Specialty drug benefit design isn't just one decision — it triggers a domino effect impacting employer and health plan costs, patient access, care delivery and patient cost-sharing. In this episode, we unpack PSG’s latest research on how employers and health plans are rethinking specialty strategies amid rising pressure: cost management as a top priority, movement toward rebate alternatives, shifting site of care models, and evolving approaches to affordability and utilization management. Our guests break down where the biggest shifts are happening, what’s still missing, and how smarter benefit design can create better outcomes across the healthcare system.

• PSG (Pharmaceutical Strategies Group)
• 2025 Trends in Specialty Drug Benefits Report
• Specialty Drugs
• Drug Utilization
• PBM (Pharmacy Benefit Manager)
• Copay Assistance (Maximizers & Accumulators)
• Drug Rebates
• Drug “Carve Outs”
• Value-Based Agreements
• Utilization Management
• Step Therapy
• Biosimilars
• Site-of-Care

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In this episode, we interview Brian Reid, the founder of Reid Strategic and the creator and editor of our favorite industry newsletter, the Cost Curve. Brian shares his journey to create the Cost Curve and how he navigates the onslaught of information to identify the most important issues of the day. We also get his take on what he calls the highest “importance-to-attention” healthcare stories, highlighting critical topics that are undercovered related to their significance. We also get the opportunity to understand his perspectives on the threats to innovation, the risks to patient affordability programs, and what all of us should be doing to be better healthcare consumers.

• Brian Reid- Reid Strategic
• Cost Curve Newsletter
• Martin Shkreli & Daraprim
• BioPharma Dive: Biotech and Pharma Industry News
• GLP-1s
• Net Price– “a drug’s net price equals the actual revenues that a manufacturer earns from a drug after rebates, discounts, and other reductions” Source: Drug Channels
• Armamentarium
• Pharmacy Benefit Managers (PBMs)
• Mark Cuban Pharmacy
• Psuedo-Generic Medication
• CVS Cordavis
• Quallent
• Nuvalia
• Biosimilars
• Lilly Direct
• Novo

• 340B Drug Pricing Program

• Copay maximizers
• AFPs

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In this episode, we explore the complex and often debated concept of value in prescription drugs. They discuss how different stakeholders—payers, manufacturers, providers, regulators, and patients—define value, and how methodologies like health technology assessments (HTA) and cost-effectiveness analyses shape drug pricing and access. With insights from leading experts, the conversation examines the controversies surrounding value-based pricing, including the role of real-world evidence, quality-adjusted life years (QALYs), and innovation incentives. Can we strike a balance between affordability, innovation, and patient access? And what does the future hold for value-based drug pricing in the U.S.? Tune in for a deep dive into one of the most critical issues in healthcare today.

• Daniel Ollendorf, Chief Scientific Officer and Director of HTA Methods and Engagement

• Lou Garrison, Professor Emeritus at University of Washington CHOICE

• Institute for Clinical and Economic Review (ICER)
• FDA
• GLP-1 Drugs
• Medicare
• Biosimilars
• Generics Versus Biosimilars
• PBMs (Pharmacy Benefit Managers)

• 340B Drug Pricing Program

Questions or comments?
Email us at comments@prescriptionforbetteraccess.com.
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