AH104 - Biosimilars, GLP-1s, PBM Reform, and Other 2026 Pharmacy Drivers, with Bridget Mulvenna

On this episode of the Astonishing Healthcare Podcast, we sit down with return guest Bridget Mulvenna, Vice President of National Business Development at Judi Health, to break down the biggest pharmacy drivers of 2026. Bridget offers insights into how plan sponsors and benefits brokers and consultants can strategically evaluate pharmacy benefit managers (PBMs) by looking beyond unit costs and focusing on drug mix - formulary decisions and the shift to biosimilars, prior authorization approval rates, the generic dispensing rate (GDR), and much more.The discussion covers the growing need to understand what challenges employer plan sponsors face, and why bringing a consultative approach to the table to help solve them is so important. How will moving to a biosimilar-first approach lower net drug costs for plan sponsors? How can a plan cover GLP-1s given their evolution and greater price transparency, expanding clinical indications, and direct-to-plan pricing models? And of course, Bridget shares her views on the sudden acceleration of state and federal PBM reform. As new legislation forces the industry to adapt, plan sponsors must seek forward-thinking platforms already aligned with the changes to provide better pricing and care for members.HighlightsBridget emphasizes the financial advantages of adopting a biosimilar-first approach, which can significantly lower net drug costs for plan sponsors despite smaller rebate checks.GLP-1s are transformative medications - price transparency, expanding clinical indications, and direct-to-plan pricing models will influence future plan designs.Evaluating PBMs beyond unit costs is critical: formulary management, prior authorizations, and other clinical programs have the greatest impact on total pharmacy spend.The rapid acceleration of state and federal PBM reform is astonishing, and alignment with future proof organizations is essential, because there's more to come.Related Content6 recommendations for PBM procurement and Rx benefits optimizationAH102 - PBM Reform Update: Health Policy Changes Slowly, Until it Doesn't, with Lloyd FioriniReplay - PMPM vs Clinical Guarantees: A Pharmacist and an Actuary Explain How to Create Predictability Around Pharmacy SpendAH064 - Empowering Plan Sponsors: Data Access & Analysis, with Bridget MulvennaFor more information about Judi Health and this episode, please visit Judi Health - Insights.