Featured Guest: Stan Mehr — Editor of Biosimilars Review & Report, healthcare journalist, and market strategist with decades of expertise in biosimilars, pharma reform, and drug pricing dynamics. https://biosimilarsrr.com/about/

In this critical episode, we explore the evolving biosimilars landscape, pricing transparency, and the tangled web of pharmacy benefit managers (PBMs) with biosimilars expert Stan Mehr. From inflated rebates to private-label manipulation, Stan sheds light on how PBMs and policy changes under the Inflation Reduction Act are reshaping access to lower-cost drugs.

If you're an employer, payer, or pharma manufacturer navigating the biosimilar space, this episode is your roadmap to understanding where opportunity lives—and where it's quietly being suffocated.

Key Topics Covered:

• The $25B+ in biosimilar savings… and why it could vanish
• Why employers aren’t seeing those savings—and how PBMs control the game
• The problem with private-label biosimilars
• How the Inflation Reduction Act could unintentionally collapse biosimilar pipelines
• What fiduciary responsibility means for employer health plans
• Long-term predictions: who survives, who exits, and who profits

Hosted by:
Michael Navin & Dr. Randy Vogenberg

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/.

Music by:
Hanu Dixit, https://www.youtube.com/hanudixit

Join us as we examine the heart of the healthcare affordability crisis.

In this episode, Michael Navin and Randy Vogenberg, PhD discuss the hidden costs exacerbating healthcare access and decision-making.

Listen in as they set the stage for a compelling conversation about healthcare's lack of price transparency and how this obscurity fuels an ongoing affordability crisis.

Key Discussion Points:

• Examining how opaque pricing impacts patient decisions and the healthcare system.
• Insights into technological advancements that could revolutionize how patients and plan sponsors view and manage healthcare expenses.
• Discuss the pivotal role of price transparency in improving healthcare outcomes and reducing unnecessary expenditures.

Hosted by:
Michael Navin & Dr. Randy Vogenberg

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/.

Music by:
Hanu Dixit, https://www.youtube.com/hanudixit

Join Michael Navin in this insightful brief episode of the "Ask The Expert" series on The Only Healthcare Podcast.

In this episode, Michael dives into President Trump's recent executive order to enforce drug price transparency across the United States. Issued on February 25, 2025, this mandate directs federal agencies to ensure that hospitals and insurers disclose actual healthcare costs, building on a 2019 initiative.

Episode Highlights:

• Understanding the Executive Order: A detailed explanation of the new directive and its expectations from healthcare providers and insurers.
• Impact on PBMs and Carriers: Explore how Prescription Benefit Managers and health insurers must adjust to new regulations that demand greater transparency and how this could reshape their operations and pricing strategies.
• Potential Changes for Consumers: Discuss how this shift towards transparency could empower patients, enabling more informed decisions and potentially lower costs.
• Industry Reactions: Insight into how different stakeholders within the healthcare system might respond to these changes, including potential challenges and benefits.
• Future of Healthcare Costs: Considerations on how this policy could influence the broader healthcare pricing and access landscape in America.

Tune in to understand how this pivotal policy could affect you, whether you're a healthcare professional, industry stakeholder, or a concerned citizen. This episode is a must-listen for anyone interested in the intersection of policy and patient care.

Hosted by:
Michael Navin & Dr. Randy Vogenberg

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/.

Music by:
Hanu Dixit, https://www.youtube.com/hanudixit

Join hosts Michael Navin and Randy Vogenberg, PhD as they discuss more on the pivotal healthcare policy changes under the Trump administration. This episode delves into the fresh legislative adjustments affecting PBMs, the impacts of new Medicare reports, and advancements in gene therapy and R&D. It also discusses the broader implications of these policies on healthcare costs, accessibility, and the expansion of IVF coverage. Tune in for a critical analysis of what these changes mean for public and industry stakeholders and how they align with the "Make America Healthy Again" agenda.

Episode Highlights:

• Introduction to Current Healthcare Policies: Explore the critical changes brought about by the new administration, including a focused look at the fresh legislative and administrative shifts in healthcare policy.
  
  
• Detailed Look at Commercial Insurance and Government Programs: Delve into the specifics of recent legislative efforts around Pharmacy Benefit Managers (PBMs) and the implications of the latest reports from CMS and OIG on Medicare and healthcare costs.
  
  
• The Role of R&D and New Therapies: Discuss the ongoing advancements in gene therapy and other R&D improvements, examining how they are poised to transform healthcare delivery.
  
  
• Impacts of Policy on Healthcare Costs and Accessibility: Analyze how these policies are intended to shift costs between government and private programs, emphasizing out-of-pocket patient expenses.
  
  
• IVF Coverage Expansion Discussion: Highlight the recent policy developments related to In Vitro Fertilization (IVF), including expanding coverage and its potential implications on healthcare insurance and patient access.
  
  
• Future Directions and Continued Debates: Consider the expected developments in healthcare policy, including the potential impacts of the Make America Healthy Again agenda and the expanded use of novel therapies under the new FDA leadership.

Hosted by:
Michael Navin & Dr. Randy Vogenberg

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/.

