Dr. Jeni Hayes, Senior Clinical Manager, Strategic Clinical Intelligence, and Dr. Heather Pace, Senior Clinical Manager, Ambulatory Care, join host Carolyn Liptak to discuss the Vizient Winter 2026 Spend Management Outlook, with a focus on pharmacy projections and key changes from prior outlooks. The episode also covers ambulatory care and self-administered drugs, biosimilar therapeutic insights, and dynamic pharmacy market forces.
Senior Clinical Manager, Strategic Clinical Intelligence
Vizient Spend Management Solutions
Senior Clinical Manager, Ambulatory Care
Vizient Center for Pharmacy Practice Excellence
Carolyn Liptak, MBA, BS Pharm
Pharmacy Executive Director, Regulatory Compliance & Revenue Integrity
Center for Pharmacy Practice Excellence (CPPE)
Announcer welcomes listeners to Verified Rx, produced by the Vizient Center for Pharmacy Practice Excellence.Host Carolyn Liptak, Pharmacy Executive Director at Vizient, introduces the Winter 2026 Spend Management Outlook (SMO).Focus areas:Pharmacy inflation projectionsAcute vs ambulatory care trendsProvider-administered vs self-administered drugsBiosimilar therapeutic insightsDynamic pharmacy market forces shaping 2026–2030Guests: Jeni Hayes, Senior Clinical Manager, Strategic Clinical Intelligence Heather Pace, Senior Clinical Manager, Ambulatory Care01:09 — What Is the Spend Management Outlook (SMO)?
Biannual Vizient publication projecting price trends across healthcare spend categories.Pharmacy headline:Inflation slightly lower than last editionTotal spend still rising, driven by utilization growth and new technologies01:49 — Top-Line Pharmacy Inflation Projection
2.84% projected drug inflation for purchases between July 2026 – June 2027.Down from 3.35% in the prior edition.Based on October 2024 – September 2025 wholesaler data.Heavily weighted toward highest-spend drugs.Contracted products show lower inflation; non-contract drugs still ~70% of spend.02:45 — Inflation by Site of Care
3.03% projected inflationDriven by:SugammadexKcentraClotting factors2.85% overall, but with key divergence:Provider-administered drugs: 3.35%Self-administered drugs: 2.43%04:02 — Provider-Administered Drugs: What’s Driving Growth
Oncology infusions are the main drivers.Key agents:KeytrudaDarzalex FasproContinued growth due to:Expanded indicationsIncreased outpatient infusion utilizationOncology split by site of care:Inpatient: High-cost CAR T (e.g., Yescarta)Outpatient: Infusions, bispecifics, emerging cellular therapiesEmphasizes importance of site of care strategy.05:14 — Self-Administered Drugs: Utilization Over Inflation
Five key drivers:Autoimmune / inflammatory: Skyrizi, Dupixent, RinvoqDiabetes / metabolic / weight loss: Ozempic, Wegovy, Mounjaro, ZepboundSpend growth fueled by:Media exposureExpanded indicationsIncreased patient demandOpportunity for:Retail & specialty pharmacy optimizationMargin capturePatient support (adherence, counseling, benefits investigation)06:45 — New Section: Dynamic Pharmacy Market Forces (2026–2030)
Seven strategic forces influencing pharmacy practice:
Growth in specialty and cell & gene therapiesExpansion of value- and outcomes-based contractingSiteofcare shifts toward ambulatory and homeDigital transformation & automationSupply assurance and resilienceExpanded pharmacist clinical scope & workforce modelsRegulatory and policy efforts to lower drug prices340B changesIRA Medicare Part D negotiations09:37 — Practical Takeaways for Pharmacy Leaders
Use 2.84% inflation as a baseline — then customize using Vizient Pharmacy Analytics.Leverage segmented views to prioritize:Acute vs ambulatory strategiesProvider-administered vs self-administered drugsIdentify top spend movers and align them with long-term market forces.Consider:Specialty pharmacy expansionSite of care optimization10:48 — Biosimilar Therapeutic Insights: 2025 Recap
Shift from biosimilar approval to active adoption management.Ustekinumab (Stelara) as defining example:Multiple biosimilarsUptake driven by payer and PBM strategyUtilization varies widely based on:Formulary designBenefit alignmentBiosimilars now actively steered, not passively adopted.11:50 — Why Stelara Was a Turning Point
PBM-developed, private-label biosimilars drove adoption.Net cost and copay design outweighed:Interchangeability statusManufacturer differentiationSets expectations for future biologic launches.12:25 — Operational Impact for Health Systems
Expect payer-specific product preferences.Frequent switching will become routine.Key considerations:Siteofcare mandatesProduct presentationSupply chain logisticsBilling & reimbursement complexityClinical barriers are decreasing; workflow flexibility is critical.13:09 — What to Expect From Biosimilars in 2026
Faster adoption timelinesEarlier payer-driven switchingFewer preferred productsLess reliance on reference product trial periods13:45 — Biosimilars With Major 2026 Impact
Eylea — multiple launches expected post-litigationXolair — expansion into asthma/allergy and retail specialtyPerjeta — oncology pathway disruption expected late 2026 / early 202715:01 — 2025 Biosimilars Impacting 2026
Ustekinumab (Stelara): broader formulary shiftsDenosumab (Prolia, Xgeva): full year of impact; all interchangeableEculizumab (Soliris): first rare-disease biosimilar entry15:58 — FDA Biosimilar Guidance to Watch
Late-2025 FDA guidance:Reduced reliance on clinical efficacy trialsGreater emphasis on analytical similarityAims to:Reduce development costAccelerate market entry16:26 — Interchangeability: Where Things Are Headed
Moving toward expectation that all biosimilars are interchangeable.Shifts responsibility to:PayersHealth systemsPharmacists managing transitions and education17:17 — Biggest Shift in the Biosimilar Landscape
Faster launchesLarger scale adoptionPayer strategy more influential than timing of approvalSuccess depends on:Formulary fitChannel alignmentOperational simplicity17:41 — Final Biosimilar Insight
Biosimilar strategies must be molecule-specific.One-size-fits-all approaches are no longer effective.18:13 — Final Thoughts on the SMO
Inflation projections are a starting point.Leaders should:Focus on top spend drugsUnderstand siteofcare and specialty driversTranslate projections into actionable budgetsWinter 2026 Spend Management Outlook available on Vizient’s SMO Hub.Includes current and prior editions and related insights.Carolyn thanks Jeni and Heather.Reminder to subscribe, like, and share feedback.Verified Rx is produced by the Vizient Center for Pharmacy Practice Excellence.Vizient Spend Management Outlook webpageVizient Winter 2026 Spend Management OutlookVizient Biosimilars Therapeutic Insights