Wholesalers Master Vertical Integration Playbook (Again), Regulators Ease Biosimilar Approvals (Market Yawns), and Insurgent Medicare Plan Succeeds Where Giants Struggle

Hey all,

Happy Tuesday! Healthcare reform has a funny way of creating new problems while solving old ones. The FDA clears pathways for cheaper biosimilars, PBMs choose expensive options because rebates pay better, and everyone acts surprised when the cost savings never materialize. Turns out pulling one lever in a system designed to resist change mostly just reveals which other levers are bolted down.

Enjoy the rundown! 

Jacob Brody (Co-Founder & CEO, ZorroRX)

(Modern Healthcare) Pharma Distributors Expanding into Physician Management

Pharmaceutical wholesalers like Cardinal Health, McKesson, and Cencora are moving aggressively into physician practice management as private equity pulls back from the space. After all, who wouldn’t trust drug distributors to suddenly become experts in running medical practices? While these moves promise financial stability and supply chain support for specialty providers, they’re also drawing antitrust scrutiny and skepticism from doctors wary of corporate overreach. Full Article

(BenefitsPRO) FDA Plan to Cut Biosimilar Testing

A new FDA draft guidance proposing the elimination of certain biosimilar testing requirements is being praised by the ERISA Industry Council (ERIC) as a major step toward reducing prescription drug costs. The move aims to spur competition for expensive biologic drugs—often 20 times costlier than traditional medications—by easing the path for biosimilar alternatives, which remain scarce despite numerous upcoming patent expirations. Of course, it still remains to be seen whether employers and PBMs will actually embrace these lower-cost drugs—since they seem far more hooked on rebates than savings, and current biosimilars haven’t exactly been flying off the shelves with deep discounts. Full Article.

(Fierce Healthcare) Alignment Healthcare Q3 Earnings and 2025 Outlook

Alignment Healthcare reported strong Q3 2025 results with revenue reaching $993.7 million—a 44% year-over-year increase—driven by a 26% rise in health plan membership and improved cost management, prompting the company to raise its full-year guidance. The Medicare Advantage insurtech now expects nearly $4 billion in 2025 revenue, bolstered by industry-leading quality ratings (100% of members in 4-star+ plans) and expansion outside California through its tech-driven care model, AVA. It will be interesting to see whether insurgent plans like Alignment can build profitable businesses at scale as incumbents like Aetna and Cigna shrink their Medicare Advantage footprint—or exit entirely. Full Article