AH095 - What's in Store for the New Year? A Special Round-Robin Episode of Astonishing Healthcare

Transcript

Lightly edited for clarity.

[00:22] Justin Venneri: Hello and welcome to a special New Year's episode of Astonishing Healthcare. I'm Justin Venneri, your host and senior director of communications at Judi Health. I want to extend a big thank you to you, our audience, for tuning in over the last two years. Welcome to the show if this is your first time listening to our podcast. We're bringing you two lists today because everyone loves lists to start a new year, right? So we're doing a virtual roundtable of the most astonishing things people have seen over the last year—the top most astonishing things of 2025. And then everyone's giving us a prediction, too.

So you'll get a list of predictions for 2026. We're going to kick off this episode with Jeff Hogan, who we've worked with as an advisor for years and has been on the show several times. Most recently, Jeff joined us for episode 76, which had one of my favorite titles, Jeff, "PBM Boogeyman and Stopping the Madness Out There." Episode 57 was "How First Movers Are Taking Control of Their Health Plans in 2025." So, Jeff, thank you so much for joining me for this one. Welcome back to the show.

[01:21] Jeffrey Hogan: Justin, great to be here again.

Jeff Hogan on a Healthcare Tipping Point

[01:22] Justin Venneri: All right, most astonishing thing of 2025. For compliance, I'm going to give everybody the same disclaimer. Just keep your compliance hat on. Tell us a good story. Tell us the most astonishing thing or most surprising thing you experienced related to the pharmaceutical supply chain or health benefits world over the last year.

[01:38] Jeffrey Hogan: I think in general, having been in healthcare literally for four decades, the most astonishing thing by far for me is the extent and scope of the displeasure that's been shown about healthcare in the marketplace. I think literally we've finally hit that proverbial tipping point where people have just had enough. They're sick and tired of not only the system itself and the BUCAs who we've seen in this market consolidating the market for a long time; they're sick of the cost. They're sick of the fact that they don't have access to care because their deductibles are too high and their premiums are too high. This year, astonishingly, I saw the first $70,000 family plan on a jumbo group as well. The extent and scope of displeasure is unlike anything that I've seen before in my career.

[02:39] Justin Venneri: Yeah, that's a big number for a family plan. That's wild. Okay, and Jeff, how about a prediction for 2026 related to our industry? What do you think's going to happen?

[02:47] Jeffrey Hogan: Yeah, so I predict this year, and I have already started to see it, that this will be the year that finally purchasers of healthcare gain agency over their own plans and begin to do things differently. We have seen, particularly toward the end of the year, hundreds of employers—and I would say anecdotally, I think the number is in the thousands—who have finally secured their data on their own groups and really seen how poorly they've purchased healthcare in the past and the details of what their administrators, including BUCAs and other TPAs, have charged them upfront and on the backside in every which way. There is this general unrest and unwillingness to continue on the trajectory.

So my prediction is that this is the year that we see employers do things and demand things differently, including accountability for costs, risk, all of the features of healthcare, including what their brokers do or don't do for them, what their TPAs do or don't do, what their PBMs do or don't do. We are finally seeing purchasers assess the resources that they need to manage their plans most appropriately, number one. Number two, on the care delivery side, we're also seeing health systems, big health systems, who are predominant employers in their areas, start to look at their own plans as a way to look at the purchasers that are in their catchment zone as well, to find ways to direct contract. This will be a big year for direct contracting and direct relationships between care delivery and purchasers. That's my prediction.

[04:38] Justin Venneri: How do you think we measure whether you're right or wrong on that one? I know there's a recent KFF survey out there about the PBM industry that shows the same stat in a different way, of course, that everyone knows the big three have 79-80% market share. Will we finally put a dent in that in 2026?

[04:53] Jeffrey Hogan: Yeah, so it's a really good question. I would say that the jumbos, the Fortune 500 companies, even large employer groups and Taft-Hartley groups are the first movers in this space. They continue to be. I mean, you've seen it with Capital Rx, with your own customers. The employers who wanted to do things differently started with their PBM. Why? It was the hardest thing to look at. It was the most opaque aspect of their spend, the trend factor that often was double other diagnostic cost categories, the area that created lots of catastrophic risk, even on the med-pharmacy side. It was certainly a driver of costs that they needed to tame. And many have done that. Many have done it successfully. And now we're saying, "All right, game on. We're going to do the rest of our plan. We're going to look at health services, we're going to look at our medical costs just like we looked at our PBM in a very transparent, contractually focused basis." And we're going to take control. And the Jumbos have done a really great job. They've got the ROI to show it's worth it to go through this process. I think those are going to be the ways that you measure whether this prediction works or not.

