ONLY HEALTHCARE
The “Only Healthcare” podcast reveals shocking truths about the healthcare industry. Why are US Healthcare costs and risks so high? How will new technologies impact the system? What are the challenges in accessing new therapies and treatments? What is happening with Big Pharma and how do they influence other stakeholders in healthcare? Hosted by industry experts Michael Navin and Dr. Randy Vogenberg, to provide you with actionable and inspirational insights on how we can improve healthcare cost, care and accessibility for all.
Hosted by:
Michael Navin & Dr. Randy Vogenberg
Michael's LinkedIn
https://www.linkedin.com/in/michael-navin-7411388/
Randy's LinkedIn
https://www.linkedin.com/in/randyvogenberg/
Sponsored by:
Only Healthcare is sponsored by Peek and the Institute for Integrated Health.
Peek: Peek is reimagining access through innovation, technology, connectivity, and partnership. Peek offers a comprehensive and unique suite of solutions to help clients improve access and affordability for prescription drugs.
The Peek Meds Marketplace is one of Peek’s differentiated offerings that gives employers a revolutionary new approach to controlling runaway prescription costs for their employees by providing unprecedented transparency, simplicity - and cost savings. The Peek Meds Marketplace aggregates cash discount cards, manufacturer copay offset programs, and an employee’s insurance information to provide a holistic and personalized view of prescription price options. This easy-to-use platform offers a one-stop-shopping experience for prescription drugs.
Peek’s team has decades of experience in the pharmaceutical industry and offers various services to biopharma manufacturers, brokers, benefits consultants, third-party administrators and employers. Visit peekmeds.com to learn more.
Institute for Integrated Health (IIH):
Healthcare benefits, insurance coverage regulations, and business in the healthcare industry can be complicated. At IIH, Dr. Randy Vogenberg and his team understand these unique challenges and provide strategic guidance customized to every client. To help overcome your unique challenges, IIH delivers education, planning, and advisory on market trends and U.S. healthcare market intelligence. The firm’s decades of proven success are due to strategic collaboration with associates from the business, clinical, and scientific communities. Learn more by visiting https://iih-online.com/.
Music by:
Hanu Dixit, https://www.youtube.com/hanudixit
Disclaimer:
© 2025 Only Healthcare Podcast. All rights reserved.
This podcast and its content, including but not limited to audio recordings, images, and text, are the property of the Only Healthcare Podcast and are protected by international copyright laws. We appreciate all distribution and content sharing. Contact us at onlyhealthcarepodcast@gmail.com to access our media kits, provide feedback or inquire about guest participation. Thank you for listening.
ONLY HEALTHCARE
Ep 36 | Drug Pricing at the Center: IRA, MFN, and Employer Direct Purchasing in 2026
In this episode of the Only Healthcare Podcast, hosts Michael Navin and Dr. Randy Vogenberg welcome back Jayson Slotnick for a fast-moving year-in-review of 2025 and a grounded outlook for 2026. The conversation breaks down what changed through the Inflation Reduction Act implementation, why Most Favored Nation pricing keeps resurfacing, and how these policy forces could ripple across Medicare, Medicaid, and employer-sponsored coverage.
Jayson also explores how direct purchasing, transparent pricing models, and the shifting PBM landscape may affect affordability, access, and benefit design. From Part D redesign and underused smoothing to biosimilars, 340B dynamics, and the role of the FDA in driving competition, this episode connects the policy headlines to what employers, manufacturers, and plans should realistically watch next.
Key Topics
• 2025 recap: IRA implementation and Part D redesign
• Drug negotiation timelines and spillover effects
• Most Favored Nation pricing: what is voluntary vs mandatory
• Patient affordability: premiums, deductibles, out-of-pocket pressure
• Employer direct purchasing, net pricing, and PBM disruption
• Biosimilars, patent cliffs, and what 2027 could change
• 340B, hospital economics, and who really benefits from drug money
• FDA’s role: faster approvals, competition, and innovation
• 2026 watchlist: Part B negotiation list, CMS rules, ACA dynamics, CMMI models
Chapters
00:04 Welcome and intro to Jayson Slotnick
02:04 2025 recap: IRA, CMS, affordability pressures
02:45 Predictable vs unpredictable: Part D redesign, MFN momentum
06:22 IRA vs MFN: separate lanes, real-world collisions
09:12 Voluntary MFN models, IRA is not voluntary
12:24 Employer net pricing and direct purchasing trends
16:30 Affordability, hospital costs, and 340B dynamics
18:57 FDA’s role: competition, generics, biosimilars, faster approvals
23:22 2026 predictions: what we know is coming
29:06 Stay current, stay calm, stay focused
31:51 Commercial market changes and employer leverage
39:33 Wrap and where to follow OHP
Michael's LinkedIn
Randy's LinkedIn
Sponsored by:
Peek: A game-changing prescription shopping solution that allows its members to view all their prescription cost options across cash discount programs and their insurance in one easy-to-use platform. Peek is currently being offered to organizations to help both employees and plan sponsors save money on their prescription spend. https://peekmeds.com/.
Institute for Integrated Health (IIH): Health care benefits, insurance coverage regulations, and doing business in the healthcare industry can be complicated. At IIH, Dr. Randy Vogenberg and his team understand these unique challenges and provides strategic guidance customized to every client. To help overcome your unique challenges, IIH delivers education, planning and advisory on market trends, and U.S. health care market intelligence. The firm’s decades of proven success are due to strategic collaboration with associates from the business, clinical, and scientific communities. https://iih-online.com/.
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