AH046 - What's Hot In and Around the Pharmacy Supply Chain, with RSM's Tom Evegan

Transcript

Lightly edited for clarity.

[00:27] Justin Venneri: Hello and thank you for joining us for this episode of the Astonishing Healthcare Podcast. This is Justin Veneri, your host and Director of Communications at Capital Rx. And today I'm excited to have Tom Evegan with us, a partner and the life sciences national consulting leader at RSM. He's the resident expert on all things gross to net -- drug pricing, contracting, distribution, market access, you name it. Tom, welcome to the show today.

[00:52] Tom Evegan: Thank you for having me, Justin. I appreciate it.

[00:55] Justin Venneri: So Tom, really excited to have you here. I gotta send a big shout out to John Lanza for making the intro. He's your Head of Industry there, and it's just another example of why playing hockey later in life is 1000% a good idea. And that's how I met John, long ago. So tell us a bit about yourself and your background. How does someone become a gross to net expert?

[01:14] Tom Evegan: Sure. I'd like to say my gross to net career began at a very young age, memorizing the back of every baseball card, understanding statistics. But in general, I was fortunate to have a great pathway while I was in college. I was actually working on the investment banking side of things for companies like UBS, Paine Webber, Merrill Lynch, as well as Bloomberg. And I had a great mentor back then named Dennis Maharis. Dennis gave me a piece of advice while I was still at Rutgers University. That advice was if you want a career, go to healthcare and life sciences. If you want a temporary job or a cyclical job, stay in financial services and investment banking.

I took Dennis's advice and actually started to work coming out of school for Johnson and Johnson. And really I'd like to say that I was fortunate enough through some of the positions I've held throughout time to take bits and pieces of those positions and really focus in on what I do today, which is come up with a macro level approach to gross to net and how things are handled.

And what I say that by means of really at Johnson and Johnson, I was able to learn different things that focused in on contracting, strategy, treasury operations, how cash management flow works, stock compensation program, how folks are incentivized, and then from there I actually pivoted and moved to a company called Medco, which is now known today as Express Scripts.

At Medco, I was able to work on their national accounts team focusing in on running pharmacy benefits and understanding how the PBM industry worked, not only with the drug manufacturers but with the employer groups, national groups ,and government benefit groups. Another important piece of my career at Medco that occurred was we learned a lot about the Medicare Part D subsidy and the retiree benefit in terms of how that would actually come out to play. And here we are, almost 20 years later, and that's such a relevant topic for discussion in terms of where we are today.  

From there, I went to work for a company called Acorda Therapeutics that was actually founded by a CEO, Ron Cohen, out of his New York City apartment. And I like that story because it really shows you the entrepreneurial spirit of how our industry is impacted today by so many scientists who come up with cures in rare disease for patients to help solve their patient journeys.  

We were able to launch a multiple sclerosis drug called Ampyra that was designed to treat walking impairment and gait issues in MS patients, early defined. I was thrust, I'd like to say, into the gross to net world as we had a very deep commercial contracting presence. We set up a large specialty pharmacy and distribution network and my chief commercial officer at the time allowed me the opportunity to work directly with some of the investor relations folks on Wall street to help engage them in what we were doing that was so novel and different from everybody else from a gross to net perspective. And the way I like to talk about it was we actually solved gross to net by understanding where each patient would receive their medication, what their journey would look like, and where the flow of the dollar would go from there on out.

So I took those principles from Acorda and was able to work for a couple of consulting firms including CIS, Compliance Implementation Services, which was later sold to Deloitte. From there I really understood that I wanted to work in more of a partnership based model. So I partnered with a few folks at a company called Cumberland Consulting Group. At Cumberland we were able to service over 200 drug manufacturers in everything from commercial operations, government price reporting, market access and launch strategy, all the way through gross to net, and built a managed service platform and consulting platform around that.

From there I actually met members of the RSM team -- and I'll tell you a funny story about John. John and I both didn't know this. The first time we ever met face to face was out at J.P. Morgan. So I asked him, John, where's your office? He says, in Metropark, New Jersey. I said, John, that's funny, I'm in Metropark, New Jersey as well. He said, I thought you're based out of Cincinnati. I said, no, my office is in Metro Park. Turned out our offices were in the exact same parking lot together. So that's how I got indoctrinated and introduced to that RSM team.  