[06:03] Justin Venneri: All right, Jeff, thank you so much. Happy New Year. I appreciate you coming back on the show for this quick one and look forward to staying in touch.

[06:09] Jeffrey Hogan: Thanks, Justin.

Lloyd Fiorini on AI, PBM Reform, and Drug Pricing

[06:10] Justin Venneri: Next up, we have none other than our general counsel and chief compliance officer, Lloyd Fiorini. Lloyd actually hasn't been on the show in a while, but he almost had an incredible Stanley Cup prediction last time he was on; the Oilers came very close to actually hoisting the Cup. That was episode 15 on PBM legislation, contracting, and more. Lloyd, thanks for joining me today.

[06:30] Lloyd Fiorini: No, it's good to be here.

[06:32] Justin Venneri: So my two questions are, and we'll start with the first one. What would you say is the most astonishing thing that you saw? This could be good, could be bad, could be just surprising. Just tell us a good story of something that caught your eye and made you think over 2025.

[06:46] Lloyd Fiorini: Well, I guess the positive is how quickly AI is changing healthcare. I didn't think the speed would be as quick as it has been, which has been a surprise to me. It's positive. I think it's going to help. I think from the negative side, it's unfortunate that the federal government hasn't implemented PBM reform yet. You know, it's like the one thing that unifies the Democrats and the Republicans, but it still hasn't gotten across the finish line yet. So that's a surprise to me that we're still in the same position we are now at the federal level. But the states are showing their innovation and desire to change. And so their reform has been cutting-edge and trailblazing. So maybe the federal government will catch up.

[07:24] Justin Venneri: Got it. And just curious, what about AI has been so surprising to you? The speed, you said. But are there particular functions that you see things changing in these days?

[07:32] Lloyd Fiorini: I just think it's being adopted everywhere and I just see it changing how we do business in a very positive way.

[07:40] Justin Venneri: That's awesome. And then my second question to you, which is a prediction for 2026. Give me your best crystal ball prediction for what we'll see related to our industry—health benefits, pharmaceutical supply chain. And of course, who do you think is going to win the Stanley Cup?

[07:53] Lloyd Fiorini: Well, I do not think Florida is going to three-peat, that's for sure. I don't think so, but, you know, I didn't think they were going to repeat as well. So from a hockey perspective, I think it's going to be Dallas that wins. Pains me to say it, but that's who I think will win.

[08:08] Justin Venneri: North Stars get a Cup.

[08:10] Lloyd Fiorini: Yes, yes, yes. The North Stars will rise again. But, you know, I'm really optimistic that there's going to be major reform in how drugs are priced in the new year, not just on the cash-pay side. I'm optimistic it's going to go beyond that, and that's my dark-horse type of prediction. I just see something happening more in that area than what we've seen so far.

[08:35] Justin Venneri: And what we've seen so far includes stuff like mandatory NADAC and price transparency-related reporting and audit requirements and things along those lines.

[08:45] Lloyd Fiorini: Well, yeah, but you see, like, some are dancing around the fringe of cash pay and whatnot. And I sense they want to go deeper. And so can they bring to the marketplace transformational pricing throughout the whole market, including health plans, employer plans, as well as cash-pay patients? That is what I think they want to do, and I think they're going to do something in the next 12 months.

[09:10] Justin Venneri: Lloyd, thank you so much for joining me today and sharing your most astonishing thing of 2025. That is a definitely an interesting prediction for 2026. We'll look forward to seeing that.

[09:17] Lloyd Fiorini: Yeah, I don't know if it's going to be right, but I'll put some money on that, you know what I mean?

[09:21] Justin Venneri: Awesome.

[09:22] Lloyd Fiorini: Happy New Year, everyone. Justin, thank you. Take care.

