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…
This is the first in a series of legislative updates from Mike Strahan, Senior Vice President of Strategy at Gateway Health Partners. After more than two decades as a healthcare attorney, including time spent leading legal strategy and operations for a major PBM and helping launch Ascent Health Services, I’ve had a front-row seat to…
By A. Azim Bari, PharmD, MBA, BCPS, Chief Clinical Officer for Gateway Health Partners In the nearly two decades since their introduction to the market, there has been a steady increase in the number of glucagon-like peptide-1 (GLP-1) agonist class products. Most recently, a newer generation of GLP-1s that includes semaglutide (Ozempic, Rybelsus and Wegovy)…
Despite a slight improvement in recent months, drug shortages remain a persistent challenge across the U.S. healthcare system. As of April 2025, there were 270 active shortages, according to the American Society of Health-System Pharmacists (ASHP). More than 40% of those began in 2022 or earlier, signaling more long-term issues and not just temporary setbacks….
Written By Jen Proudfit, Executive Director of Sales and Business Development Rebate reconciliation is essential for ensuring you’re not leaving money on the table in your pharmacy rebate agreements. However, the process can sometimes become complex without clarity and a structured approach. To simplify the process, start by asking these key questions: What Claims Qualify…
Written By Jen Proudfit, Executive Director of Sales and Business Development Pharmacy rebate management can be a game-changer for managing drug costs and optimizing savings, with some rebate values for brand-name drugs exceeding 30-50% of list price. Yet, many organizations neglect to regularly review their rebate payments to ensure they align with their contract terms….