We became strategic partners for quite some time. And then when Cumberland was divested, I ultimately built my own market access practice with Dan Boyarski, Neil Shaw and Joseph Magnate and then moved that over and James Powell and move that over to RSM in 202. And the opportunity was perfect. RSM presents a great culture of stewardship and really being entrepreneurial within industries and have the luxury of working with some great people at RSM, including many of my partners today, folks like Bill Kirkunis, Jim Cash, and Joe Goldberg, just to name a few, as part of the process.

[06:31] Justin Venneri: That sounds like a great fit and it must have been pretty wild, but really educational to be involved in some of those situations as you kind of transitioned from company to company, especially going from pharma to PBM to biotech, right? And then to consulting, bigger picture, is a really interesting journey there. You know, whether contracting, damage control, network setup, etc. Is there a common theme you found or something you've taken away from all that collective experience that you employ now at RSM.

[07:02] Tom Evegan: That's a great question, Justin. And really I think it's critical to anyone coming out of college or entering the workforce today, which is you may not understand why you're in a certain role when you start, but over time you realize all the transferable skills that you can take from one job to the next may lead you ultimately to where you're meant to be.

And I truly feel that way, whether it's at Medco, I got to learn about Medicare Part D and what occurred there at Acorda. I really got to refine what that that gross to net approach should be and how industry should be looking at gross to net, government price reporting, and working on compliance issues and matters and being able to understand different problems as they arise, how to address them.

This evolution of life sciences has really been changing since 2010, since the Affordable Care Act was instituted. And since then, the compliance aspects have impacted both gross to net government price reporting and even some of the state transparency compliance we have today. I like to say that my background helped me prepare for where I am today.

[08:12] Justin Venneri: That's awesome. We might as well start out on politics. It seems like everything is coming to a head or has come to a head in Washington under Trump and with the sweep. So you have Kennedy, new healthcare czar, NIH, FDA, CDC investigations. There's a ton going on in D.C. There's also been a ton of focus, as you just mentioned, at the state level across the US on reforms, focusing in on drug prices and pharmacy benefit management and our industry. What's your outlook there?

[08:42] Tom Evegan: The current landscape in terms of the level of scrutiny around drug pricing? Higher than ever, I really think the conversations around drug pricing date back to 2015. The election of Clinton versus Trump, the first time that they ran, drug pricing was actually a heavily contested issue across the industry and really companies started to get looked at for drug pricing, drug pricing reform.

Since then we've had other facets of the industry looked at or scrutinized. You know, you have FTC's investigation presently of PBMs being looked at, hospitals and 340B network right now as heavily constituted issues.

So I think with the upcoming administration, I should say coming into play, their focus will still continue to be on price transparency. I think there's also going to be a refocus or reshift with some of those government agencies around evidence-based medicine and controls in terms of how things are approved and whether Kennedy heads into that what we call healthcare czar role, or Dr. Oz's most recent appointment for CMS, or even some of the other appointments that have been made, it's interesting to see where they might align.  

Now we get the opportunity to work with a lot of government agencies day in, day out and for them it doesn't feel like much of a change or shift in terms of what their day-to-day jobs are. It just might be a little bit tweaking of really where the focus is going to be in the future and also where some of the investigations might come up.

[10:21] Justin Venneri: Do you see any like obvious targets, for lack of a better way of asking the question, out there, amongst the different classes of drugs or medicines themselves?

[10:31] Tom Evegan: Medicines themselves, I think one area that we're still seeing a lot of growth is in that biosimilar market where biosimilars have actually reduced the overall cost of medication directly to the patient. However, the actual costs have gone up in hospital markets, if you look at hospital markets or other areas as well. So, the interesting dichotomy is going to be that how do we still continue to actually improve the cost to the patient versus actually the cost to the other ancillary players that are in the gross to net bubbles, so to say.  

So I think the focus might be around reform, might be a little bit more nuanced in terms of, you know, with drug manufacturers, there's now 24 states that have come up with state transparency guidance in terms of looking at everything from R&D costs to actual drug costs to what the manufacturers are doing in the marketplace.

By this time next year, 30 states may be online. In terms of where we're heading from a PBM side, I think there's still a lot of talk around the vertical integration that has occurred to date. Have these companies become too large as they're all balanced with, you know, insurers, payer provider networks, different specialty pharmacies, specialty distributors, all within the same network, while still administering the patient's benefit as well?