Nick Welle on Fiduciary Duty and the Rise of Cash Pricing

[09:25] Justin Venneri: And next up for our special episode, here we have Nick Welle. Nick is partner and chair of the health benefits practice at Foley & Lardner. He was our guest for episode 52, "ERISA Insights, Challenges, and Compliance in Modern Healthcare" nearly a year ago, which is kind of insane. But Nick, thanks for coming back on the show and thanks for sharing a couple of observations and a prediction for 2026 on this New Year's episode.

[09:50] Nick Welle: You bet. Justin, thanks so much for having me on again.

[09:52] Justin Venneri: All right, first, most astonishing, surprising, interesting, something you saw, read, experienced in 2025 related to the business of health benefits, pharmacy supply chain. Share a story with us.

[10:04] Nick Welle: Yeah, so I think when I look back on 2025, I have two big observations that I think sort of shocked me or I just can't get over. The two for me are: one, how creative and, dare I say, aggressive the entire self-funded health benefits industry has gotten to try to bend the cost curve and still not sacrifice on quality of healthcare and drugs. And the second thing I think is the limelight that's been put on fiduciary duties and fiduciary duty lawsuits and new laws in the last 12 to 18 months, and sort of the rubber hitting the road where we're actually at when it comes to enforcement and teeth and whether we actually saw any big, huge consequences. So those are the two big ones I've seen. Happy to tackle one or both of those.

[10:51] Justin Venneri: They're related, right? So maybe we'll tackle the latter. What shocked you the most or was most surprising about the fiduciary obligation? I mean, we've been talking about the CAA and how that laid this out for three, four years now.

[11:04] Nick Welle: Yeah. So at my core, I'm a dorky ERISA lawyer, and every ERISA wonk has to say, if you have an ERISA health plan, an employer-sponsored health plan, most of them are subject to ERISA. You are subject to fiduciary duties. And some service providers are as well, to a certain extent. And that is the highest duty owed in the land. And it's no joke. And so I don't want anyone to yell at me for what I'm about to say. But what I've seen so far is we've had multiple lawsuits where plan sponsors have been sued based on fiduciary standards. We have state laws imposing fiduciary standards. We have lots of draft bills in D.C. floating around trying to enlarge or heighten the fiduciary responsibilities as they attach to employer-sponsored health plans.

[11:45] Nick Welle: But my point is, so far we haven't actually seen the hammer drop in terms of actual enforcement. Again, if you look at a legal chalkboard, we have ERISA duties. These are very important duties and these are things that we need to uphold and we all need to consider as an industry. But in terms of everyone saying this giant ship that's been floating in the ocean is now going to do a 180 because of these fiduciary lawsuits and the new rules that have come out, I haven't seen that yet when it comes to true practical consequences. And maybe it does in the future. But at this point, the courts seem to be saying, "You guys have not shown us enough concrete injury." We haven't seen anything in terms of having significant legs yet. We've seen some bipartisan stuff, but nothing with significant legs yet to make it to the finish line on the federal level to enlarge these fiduciary responsibilities. And in the states, we have sort of a patchwork of some fiduciary responsibilities for PBMs and service providers. But my ultimate point is I have not seen the hammer drop hugely or immensely from any regulator, from any court decision in terms of penalties or massive damages. So I don't want to minimize these important fiduciary responsibilities that continue to attach and have attached for over 50 years in this industry. But I do think as much as we've talked about it, we haven't seen a lot of practical teeth to this discussion yet.

[13:03] Justin Venneri: All right, and how about a prediction? What does your crystal ball say for 2026?

[13:08] Nick Welle: So prediction-wise, I think I have two big ones and they're sort of hand-in-hand. The first one I'll start with is I think this is the year of the cash price and the winding down of the value of the rebate. And I think because of GLP-1s—we all talk about GLP-1s, and this is not a fresh topic—but I do think it illustrates something that's really important. Everyone and their grandma wants to talk about GLP-1s. If you look at studies, depending on how wide of a scope you go with in terms of eligibility, 30% of a health plan population may be eligible. In most studies I see, it's only like 8 to 13% who are actually on them. We now have an FDA-approved pill form of GLP-1; it costs less and will be more popular, that's for sure.

