐥𝐢𝐨𝐧 𝐃𝐨𝐥𝐥𝐚𝐫 𝐈𝐬𝐬𝐮𝐞 𝐇𝐢𝐝𝐢𝐧𝐠 𝐈𝐧 𝐏𝐥𝐚𝐢𝐧 𝐒𝐢𝐠𝐡𝐭 Request a complimentary analysis from RIS Rx: drugch.nl/49kWbz6 Read the article: drugch.nl/4o4sFDO #sponsored

𝐍𝐞𝐱𝐭 𝐅𝐫𝐢𝐝𝐚𝐲: 𝐃𝐫𝐮𝐠 𝐂𝐡𝐚𝐧𝐧𝐞𝐥𝐬 340𝐁 𝐈𝐧𝐝𝐮𝐬𝐭𝐫𝐲 𝐔𝐩𝐝𝐚𝐭𝐞 2026 The 340B program is at a crossroads. Legal battles. Contract pharmacy restrictions. Rebate-model proposals. Expanding state legislation. New scrutiny of program economics. Taken together, these developments are reshaping one of the most influential—and controversial—parts of the U.S. drug channel. Next Friday, my colleague Tyler Novotny and I will present a live Drug Channels Institute webinar examining what these changes mean for manufacturers, covered entities, pharmacies, PBMs, employers, and other stakeholders. We'll discuss: • Will a 340B rebate model become reality? • How the Net Pricing Drug Channel could reshape 340B economics • The legal, regulatory, and legislative battles reshaping 340B • Exclusive DCI data on the contract pharmacy marketplace and its leading participants • How manufacturers are responding to the changing economics of 340B • What comes next for 340B——and the stakeholders most likely to benefit or be affected If your organization is affected by 340B, this session will help you understand what's changing, why it matters, and what may happen next. 📅 Friday, June 12 🕛 12:00 p.m. – 1:30 p.m. ET Register here: drugch.nl/june2026 P.S. Can't attend live? Every registrant receives access to the full replay and slide deck. #340B #DrugChannels #Healthcare #Pharmacy #PBM #HealthcarePolicy

Like it or not, the Inflation Reduction Act (IRA) is forcing unprecedented visibility into the 340B program. @edsilverman of @statnews broke the story that @EliLillyandCo is requiring #340B hospitals to submit claims data or lose access to 340B discounts. As I told Ed, this is a predictable consequence of the IRA's drug pricing provisions. The law created new pricing obligations for manufacturers, but policymakers never established a reliable way to identify which claims qualify for 340B pricing. Here's the relevant section from his article: "The issue has intensified thanks to the Inflation Reduction Act, which imposes a maximum fair price on drugs paid for by Medicare and obligates drugmakers to pay added inflation rebates in Medicare. But the requirement overlaps with the 340B program. Why? Drugmakers must offer hospitals the lower of the maximum fair price or the 340B price — and pay inflation rebates only on drugs not sold at the 340B price. 'The Inflation Reduction Act is forcing transparency into the notoriously opaque 340B program,' said Adam Fein, who heads the Drug Channels Institute and tracks prescription drug pricing and insurance coverage. 'The IRA’s maximum fair price requirements make it impossible to ignore the long-standing lack of visibility into 340B claims.' He noted, however, that the federal government has not created a mechanism to identify 340B claims, and the HRSA maintains that it lacks the authority to do so. 'The result is a growing compliance dilemma that Congress never intended and regulators have yet to resolve,' he said." Full article: drugch.nl/3RG15Rb

Congratulations to @GeBaiDC on her nomination to be Assistant Secretary of U.S. Department of Health and Human Services. Ge is exceptionally knowledgeable, thoughtful, and dedicated to improving healthcare. She would be a tremendous asset in this important leadership position. drugch.nl/4dTBUC4

𝐓𝐡𝐞 340𝐁 𝐂𝐨𝐧𝐭𝐫𝐚𝐜𝐭 𝐏𝐡𝐚𝐫𝐦𝐚𝐜𝐲 𝐌𝐚𝐫𝐤𝐞𝐭 𝐢𝐧 2026: 𝐀 𝐌𝐚𝐭𝐮𝐫𝐢𝐧𝐠 𝐈𝐧𝐝𝐮𝐬𝐭𝐫𝐲 𝐃𝐨𝐦𝐢𝐧𝐚𝐭𝐞𝐝 𝐛𝐲 𝐁𝐢𝐠 𝐂𝐡𝐚𝐢𝐧𝐬 𝐚𝐧𝐝 𝐏𝐁𝐌𝐬 The 340B program was created in 1992 as a narrow policy solution to address an unintended consequence of Medicaid’s best-price provision while supporting core safety-net providers. But Drug Channels Institute's latest exclusive analysis of the 340B contract pharmacy market shows just how dramatically the program’s current operations and economic incentives have diverged from that original intent. In 2026, five publicly traded mega-corporations—Cigna, CVS Health, UnitedHealth Group, Walgreens, and Walmart—are capturing 77% of all 340B contract pharmacy relationships. For the full 2026 market breakdown—including which companies are winning and how the market keeps consolidating—read our latest analysis on Drug Channels: 👇 drugch.nl/4nYd6NT