And then I think if you look in the hospital side, there is going to be a tipping point, if we're not already there, around 340B. Last year alone, I read a KFF study that showed I think there were $66 billion in spend just in the 340B program alone.

[12:13] Justin Venneri: Interesting. Maybe one or two specific questions on -- first, what's going on with the IRA, the Inflation Reduction Act, the stacking rule, rebates, et cetera. Do you have a point of view there?

[12:26] Tom Evegan: Sure. The IRA introduced several changes that have been proposed to the drug manufacturers and they were aimed at really increasing price transparency and reducing cost. The cost savings has been apparent to the government, but it has also created a couple of ancillary problems I think the government did not expect. What I mean by that is there's been a focus around 340B as a result. You've probably seen some cases in the news that have been presented, including ones by Johnson & Johnson, around their 340B rebate program and what they want to administer in place of where the program was before.

What we're also starting to see with the IRA is companies think about innovation for certain therapies and categories for now and in the future around how that might be impacted around the IRA, how they're modeling their price points and gross to net in future and outlook years.

[13:26] IRA has actually impacted the M&A space as well. As we're looking at capital markets. I think one area I've seen the IRA impact is how manufacturers are negotiating terms and conditions, representations, warranties in transition service agreements with their negotiation deals between drug companies. And what I mean by that is thinking about, hey, if I owe rebates down the road as a lag concession, how do I factor that in as part of the IRA approach in terms of modeling altogether.

[13:57] Justin Venneri: And what about its longevity itself? I mean, I think I've seen some chatter about Trump just doing away with the IRA if he can.

[14:05] Tom Evegan: I think it's tough to unwind, given that there is a savings directly to the government. What I'd like to see is more of a focus and a shift on savings given back to the patients themselves that are participants in the Part D program.

I think we've seen across the board, you know, reimbursements have gone down in Medicare. That's one of the issues that's popped up as well. And it's an interesting time. I think repeal might be a difficult piece, but maybe there are parts that can be replaced in terms of exactly how the rule and guidance has been written. And keep in mind, the drug selection process in itself is being contested right now as well.

[14:45] Justin Venneri: Right. And you brought up something in our original discussion about the Chevron ruling and its implications. Can you expand on that and share your take?

[14:53] Tom Evegan: With regards to the Chevron doctrine, The Supreme Court ruled that the overturned doctrine require courts to defer federal agencies reasonable interpretations of the statute. And where this comes into play is primarily in the 340B program, because the effect that this has is it weakens, frankly, the authority of government agencies and allows for opportunity to increase likelihood of lawsuits of those government agencies over time.

This is important because this decision happened earlier this year and we're already starting to see a pivot towards the legislation. If you look at the cases right now that are being pendant as it relates to 340B. The other key piece I think in all of this is that we do not presently today by CMS definition, have a definition of what constitutes a patient.

[15:50] Justin Venneri: And just at a high level, what it specifically overturned or allowed, whether the government was allowed to impose or pass legislation regulating something, whether it's environmental or in the healthcare arena, can you just take a quick step back and add a little bit of color for someone that may not understand what the Chevron ruling actually did or said?

[16:11] Tom Evegan: Sure. This impacted the HRSA's guidance around the 340B program to ensure that the abilities they had to weigh in on certain topics could actually be challenged.

[16:25] Justin Venneri: Okay.

[16:26] Tom Evegan: And what I mean by that is this has presented opportunities where now manufacturers and covered entities on both sides of the relationship or hospitals to that matter, are able to sue as it relates to the overturning of Chevron.

[16:40] So HRSA is losing its power to weigh in and generally solve these issues with what it used before, what's called A process of good faith resolution where drug manufacturers actually worked with the covered entities to solve issues to their problem as it related to certain prescriptions or potentially rebates that may have been utilized in multiple government programs such as 340B, Medicaid, Medicare Part D extending over to commercial rebates.

[17:11] Justin Venneri: And HRSA is the Health Resources and Services Administration, right?

[17:15] Tom Evegan: That's correct.

[17:16] Justin Venneri: Okay, got it. Yeah. It's really fascinating the developments on the 340B front and the complexity of some of these rulings that.

[17:25] Tom Evegan: It's beyond fascinating.

