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 Chapters00:04 Welcome and intro to Jayson Slotnick02:04 2025 recap: IRA, CMS, affordability pressures02:45 Predictable vs unpredictable: Part D redesign, MFN momentum06:22 IRA vs MFN: separate lanes, real-world collisions09:12 Voluntary MFN models, IRA is not voluntary12:24 Employer net pricing and direct purchasing trends16:30 Affordability, hospital costs, and 340B dynamics18:57 FDA’s role: competition, generics, biosimilars, faster approvals23:22 2026 predictions: what we know is coming29:06 Stay current, stay calm, stay focused31:51 Commercial market changes and employer leverage39:33 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/.