Direct-to-consumer (DTC) pricing for medications is making a splash. With DTC, drug manufacturers sell medications directly to patients instead of through a retail pharmacy or pharmacy benefit manager (PBM). This is a shift from the traditional pharmacy model. Some drugs, including those for weight management, now have a DTC model. Eli Lilly & Co. and…
The first biosimilar was approved in the U.S. in 2015. And now, just over 10 years later, the U.S. Food & Drug Administration (FDA) has approved an additional 81 biosimilars. In 2025 alone, the FDA approved 18 new biosimilars for a range of indications. However, only 73% of those approved biosimilars have been launched as of September 2025. Last year, the U.S. market size for biosimilars was estimated to be $22.59 billion….
What’s ahead in the GLP-1 market in 2026 The obesity rate has been increasing over time in the U.S. From August 2021 to August 2023, about 40% of American adults were considered obese. A recent study shows that these rates will continue to rise for about 20 more years. Complications related to obesity include heart…
From IRA implementation to the impacts of AMP Cap and biosimilar adoption, here are five market trends Gateway Health Partners is keeping an eye on as we head into 2026 and how we’re helping clients stay ahead as the market continues to evolve.
A recent headline announcing plans to transition commercial clients to a “rebate-free” model, passing previously negotiated drugs savings directly to members at the point of sale, marks yet another potential shift in the pharmacy landscape. The new proposed model underscores how quickly the industry is continuing to evolve and could reshape how plan sponsors, payers, employers, health plans, and health systems define value in 2026…
Beyond Diabetes and Obesity: The Expansion of GLP-1 Medications Glucagon-like peptide-1 (GLP-1) medications have revolutionized the treatment of diabetes and obesity, but their impact is rapidly broadening. Recent research and regulatory approvals reveal that GLP-1s may offer hope for a range of other health conditions, some of which might surprise you. Metabolic dysfunction-associated steatohepatitis (MASH)…
As the rebate landscape evolves, with biosimilars gaining traction and legislation reshaping pricing dynamics, staying ahead means having the right technology in place. The right tools can change everything, and Gateway Health Partner’s ProOptimizer is built to help you succeed. From complexity to clarity. ProOptimizer exists to help clients simplify their reporting by breaking down…
Discover how ProOptimizer can simplify complex rebate management with accurate, streamlined tools to help save time and optimize results. At Gateway Health Partners, our goal is to make the complex world of pharmacy rebate and formulary management easier to navigate. To do this our team of industry veterans and experts focus on building tools that…
By: Mike Strahan On July 16, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule that has the potential to significantly impact how 340B drugs are handled under Medicare Part D, and by extension, how pharmaceutical rebates are calculated. So, what does that mean? For context: beginning January 1, 2026, CMS is…