[17:27] Justin Venneri: So our CEO, AJ Loiacono, he always talks about the importance of a fair and unencumbered market where buyers and sellers can see the price of a drug. That's clearly not how this pharma supply chain has worked to date for years, aside from over the counter medications. And then NADAC, National Average Drug Acquisition Cost, being arguably the best available price benchmark. What are your thoughts there and what do you think can or should be done about the lack of consistency in terms of drug pricing and visibility into drug prices?

Related Content

• What is NADAC & How Does It Differ From AWP?
• AH022 - Pharmacy Benefits 101: Pharmaceutical Rebates, with Ben Schuster

[18:03] Tom Evegan: First off, I'd start by saying AJ is a very smart man because I agree with him wholeheartedly on this. Transparency in the pharmaceutical supply chain is an issue. It's going to continue. NADAC really acts as a benchmark, so think directionally speaking, but there's still a lack of the visibility because of some of the complexity of the contracts as far as what the true costs are.

So in order to enhance that transparency, we've got to think about some of the regulatory means by which we're addressing that pricing as well. So, the public access to pharmacy purchase data is harder and harder to get a hold of these days. But I think what's happening is there is a creation of tools both in the hospital and the retail setting that are trying to take place in terms of ensuring that the patient is receiving a transparency benefit.

I am aware of several companies working on hospital price transparency that's out there. And then from more of the retail setting, we've seen this with everything taking place in the GoodRx model all the way through manufacturers trying to actually provide information out there around price transparency as it relates to what the actual costs of their products are and where they are making money in terms of rebates and price points to companies.

And what I mean by that Justin, is this information is publicly available out there. Not to pick on J&J again, but they do a great job in terms of providing a price transparency report -- them along with other larger manufacturers generally publish an annual report. So, patients could actually go out there and see what's taking place from a price perspective.  

The overall theme though, and I think this is what AJ is trying to address, is that we need to do a better job in the US is a focus around education of what pricing is and what it means and educate the consumers on drug pricing. You know, we do publish a wholesale acquisition cost out there in different price compendiums around what the list price of the product is. But by the time the patient receives their benefit, they're not always paying one set price for all of these different medications out there.

[20:25] Justin Venneri: Yeah, we see that as a huge issue and unnecessary complexity opacity of how the prices change, because they do, unfortunately. And then the confusion that causes. It does seem like that education and access to information in a timely fashion has been a big challenge.

[20:42] Tom Evegan: Yeah, couldn't agree more. And the other piece might be that not all benefits and formularies are created equal too, right? So depending on where certain products are listed or covered and the timing of patients out of pocket benefits and you know, whether or not they utilize the copay program or not, might also garner changes to what price the patient actually pays and how they receive access to that medication.

[21:11] Justin Venneri: That's a great segue to my next question, which is how do you think we can do a better job collectively of ensuring access to medication across the country, across populations, so we have more equitable access?

[21:23] Tom Evegan: That's a great question. And ensuring that equitable access to medication, I think would be a multifaceted type of approach. You've got everything from policy reform to prices that are being provided transparently. Insurance coverage is another issue that I think would have to be addressed within this as well. And the example I'll give you, Justin, is right now, commercial patients could receive free goods or benefits of free goods from most drug manufacturers, especially for rare ultra orphan type products out in the marketplace.

What they don't understand is that for Medicare Part D patients, they cannot receive both their government benefit and a free goods benefit. So do we need to actually correct some of the benefits as well as it relates to the program. Medicare Part D, although it's stated publicly as this should be the lowest price out in the market, oftentimes isn't always the lowest price that's being provided out in the market.

So I think there has to be a lot more collaborative concept between the manufacturers government to understand truly at what point is the patient paying for a product? The access component to medication, I think has been relieved quite a bit between manufacturers and payers really trying to work together in terms of getting access to products for patients, especially those that really need them out in the marketplace. I've seen some severe cases out there in terms of manufacturers who've done an excellent job trying to ensure a patient will always receive the medication and then deal and address with what I would call the best price issue at a later date and time. Meaning that if a $0 product goes out, the manufacturer could also be penalized for that $0 product going out the way it did. So how do they address that but also meet the patient's need and definition as well?

[23:22] Justin Venneri: Interesting. Okay, and then you mentioned rebates a little bit earlier and they're a pretty consistent topic of discussion. Their importance, that is, out in the marketplace. They obviously play a big part in the gross genetic equation and the bubble that you, Adam Fine, and many others talked about for years. What do you think people should be paying attention to in and around rebates as we head into 2025?