Music by:
Hanu Dixit, https://www.youtube.com/hanudixit

Welcome to another insightful episode of "The Only Healthcare Podcast," where we unpack the demand for change in risk management for employers within commercial insurance and benefit design. In this episode, our host, Dr. Randy Vogenberg, is joined by Rajiv Sood, the founder of Sood Health Advisors. With over 30 years of experience spanning healthcare, clinical settings, insurance, and InsureTech, Rajiv brings a wealth of knowledge and a unique perspective on managing financial risks in healthcare.

In this episode, you will learn:

• Innovative Risk Management: Explore how innovative financial strategies can mitigate risks for employers, touching on the significance of tier five initiatives.
• Demand for Benefit Design Innovation: Explore the transformative impact of innovative benefit designs on equitable access and whole-person care, addressing the evolving needs of patients with rare diseases.
• Essentials of Reinsurance: Delve into the function and importance of reinsurance in the healthcare sector, highlighting its role in mitigating financial risks associated with benefit designs for rare diseases.
• Challenges of Asynchronous Timing: Unpack the issues stemming from asynchronous timing in stakeholder collaborations and discuss strategic approaches to enhance synchronization and efficiency among all parties involved in healthcare management.
• Future of Healthcare Financing: Discussion on the future landscape of commercial insurance and how upcoming changes will affect stakeholders across the board.

Join us as we unpack these complex topics, providing valuable insights for employers, HR professionals, C-suite executives, and insurance experts. Connect with Rajiv on LinkedIn for assistance in reinsurance and with Randy on LinkedIn for aid in benefit design and stakeholder collaboration.

Hosted by:
Michael Navin & Dr. Randy Vogenberg

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/.

Music by:
Hanu Dixit, https://www.youtube.com/hanudixit

Welcome back to "The Only Healthcare Podcast." This episode delves deep into the evolving landscape of healthcare policy in 2025. Hosted by Randy Vogenberg, PhD we are joined by special guest Jayson Slotnik, a seasoned health policy expert from Health Policy Strategies, LLC.

Jayson Slotnik is a prominent figure in health policy consultation, with over 15 years of experience at Health Policy Strategies, LLC. He works with government agencies, manufacturers, patient advocacy groups, and healthcare providers to navigate and influence significant policy changes. His expertise includes advocating for better patient access and developing commercial strategies. Jayson's approach combines his legal background with a deep understanding of healthcare operations and policy impacts.

Key Insights:

• Understanding New Policies: Jayson provides an in-depth look at how upcoming policy changes, particularly concerning PBMs and Medicare, could reshape the industry.
• Forecasting Commercial Insurance Trends: Discussion on how commercial insurance may adapt to regulatory changes and what businesses might expect in terms of cost management and policy impacts.
• Future Outlooks: Speculation on major healthcare topics like chronic disease management, Medicare negotiations, and the implications of AI on healthcare services.

Hosted by:
Michael Navin & Dr. Randy Vogenberg

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/.

Music by:
Hanu Dixit, https://www.youtube.com/hanudixit

Join us on the "Only Healthcare Podcast" as we dive into the transformative discussions from the recent Clinical Pathways Congress in Boston with Dr. Randy Vogenberg. Discover the latest trends in clinical practice, payment models, and policy shaping healthcare's future.

What You’ll Learn:

• Insights on Clinical Practice Changes: Understand the new dynamics in clinical pathways affecting patient care and how healthcare providers are adapting to these changes.
• Impact of Benefit Design on Care: Explore how benefit design influences patient access to treatments, particularly in oncology, and what it means for future coverage.
• Navigating Payment Innovations: Learn from Dr. Vogenberg about the challenges and solutions in securing payment for quality care amidst healthcare transformations.
• Future of Oncology Care: Get an inside look at how oncology care evolves through practice management and standardization innovations.
• Virtual Care and Home-Based Models: Delve into the shift towards home-based cancer care and its implications for patient outcomes and healthcare delivery.

Hosted by:
Michael Navin & Dr. Randy Vogenberg

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/.

Music by:
Hanu Dixit, https://www.youtube.com/hanudixit

In this episode of The Only Healthcare Podcast, co-hosts Michael Navin and Dr. Randy Vogenberg, PhD, welcome esteemed guest Tonya Vyhlidal, a senior consultant with over 25 years of experience in building comprehensive health and wellness programs. Together, they dive deep into the components of employer and biopharmaceutical manufacturer collaboration and the benefits it holds for all stakeholders involved.

Key Highlights:

• The Current Landscape: Understanding why collaboration between employers and manufacturers remains fragmented and what obstacles exist that hinder these essential partnerships.
• The Role of Stakeholders: How employers, benefit consultants (EBCs), and manufacturers fit into the complex healthcare ecosystem and the significant influence each has on outcomes.
• Access and Affordability: Why direct collaboration can lead to enhanced access to medications, more informed decisions, and cost savings that benefit both employers and employees.
• Whole Person Care: The shift towards patient-centered care and the importance of aligning clinical pathways and treatment plans for holistic health outcomes.
• Forecasted Outlook: The potential integration of medical and pharmacy benefits and how technology can act as a catalyst for innovation and improved access.

Tonya shares her firsthand experiences on how employer-initiated collaborations can yield financial, cultural, and operational benefits. This episode is a must-listen for employers, benefit consultants, and manufacturers looking to navigate and innovate within a complex system that demands strategic partnerships.

Hosted by:
Michael Navin & Dr. Randy Vogenberg

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/.

Music by:
Hanu Dixit, https://www.youtube.com/hanudixit