February 04, 2026

Winter 2026 Spend Management Outlook

19 minutes

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.

Guest speaker: 

Jeni Hayes, PharmD, BCPS 

Senior Clinical Manager, Strategic Clinical Intelligence

Vizient Spend Management Solutions

Heather Pace, PharmD 

Senior Clinical Manager, Ambulatory Care

Vizient Center for Pharmacy Practice Excellence 

Host: 

Carolyn Liptak, MBA, BS Pharm

Pharmacy Executive Director, Regulatory Compliance & Revenue Integrity

Center for Pharmacy Practice Excellence (CPPE)

Vizient

Show Notes:

00:05 — Introduction

Announcer welcomes listeners to Verified Rx, produced by the Vizient Center for Pharmacy Practice Excellence.

00:14 — Episode Overview

Host Carolyn Liptak, Pharmacy Executive Director at Vizient, introduces the Winter 2026 Spend Management Outlook (SMO).

Focus areas:

Pharmacy inflation projections

Acute vs ambulatory care trends

Provider-administered vs self-administered drugs

Biosimilar therapeutic insights

Dynamic pharmacy market forces shaping 2026–2030

Guests:

Jeni Hayes, Senior Clinical Manager, Strategic Clinical Intelligence

Heather Pace, Senior Clinical Manager, Ambulatory Care

01:09 — What Is the Spend Management Outlook (SMO)?

Biannual Vizient publication projecting price trends across healthcare spend categories.

Pharmacy headline:

Inflation slightly lower than last edition

Total spend still rising, driven by utilization growth and new technologies

01:49 — 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

Acute Care

3.03% projected inflation

Driven by:

Sugammadex

Kcentra

Clotting factors

Ambulatory Care

2.85% 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:

Keytruda

Darzalex Faspro

Continued growth due to:

Expanded indications

Increased outpatient infusion utilization

Oncology split by site of care:

Inpatient: High-cost CAR T (e.g., Yescarta)

Outpatient: Infusions, bispecifics, emerging cellular therapies

Emphasizes importance of site of care strategy.

05:14 — Self-Administered Drugs: Utilization Over Inflation

Five key drivers:

Autoimmune / inflammatory: Skyrizi, Dupixent, Rinvoq

Diabetes / metabolic / weight loss: Ozempic, Wegovy, Mounjaro, Zepbound

Spend growth fueled by:

Media exposure

Expanded indications

Increased patient demand

Opportunity for:

Retail & specialty pharmacy optimization

Margin capture

Patient 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 therapies

Expansion of value- and outcomes-based contracting

Siteofcare shifts toward ambulatory and home

Digital transformation & automation

Supply assurance and resilience

Expanded pharmacist clinical scope & workforce models

Regulatory and policy efforts to lower drug prices

340B changes

IRA Medicare Part D negotiations

09:37 — 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 strategies

Provider-administered vs self-administered drugs

Identify top spend movers and align them with long-term market forces.

Consider:

Specialty pharmacy expansion

Site of care optimization

10:48 — Biosimilar Therapeutic Insights: 2025 Recap

Heather Pace highlights:

Shift from biosimilar approval to active adoption management.

Ustekinumab (Stelara) as defining example:

Multiple biosimilars

Uptake driven by payer and PBM strategy

Utilization varies widely based on:

Formulary design

Benefit alignment

Biosimilars 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 status

Manufacturer differentiation

Sets 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 mandates

Product presentation

Supply chain logistics

Billing & reimbursement complexity

Clinical barriers are decreasing; workflow flexibility is critical.

13:09 — What to Expect From Biosimilars in 2026

Faster adoption timelines

Earlier payer-driven switching

Fewer preferred products

Less reliance on reference product trial periods

13:45 — Biosimilars With Major 2026 Impact

Eylea — multiple launches expected post-litigation

Xolair — expansion into asthma/allergy and retail specialty

Perjeta — oncology pathway disruption expected late 2026 / early 2027

15:01 — 2025 Biosimilars Impacting 2026

Ustekinumab (Stelara): broader formulary shifts

Denosumab (Prolia, Xgeva): full year of impact; all interchangeable

Eculizumab (Soliris): first rare-disease biosimilar entry

15:58 — FDA Biosimilar Guidance to Watch

Late-2025 FDA guidance:

Reduced reliance on clinical efficacy trials

Greater emphasis on analytical similarity

Aims to:

Reduce development cost

Accelerate market entry

16:26 — Interchangeability: Where Things Are Headed

Moving toward expectation that all biosimilars are interchangeable.

Shifts responsibility to:

Payers

Health systems

Pharmacists managing transitions and education

17:17 — Biggest Shift in the Biosimilar Landscape

Faster launches

Larger scale adoption

Payer strategy more influential than timing of approval

Success depends on:

Formulary fit

Channel alignment

Operational simplicity

17:41 — 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 drugs

Understand siteofcare and specialty drivers

Translate projections into actionable budgets

18:40 — Resources

Winter 2026 Spend Management Outlook available on Vizient’s SMO Hub.

Includes current and prior editions and related insights.

18:58 — Closing

Carolyn thanks Jeni and Heather.

Reminder to subscribe, like, and share feedback.

Verified Rx is produced by the Vizient Center for Pharmacy Practice Excellence.

Links | Resources:

Vizient Spend Management Outlook webpage

Vizient Winter 2026 Spend Management Outlook

Vizient Biosimilars Therapeutic Insights

Subscribe Today!