From @Kalderos: 𝐃𝐫𝐮𝐠𝐬, 𝐃𝐢𝐬𝐜𝐨𝐮𝐧𝐭𝐬 𝐚𝐧𝐝 𝐃𝐚𝐭𝐚: 𝐂𝐫𝐚𝐟𝐭𝐢𝐧𝐠 𝐒𝐮𝐬𝐭𝐚𝐢𝐧𝐚𝐛𝐢𝐥𝐢𝐭𝐲 𝐢𝐧 𝐚𝐧 𝐈𝐦𝐩𝐞𝐫𝐟𝐞𝐜𝐭 𝐒𝐲𝐬𝐭𝐞𝐦 Register for "GTN Oversight: A New Standard of Transparency Is Here" (free 6/23 webinar): drugch.nl/4wPLO0a Read the article: drugch.nl/431OVEI #sponsored

𝐌𝐚𝐫𝐤 𝐂𝐮𝐛𝐚𝐧 𝐖𝐢𝐧𝐬 𝐭𝐡𝐞 𝐆𝐞𝐧𝐞𝐫𝐢𝐜 𝐏𝐫𝐢𝐜𝐞 𝐖𝐚𝐫 (𝐀𝐠𝐚𝐢𝐧) 🏆 For a surprising number of generic drugs, paying cash through @costplusdrugs can be dramatically cheaper than using commercial insurance: A new article from @AnnalsofIM found: • For generic prescriptions with out-of-pocket costs above $15, nearly 80% would have been cheaper through Cost Plus Drugs. • For prescriptions with cost sharing above $100, the median patient cost dropped from $140 through insurance to just $25 through Cost Plus. Affordability directly impacts adherence and outcomes. Unfortunately, the warped incentives of the U.S. drug channel mean that many insured patients pay MORE than transparent cash pricing. Small caveat: Less than 5% of generic prescriptions had OOP<$15. Nonetheless, another reminder from Mark Cuban @mcuban that complexity is the enemy of low costs and efficiency. Full article 👇 drugch.nl/3PFwiDs

𝐃𝐫𝐮𝐠 𝐂𝐡𝐚𝐧𝐧𝐞𝐥𝐬 𝐍𝐞𝐰𝐬 𝐑𝐨𝐮𝐧𝐝𝐮𝐩, 𝐌𝐚𝐲 2026: My $0.02 on Optum Rx’s Transparency, Must-Read 340B History, PBM Unbundling Update, PA Delays, and Vegas Fun Summer unofficially kicked off last weekend. So fire up the grill and enjoy these noteworthy delicacies, seared to perfection on the Drug Channels barbeque: • Why Optum Rx Is Accelerating Its Transparency Strategy • The Most Important 340B Paper You’ll Ever Read • Blue Shield of California’s PBM Unbundling Plan Meets Reality • Prior Authorization: Administrative Complexity = Delayed Care Plus: The Drug Channels Institute team takes on Las Vegas—with stickers! Read all the juicy details here: 👇 drugch.nl/4nRMHBm

𝐓𝐡𝐞 𝐌𝐨𝐬𝐭 𝐈𝐦𝐩𝐨𝐫𝐭𝐚𝐧𝐭 340𝐁 𝐩𝐚𝐩𝐞𝐫 𝐘𝐨𝐮'𝐥𝐥 𝐄𝐯𝐞𝐫 𝐑𝐞𝐚𝐝 If you care about #340B policy, use the long weekend to read this outstanding new paper: "Stretching Scarce Authorizing Legislation as Far as Possible: A Legislative History of the 340B Drug Pricing Program." Sayeh Nikpay @saynikpay and her colleagues went back to the early 1990's to reconstruct the program's origins. Their research draws on interviews with 18 key participants and 175 primary source documents spanning 1990–1992. Their conclusion is difficult to ignore: 340B was originally designed as a narrow policy solution to address an unintended consequence of Medicaid’s best-price provision and to support core safety-net providers. But the paper makes a compelling case that today’s program extends far beyond Congress’s original intent. Whether you support or oppose the current structure of 340B, this paper is essential reading for anyone who wants to understand how we got here. Read it here: drugch.nl/4dVSiTD One especially fascinating detail: The disproportionate share hospital (DSH) eligibility threshold of 11.75% was chosen to qualify two specific hospitals and secure bipartisan support from Senator Hatch and Representative Bliley. In other words, the threshold was not grounded in any broader scientific or policy rationale. Amazing.

