The Market Access Terrain

Pharmaceutical Commerce’s December issue is a special one for various reasons. For one, it represents our final publication of the year, but it also showcases one of several new topics that the brand introduced in 2025 for deep exploration.

This month’s cover feature, authored by Editor Emeritus Nick Basta, offers an in-depth dive into the current landscape for market access, one that is being altered by many forces these days across the industry—from policy to technology. And as Basta outlines, the benefits from AI in navigating this terrain are increasing. He notes as well that even the term “market access” has evolved, contending that it “has become a catchword over the past decade in parallel with the rise of another factor in drug commercialization: the dominance of pharmacy benefit managers (PBMs).” The standard process, Basta adds, has been: “Manufacturers provide rebates to PBMs with the expectation of favorable placement on the PBMs’ formularies, which, in turn, increases the likelihood that patients will receive that therapy.”

In fact, according to IQVIA, 52% of the wholesale acquisition cost, which is considered one of the best approximations of the “list price” of medicines sold in the US, is taken up by rebates to PBMs and other payers and is anticipated to grow over the next four years.

Pivoting to other coverage this month, and speaking of IQVIA, the company’s practice leader of pharmacovigilance technology solutions, Updesh Dosanjh, shares the value of AI-powered drug safety methods. He calls its integration a must, especially for AI’s ability to boost detection and decrease risk while strengthening commercial performance. The presence of inaccurate or inconsistent reporting, overlooked signals, or delays, he believes, can cause “costly setbacks that ripple across development timelines to delay market access and erode long-term trust.”

Shifting gears to a column highlight this month is the introduction of a new series from IntegriChain’s Bill Roth that he calls “The Great Pharma Repricing.” Coming off his popular six-part “Popping the Gross-to-Net (GTN) Bubble” series, the new set of articles will examine the fragmenting market in pricing and channel strategy and its emerging payer dynamics. According to Roth, the US drug market has evolved into three distinct archetypes—commercial, government, and self-pay—each with unique incentives and compliance implications.

As always, thank you for reading, and I wish you and your loved ones a wonderful holiday season and a happy New Year.

— Mike Hennessy Jr is chairman and CEO of MJH Life Sciences.