The pharmaceutical industry and pharmacy benefit managers (PBMs) both play essential roles in getting medicines to patients. But years of complexity and competing incentives have strained the system.
Our CEO Mark Thierer recently authored an article in Pharmaceutical Commerce, noting how meaningful progress will come not from price controls, but from a modernized model built on transparency and aligned incentives.
Why Transparency Beats Price Controls
Price controls often miss the real affordability challenges: shifting benefit designs, inventory costs, rebates and patient out‑of‑pocket exposure. Mark explains that what the system needs instead is functional transparency, giving every stakeholder real-time visibility into net price and cost share so competition can bring prices down without slowing innovation.
The Case for Evolving PBMs
PBMs still serve critical functions, but only when they operate with:
- line‑of‑sight to net pricing
- transparent administrative fees
- outcomes-based performance
These principles help improve time to therapy, adherence and overall affordability.
Where Marketplaces Make the Difference
Technology-enabled marketplaces now allow each prescription to be routed to the lowest‑cost, highest‑value channel in real time. This model drives lower net prices, reduces abandoned scripts and speeds up access for patients, all while creating cleaner contracting and better visibility for manufacturers and payers.
A Practical Path Forward
In his article, Mark outlines a simple playbook for pharma:
- contract for transparency
- co-design benefit pathways
- route prescriptions with intent
- measure meaningful access and adherence metrics
- pilot and scale proven models
The private sector is already moving faster than policy, showing that aligned incentives can lower costs and improve outcomes without waiting for legislative reform.
Read the full Pharmaceutical Commerce article.
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EVERSANA employs a team of over 6000 professionals across 20+ locations around the world. From industry-leading patient service and adherence support to global pricing and revenue management, our team informs the strategies that matter…