[23:45] Tom Evegan: Rebates are going to be around as long as insurance companies and patients are in the system that we are in. And what I mean by that is contractually brawl obligated to perform one duty or another. What has taken place and what I would pay attention to from a rebate perspective are things around what is publicly available to patients. Do patients really understand that the rebate is generally that contractual arrangement between the manufacturer and the PBM or the plan versus downstream how they may receive a price point.

And we talked a little bit about wholesale acquisition cost and NADAC pricing before. One of the things that those price points do not account for are these downstream rebates that are incorporated into gross to net. And the way to really simplify gross to net, if we were just starting off is gross to net defined is really discounts and allowances across distribution, government and commercial insurance.

All of those fees that are associated within and rebates that are in that bubble are really what the manufacturer looks at from that gross to net perspective. So the flow of the dollar and where are those discounts and allowances coming in and out of the system.

So I think in order for that education to continue to occur, I highly suggest reading any of the price transparency reports that are available online. I mentioned several manufacturers publish these. Adam Fine you mentioned does a great job talking about gross to net and the bubble that's out there in terms of overall expenditures in the industry and where things are heading. Also understanding the patient co-pay benefit side of things.

And then I think it's also important to really understand what the PBMs publicly are saying as well about rebates and administrative fees. Now, I know that some of the models are starting to shift and change. The fee for service model has been an evolution of the last 20 years that I've seen over time. And you know, as more and more specialty products come into play, I think it's going to continue to change.

One thing manufacturers spend a lot of time on, Justin, is focusing in around fair market value and also bonafide service fee testing. That's a requirement based off of some of the CMS guidance that's out there that they actually have to report bona fide service fees back to CMS as part of their monthly and quarterly drug pricing.

That's one thing where I think that plans and PBMs need to do a bit of a better job understanding that oftentimes when manufacturers are asking qualitative and quantitative questions around the agreements, they're coming from a place of adhering to the guidance that we have to follow out in the marketplace as well.

[26:34] Justin Venneri: That's interesting, Tom. It definitely highlights how many moving pieces there are and how complex A, the flow of the dollar is, but B, all of the requirements that all the different stakeholders have from reporting and who sees what data and why. And it's almost like a patient, like there's a price out there that you can probably find for the drug if you know where to look for it. So yeah, hard to find it.

[26:57] Tom Evegan: And if you factor in other things such as whether you're using your own benefit, your own FSA or HSA account on top of that, depending on what you're paying for, if you do a little bit of research, you might often find a better price out there.

[27:12] And that's why I think price transparency and especially what you guys are doing at Capital Rx is very interesting and novel in terms of where the industry is really heading for the patient.

[27:21] Justin Venneri: Yeah, thanks for that. It's a little nod there. Unprompted. Sticking on this drug pricing topic for a second. Ask you to break out your crystal ball. Historically, we've seen deflation of generic drugs pretty consistently and then branded drugs more recently have been deflating too.

I mean the net prices with the government negotiating prices, those prices look pretty competitive, I think for the initial set of drugs. Obviously that's being looked at. What do you see happening with drug pricing directionally and why?

[27:55] Tom Evegan: So drug pricing since 2015, generally speaking, average annual increases of products for both generics and brands have gone down. What the public doesn't necessarily always know Is that when manufacturers take increases annually or a couple times of year, drug manufacturers actually pay penalties back to government programs such as Medicaid, 340B, and Medicare around those price increases if they are greater than the rate of inflation.

Many manufacturers, you know, using my crystal ball, so to say, are becoming more intent on what I would call strategic pricing, which is combining elements of how do I set a drug price, how do I monitor it from more of that gross net perspective and understand where it's heading.

And then also the compliance aspects and elements that we talked about around state transparency, the government report reporting back to Medicaid, Medicare. I continue to see that this is not going to change for the time being because we still have so many merchant middlemen that are taking dollars in and out of the system, you know, that are going to continue to address the need for really gross to net evaluation until one shoe drops or another.

And what I mean by that, Justin, is that right now, you know, if you looked at examples of discounts and allowances across the industry, we have wholesalers, we have PBMs, have group purchasing organizations, direct and indirect relationships with hospitals, other different service providers that might be paid in terms of fees.