𝐏𝐁𝐌 𝐒𝐡𝐚𝐤𝐞𝐨𝐮𝐭: 𝐇𝐨𝐰 𝐕𝐞𝐫𝐭𝐢𝐜𝐚𝐥 𝐈𝐧𝐭𝐞𝐠𝐫𝐚𝐭𝐢𝐨𝐧 𝐈𝐬 𝐑𝐞𝐬𝐡𝐚𝐩𝐢𝐧𝐠 𝐖𝐡𝐚𝐭’𝐬 𝐍𝐞𝐱𝐭 (𝐕𝐈𝐃𝐄𝐎) The PBM market is entering a shakeout phase. In this short video excerpt from DCI’s recent PBM Industry Update webinar, I review: • The changing market shares of the largest PBMs • Why many smaller PBMs still depend on the Big Three • How vertical integration continues to reshape the industry • Why regulation and scale pressures could accelerate consolidation We expect the PBM market five years from now to look very different from today. Watch here 👇 youtu.be/jMA_5lttnYo?si=W5rf… #PBM #Healthcare #Pharmacy #DrugChannels #HealthPolicy

𝐏𝐢𝐧𝐤 𝐒𝐡𝐞𝐞𝐭: 𝐏𝐁𝐌 𝐑𝐞𝐠𝐮𝐥𝐚𝐭𝐢𝐨𝐧 𝐌𝐚𝐲 𝐁𝐨𝐥𝐬𝐭𝐞𝐫 𝐁𝐢𝐠 𝐓𝐡𝐫𝐞𝐞 𝐌𝐚𝐫𝐤𝐞𝐭 𝐏𝐨𝐬𝐢𝐭𝐢𝐨𝐧 𝐕𝐞𝐫𝐬𝐮𝐬 𝐒𝐦𝐚𝐥𝐥𝐞𝐫 𝐂𝐨𝐦𝐩𝐞𝐭𝐢𝐭𝐨𝐫𝐬 PBM reform may not have the impact many expect. In a recent Drug Channels Institute webinar, we discussed: • How new federal transparency rules could disadvantage smaller PBMs • Why the Big Three are better positioned to adapt As transparency becomes standard, differentiation shrinks. As compensation shifts away from list prices, PBMs move toward fee-based models. (Hello, Net Pricing Drug Channel! #NPDC) The twist: these changes could reduce pressure for further legislation and ultimately strengthen the largest players. More in The Pink Sheet 👇 drugch.nl/42uam0Y #PBM #DrugPricing #HealthcarePolicy

From PHIL: 𝐏𝐫𝐨𝐭𝐞𝐜𝐭𝐢𝐧𝐠 𝐆𝐫𝐨𝐬𝐬-𝐭𝐨-𝐍𝐞𝐭 𝐏𝐞𝐫𝐟𝐨𝐫𝐦𝐚𝐧𝐜𝐞 𝐓𝐡𝐫𝐨𝐮𝐠𝐡 𝐒𝐢𝐧𝐠𝐥𝐞-𝐂𝐡𝐚𝐧𝐧𝐞𝐥 𝐄𝐜𝐨𝐬𝐲𝐬𝐭𝐞𝐦𝐬 Learn more about PHIL’s technology solution for brands: drugch.nl/4niITZA Read the article: drugch.nl/4ny2tRS #sponsored

🚨 𝐃𝐫𝐮𝐠 𝐂𝐡𝐚𝐧𝐧𝐞𝐥𝐬 𝐍𝐞𝐰𝐬 𝐑𝐨𝐮𝐧𝐝𝐮𝐩, 𝐌𝐢𝐝-𝐌𝐚𝐲 2026 🚨 Bryce Platt breaks down a timely mix of policy, pricing, and market dynamics: • Are drug launch price analyses built on flawed assumptions? • Pharmacy closures are accelerating—new data reveal where and why • The complex reality of how hospitals are paid for uncompensated care • Key differences between 340B hospitals and federal grantees • A fresh (and unexpected) take: specialty pharmacy as a luxury hotel Dive in: 👇 drugch.nl/4tsyWdy

🚨340𝐁 𝐢𝐧 2026: 𝐌𝐚𝐫𝐤𝐞𝐭 𝐒𝐡𝐢𝐟𝐭𝐬, 𝐏𝐨𝐥𝐢𝐜𝐲 𝐁𝐚𝐭𝐭𝐥𝐞𝐬, 𝐚𝐧𝐝 𝐖𝐡𝐚𝐭 𝐓𝐡𝐞𝐲 𝐌𝐞𝐚𝐧 𝐟𝐨𝐫 𝐒𝐭𝐚𝐤𝐞𝐡𝐨𝐥𝐝𝐞𝐫𝐬 (Live Video Webinar) 🚨 The 340B Drug Pricing Program remains one of the most complex—and contentious—parts of the U.S. drug channel. On June 12 (12:00–1:30 p.m. ET), I’ll be hosting a live webinar where I’ll break down what’s really happening behind the headlines: • The economics and continued growth of 340B • DCI’s latest data on contract pharmacy trends and market dynamics • How PBMs, manufacturers, and distribution strategies are evolving • Key legal, regulatory, and state policy developments • IRA implications, rebate model proposals, and oversight challenges • the growing role of employers and plan sponsors • Emerging risks and —and what to watch next • And more Clear facts. Sharp analysis. Live Q&A. If 340B affects your business, you won’t want to miss this. Register 👉 drugch.nl/june2026 #340B #DrugPricing #PBM #Pharmacy #DrugChannels