Apple Podcasts

Spotify

YouTube

RSS Feed

...more

View all episodes

By Vizient Center for Pharmacy Practice Excellence

4.6

99 ratings

February 04, 2026

Winter 2026 Spend Management Outlook

19 minutes

Guest speaker: 

Jeni Hayes, PharmD, BCPS 

Senior Clinical Manager, Strategic Clinical Intelligence

Vizient Spend Management Solutions

Heather Pace, PharmD 

Senior Clinical Manager, Ambulatory Care

Vizient Center for Pharmacy Practice Excellence 

Host: 

Carolyn Liptak, MBA, BS Pharm

Pharmacy Executive Director, Regulatory Compliance & Revenue Integrity

Center for Pharmacy Practice Excellence (CPPE)

Vizient

Show Notes:

00:05 — Introduction

Announcer welcomes listeners to Verified Rx, produced by the Vizient Center for Pharmacy Practice Excellence.

00:14 — Episode Overview

Host Carolyn Liptak, Pharmacy Executive Director at Vizient, introduces the Winter 2026 Spend Management Outlook (SMO).

Focus areas:

Pharmacy inflation projections

Acute vs ambulatory care trends

Provider-administered vs self-administered drugs

Biosimilar therapeutic insights

Dynamic pharmacy market forces shaping 2026–2030

Guests:

Jeni Hayes, Senior Clinical Manager, Strategic Clinical Intelligence

Heather Pace, Senior Clinical Manager, Ambulatory Care

01:09 — What Is the Spend Management Outlook (SMO)?

Biannual Vizient publication projecting price trends across healthcare spend categories.

Pharmacy headline:

Inflation slightly lower than last edition

Total spend still rising, driven by utilization growth and new technologies

01:49 — 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

Acute Care

3.03% projected inflation

Driven by:

Sugammadex

Kcentra

Clotting factors

Ambulatory Care

2.85% 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:

Keytruda

Darzalex Faspro

Continued growth due to:

Expanded indications

Increased outpatient infusion utilization

Oncology split by site of care:

Inpatient: High-cost CAR T (e.g., Yescarta)

Outpatient: Infusions, bispecifics, emerging cellular therapies

Emphasizes importance of site of care strategy.

05:14 — Self-Administered Drugs: Utilization Over Inflation

Five key drivers:

Autoimmune / inflammatory: Skyrizi, Dupixent, Rinvoq

Diabetes / metabolic / weight loss: Ozempic, Wegovy, Mounjaro, Zepbound

Spend growth fueled by:

Media exposure

Expanded indications

Increased patient demand

Opportunity for:

Retail & specialty pharmacy optimization

Margin capture

Patient 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 therapies

Expansion of value- and outcomes-based contracting

Siteofcare shifts toward ambulatory and home

Digital transformation & automation

Supply assurance and resilience

Expanded pharmacist clinical scope & workforce models

Regulatory and policy efforts to lower drug prices

340B changes

IRA Medicare Part D negotiations

09:37 — 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 strategies

Provider-administered vs self-administered drugs

Identify top spend movers and align them with long-term market forces.

Consider:

Specialty pharmacy expansion

Site of care optimization

10:48 — Biosimilar Therapeutic Insights: 2025 Recap

Heather Pace highlights:

Shift from biosimilar approval to active adoption management.

Ustekinumab (Stelara) as defining example:

Multiple biosimilars

Uptake driven by payer and PBM strategy

Utilization varies widely based on:

Formulary design

Benefit alignment

Biosimilars 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 status

Manufacturer differentiation

Sets 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 mandates

Product presentation

Supply chain logistics

Billing & reimbursement complexity

Clinical barriers are decreasing; workflow flexibility is critical.

13:09 — What to Expect From Biosimilars in 2026

Faster adoption timelines

Earlier payer-driven switching

Fewer preferred products

Less reliance on reference product trial periods

13:45 — Biosimilars With Major 2026 Impact

Eylea — multiple launches expected post-litigation

Xolair — expansion into asthma/allergy and retail specialty

Perjeta — oncology pathway disruption expected late 2026 / early 2027

15:01 — 2025 Biosimilars Impacting 2026

Ustekinumab (Stelara): broader formulary shifts

Denosumab (Prolia, Xgeva): full year of impact; all interchangeable

Eculizumab (Soliris): first rare-disease biosimilar entry

15:58 — FDA Biosimilar Guidance to Watch

Late-2025 FDA guidance:

Reduced reliance on clinical efficacy trials

Greater emphasis on analytical similarity

Aims to:

Reduce development cost

Accelerate market entry

16:26 — Interchangeability: Where Things Are Headed

Moving toward expectation that all biosimilars are interchangeable.

Shifts responsibility to:

Payers

Health systems

Pharmacists managing transitions and education

17:17 — Biggest Shift in the Biosimilar Landscape

Faster launches

Larger scale adoption

Payer strategy more influential than timing of approval

Success depends on:

Formulary fit

Channel alignment

Operational simplicity

17:41 — 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 drugs

Understand siteofcare and specialty drivers

Translate projections into actionable budgets

18:40 — Resources

Winter 2026 Spend Management Outlook available on Vizient’s SMO Hub.

Includes current and prior editions and related insights.

18:58 — Closing

Carolyn thanks Jeni and Heather.

Reminder to subscribe, like, and share feedback.

Verified Rx is produced by the Vizient Center for Pharmacy Practice Excellence.

Links | Resources:

Vizient Spend Management Outlook webpage

Vizient Winter 2026 Spend Management Outlook

Vizient Biosimilars Therapeutic Insights

Subscribe Today!

Apple Podcasts

Spotify

YouTube

RSS Feed

...more

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