Market Access Intelligence — July 3, 2026
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Medicare’s GLP-1 Bridge opened July 1 with $50 copays — the program’s first-ever obesity coverage for an estimated 3.8 million beneficiaries — on the same day CVS Caremark executed a massive biosimilar formulary shift, moving brand Stelara, Tysabri, and Soliris to biosimilar alternatives at $0 out-of-pocket.
Today’s top developments:
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What to Watch
- Bridge operational rollout — Humana prior-authorization turnaround times, dispensing volume (especially for the newly approved oral Foundayo), and primary-care prescriber uptake will drive actual Q3 2026 patient starts more than pricing, and will shape whether CMS extends the program beyond December 31, 2027.
- 4th Circuit en banc reconsideration — A reversal would strip PhRMA of its only favorable contract-pharmacy circuit and dampen Supreme Court certiorari incentives; an affirmance would harden the split against the 5th, 8th, and 9th Circuits. Oral arguments are possible in Q4 2026, with a ruling by mid-2027.
- MFN deal follow-through — Watch whether the Pfizer, AstraZeneca, and EMD Serono agreements show the same volume-without-price-cut gap STAT documented on GLP-1s, and whether commercial employers cite the pattern as leverage in their own PBM contracting cycles.
- CVS biosimilar switch rates — Multiple sclerosis (Tysabri) and rare-hematology (Soliris) populations are clinically more complex than the 96% Humira transition benchmark; resistance to switching in these classes is the key metric for the private-label biosimilar model’s reach.
This brief highlights the edition’s top stories. Read the full July 3, 2026 edition → for all stories and analysis — or browse the Market Access archive.
