Across the healthcare landscape, hospitals, infusion centers, and outpatient facilities are facing mounting financial pressure. In 2025, CMS reimbursement adjustments, biosimilar pricing shifts, and increased payer scrutiny have made maintaining predictable revenue more challenging than ever.

Self-funded employers have long recognized the importance of rebates in managing healthcare costs. Pharmacy benefit rebates are typically part of financial planning, built into projections, and often used to offset premiums or reinvest in employee programs.

As hospitals and health systems evolve into risk-bearing organizations, many are launching their own health plans or taking on delegated risk through Medicare Advantage, ACOs, and MSOs. This shift creates new opportunities for financial sustainability, but also introduces new challenges.

The specialty drug market continues to evolve—and quickly. The latest 2025 reports from Pharmaceutical Strategies Group (PSG) reveal notable shifts in both utilization and cost trends for specialty therapies, with significant implications for payers, providers, and rebate stakeholders.