Market Access Brief

Market Access Intelligence — Weekly Digest
Weekly Intelligence for Market Access Professionals

The market access landscape
moves fast. Read faster.

PBM reform, formulary shifts, ICER assessments, 340B policy, biosimilar dynamics, and pricing intelligence — synthesized weekly into one 15-minute read with competitive analysis and strategic implications.

9+ sources per edition Every claim sourced inline Weekly on Fridays Free — no paywall

Six coverage domains.
One integrated view.

Every week we monitor 30+ sources across the market access landscape and distill what matters into competitive intelligence — not summaries, not press releases, but strategic analysis of who wins and who loses.

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Policy & Legislation

PBM reform, IRA implementation, MFN proposals, OTC switches, executive orders — with analysis of downstream impact on payer strategy and manufacturer contracting.

F

Formulary & Coverage

PBM exclusion lists, tier changes, prior authorization shifts, step therapy requirements, Medicare Part D design changes — the decisions that determine patient access.

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Pricing & Reimbursement

IRA negotiated prices, WAC trends, gross-to-net dynamics, site-of-care economics, ASP reimbursement, and international reference pricing developments.

H

340B Program

Contract pharmacy disputes, rebate model litigation, state access laws, covered entity strategies, and the HRSA-to-CMS oversight transfer — the most contested territory in drug pricing.

B

Biosimilar Dynamics

Launch economics, PBM private-label strategies, interchangeability impact, payer adoption patterns, and the collision between biosimilar competition and government-set pricing.

V

Value Assessment

ICER evidence reports, health benefit price benchmarks, budget impact analyses, QALY debates, and how value assessments shape real-world coverage decisions.

This week’s digest

Every edition includes top story deep-dives, categorized intelligence briefs, a data snapshot, and a competitive positioning heatmap.

PBM delink signed into law · 340B Rebate Pilot vacated · ICER sets cytisinicline benchmark · Express Scripts removes brand Stelara

The Consolidated Appropriations Act of 2026 delivers the most significant PBM reform in a decade, delinking Part D compensation from rebates effective 2028. Meanwhile, a federal court vacated the 340B Rebate Pilot and ICER published its cytisinicline value assessment ahead of a June PDUFA — pricing corridors that will test launch discipline in a cost-sensitive category…

PBM Reform 340B Litigation ICER Assessment Biosimilar Formulary GLP-1 Access
Read the full edition →

Built for the people who
build access strategies

  • Market access and HEOR directors at pharmaceutical manufacturers who need to track PBM shifts, ICER benchmarks, and competitor coverage wins to inform payer value dossiers and launch pricing
  • Formulary and pharmacy directors at health plans, PBMs, and IDNs who manage coverage decisions across specialty, biosimilar, and government-negotiated categories
  • Market access consultants at advisory firms who need weekly competitive intelligence to support client pricing, reimbursement, and payer engagement strategy
  • Specialty pharmacy executives navigating biosimilar transitions, 340B contract dynamics, and limited distribution network changes
  • Government affairs and policy teams tracking legislative and regulatory developments across PBM reform, 340B, IRA implementation, and drug pricing proposals

What we’ve been tracking

Policy

CAA 2026 delinks Part D PBM compensation from rebates — the structural shift market access teams need to model now

Analysis of how the law changes contracting economics for 2027-2028 launches, which PBMs are adapting fastest, and why commercial formularies remain untouched.

340B

Federal court vacates 340B Rebate Pilot — but the reform debate is far from over

Why the Maine ruling preserves upfront discounts temporarily while HRSA’s RFI, the D.C. Circuit case, and the proposed HRSA-to-CMS transfer reshape the program’s future architecture.

Formulary

Express Scripts’ 2026 exclusions carry 2x the financial impact of 2025 — led by biosimilar-for-brand specialty swaps

Brand Stelara, Actemra, and Soliris removed. PBM private-label biosimilars dominate formulary placement. What this means for manufacturer launch and lifecycle strategy.

Pricing

GLP-1s are cost-effective but population-inaccessible — ICER data exposes the defining market access paradox

Zepbound at $53K/QALY clears every threshold, yet fewer than 1% of eligible patients can access treatment at current net prices. What breaks the impasse?

15 minutes a week.
Every development that
affects access strategy.

Free weekly digest delivered Friday mornings. Sourced, analytical, written for professionals who make pricing, coverage, and reimbursement decisions.

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Drug Channels Institute · AJMC · ICER · 340B Report · Pharmaceutical Commerce · Managed Healthcare Executive · Formulary Watch · FiercePharma · BioPharma Dive · STAT News · CMS · HRSA · FDA · Company SEC filings · PBM formulary updates · PSG Consults · DLA Piper · Sidley Austin · Congressional Budget Office · State legislative databases

Independent analysis for pricing, coverage, and reimbursement professionals.