All of these price points and allowances come out of the net price of the drug. So the trend, as you stated in the opening, is on the decline. All the studies that are out there right now show that increases have gone down, but also the net increase has gone down subsequently.

I think it's an important time to continue to really understand as we head into 2025 and this new administration. My crystal ball of thinking is that there's going to be a continued piece of scrutiny. I think the 340B program really needs to figure out a solution that could work for the hospital systems and the manufacturers and be fair to both parties and really try to present a benefit back to the patient at some point in time. And then also one thing I know you know from years of doing this is that and this isn't as much of a crystal ball as it is clockwork, there's always going to be government intervention in terms of rulings and guidance that are out there and where those laws are heading is going to be of interest.

A couple of other things I see from a crystal ball perspective, we need to continue innovation in this country. I also think onshoring is going to start to pick up in the next couple of years in terms of our overall supply chain and the way we look at drug manufacturing. Everything from drug manufacturing, tech transfer, APIs, I think those are going to be more and more on short, so to say the other thing is AI, the role of AI in terms of where it is.

I do bring up a story that from a gross to net and pricing perspective, we've actually been using AI since 2015, believe it or not. I've got a great team led by Brian Coleman that has helped our technology build out and really stay on top of where the industry is heading. The AI piece I think is going to continue more and more in drug discovery as well.

[31:31] Justin Venneri: I had a feeling AI was going to come up in the discussion. I just didn't know where one question before my last question. What's the most astonishing thing you've seen that you can share of course over the course of your career that relates to the discussion we've been having here today.

[31:46] Tom Evegan: So in terms of astonishing, Justin, I've got several stories for you. We may need a part two of this podcast.

[31:53] Justin Venneri: Just for those? Sounds dangerous.

[31:58] Tom Evegan: I'll tease you by saying may or may not have a great story on price transparency dating back to some of the things that we've highlighted today. But I think in terms of most astonishing right now, I think the GLP-1 market is fascinating to follow right now, the benefit it's having to patients. And what I find astonishing is that we're seeing more and more payer adaptation to GLP-1s in terms of coverage. Therefore the patients are actually getting the medication. What I would like to continue to see is what is almost that HE effect, or health and economics effect, to the patients over time. You know, have other disease areas been treated or addressed not only through diabetes. What's interesting is, you know, some plans, some employer groups think of it as a cosmetic drug. But I think it's going to continue to actually show benefits in the diabetes class and may become the next case for almost what we saw with insulin dating back for years to come.

Related Content

• How to Manage Pharmacy Benefit Spend in a GLP-1 World
• AH021 - Managing Pharmacy Costs in a GLP-1 World, with Bridget Mulvenna

Also, price monitoring of the GLP-1s is going to be of interest. I know there are some new and novel therapies that are out in the marketplace. We're also seeing certain manufacturers try to address drug shortages in those areas.

I thought it was fascinating the Novo Nordisk Charitable foundation arm bought Catalent for their supply chain. And in terms of really understanding what they're looking to do there and ensure that there is isn't such a drug shortage out in the marketplace, we're actually being innovative through this process of medicine that's been addressing one particular class where there have been many tangential type of benefits to it as well. And even in talking to folks like yourself and others out in the marketplace, GLP coverage is going to be a topic of conversation for the next few years.

[33:51] Justin Venneri: Got it. And Tom, last question. If anyone would like to learn more about your practice or connect with you, do you publish on LinkedIn, or what's the best way to reach out and learn?

[34:01] Tom Evegan: Thanks again Justin. And yes, anybody can feel free to reach out to me on LinkedIn or go to RSM's homepage. We have industry dedicated pages including Life Sciences where we talk a little bit about our services across our different lines of business, including tax, audit, and consulting.

I'd also like to say and encourage folks to take a look at the RSN website because we do do a lot of round stewardship and even as recent as last week we hosted a PGA tournament which raised a lot of money for local children's charities. So please feel free to reach out and happy to be in touch.

[34:35] Justin Venneri: Well, I'll put some links in the show notes as well. Tom, it's been an absolute pleasure having you on.

[34:39] Tom Evegan: Thank you Justin.

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To connect with Tom or for more information about RSM's Life Sciences Group/Management Consulting Services, please visit:

• Connect with Tom Evegan (LinkedIn)
• Life Sciences | Industries | RSM US
• Scaling at the Speed of Change: Biopharma

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