And so GLP-1s aren't going away, and they're so popular that it really put under the microscope what's the actual cost of this drug. So you can go on and get a GLP-1, let's say for $300 through a direct-to-consumer or now some retail shops like Costco are going to sell it. You can get that drug for $300. Why is your health plan paying $1,000 for that drug? And I think this is the year we start realizing we need to get to the cash price. And this is the year I think some employers are going to say—and this is not just GLP-1s, I think GLP-1s was the springboard, but it's going to happen for other drugs: fertility, migraine, arthritis, and other popular drugs—"Why is my health plan paying so much more? Why can't I just go get the drug myself?"

And I think we're going to start leveraging and baking in the cash price, whether that's on the rails of the health plan or, honestly, I think it's going to be off the rails of health plans where we say, "Hey, individual, go get it yourself and we'll reimburse it through a health reimbursement arrangement, or we'll give you a cash card and we'll partially pay for your drugs." And I think we're going to start seeing, especially now that we've seen at least one large health insurance carrier essentially state that come 2028, we're no longer going to deal with rebates. So remove the rebates, strip out other remuneration, get to the actual acquisition cost of that drug, and let's operate from that framework.

And I know there have been lots of discussions and Capital Rx is a pioneer in going with NADAC and alternative pricing and being transparent. But I'm talking more than this. We're talking about going to get the drug directly from the manufacturer, using a direct-to-consumer program, going through one of the more popular avenues where you can just get the drug directly via mail, off the rails of the health plan. That is going to force the discussion of why health plans are paying so much more and why aren't we just going from the acquisition cost? If I'm an average Joe off the street and I can get this GLP-1 for $275, why can't my health plan, or why can't I just get it myself and get a partial reimbursement or full reimbursement from my employer? So I do think this will start setting up the winnowing down of the value of the rebate and getting to the actual cash price and basically a revolt from plan members saying, "Why am I going through the plan and paying an extra copay for this?" And so I think it's going to force the industry to really start saying we have to start talking in this lane as opposed to the 15-year-old, 20-year-old, 30-year-old language of, "Well, the cost to the plan is this, the cost to the member is this, and here are some reasons that the drug the plan pays for has got other factors baked into it."

[16:26] Justin Venneri: That's a good one. And it piggybacks on Lloyd's prediction that something will change with drug pricing in the United States in '26. So I think we'll see some momentum for acquisition cost-plus transparent types of drug pricing. That'd be cool.

[16:41] Nick Welle: Yeah, I think so. And so in that vein, I also think we're going to see more consumer-driven accounts, consumer-driven healthcare, and consumer-driven health benefits, which is a big priority of this administration. And I think it's highlighted by the spike of employers adopting Individual Coverage Health Reimbursement Arrangements, known as ICHRAs, and saying, "Basically, I'm done with the traditional group game. It's time for me just to give some pre-tax money to my employees and they buy the coverage that they want." And I think that's part and parcel with this whole idea of the educated consumer, the educated consumer-driven experience. I think we're going more and more in that direction. I think we're going to see it big time come 2026.

[17:24] Justin Venneri: All right, Nick, thank you so much for taking the time today to share a couple of observations from the past 12 months and your predictions for this year.

[17:31] Nick Welle: Yeah, just don't play them again in 2027 if I'm completely wrong.

[17:35] Justin Venneri: Fair enough. Have a great rest of your day, Nick.

[17:38] Nick Welle: Great talking to you, Justin.

Related Content

• Judi Health Policy Pulse: 2025 Regulatory Roundup, the Push for PBM Reform

• Replay - Unifying Medical and Pharmacy Benefits: The Blueprint for Better Employee Health and Wellness

• AH094 - How Unified Claims Processing Evolved from Pharmacy: Improving Member Care & Operating Efficiency

• Health Benefits 101: The Importance of Clinical Programs

• How to obtain Rx data and what to do with it

Sara Izadi, PharmD & Bonnie Hui-Callahan, PharmD on Cardio-Diabesity and New Care Models

[17:40] Justin Venneri: Our next two guests just had to be on the clinical side of the business. I'm so thrilled that I could find time that worked for Sara Izadi, our chief clinical officer, and Bonnie Hui-Callahan, senior director of clinical programs. Sara was with us last on episode 17, which was about prior authorizations. Then she was on more recently for episode 36 with Joe Murad from Vida, talking about clinical programs and chronic condition management. And Bonnie joined us for episode 35, which was also on clinical programs. Not surprising. Thank you both so much for joining me today for this special episode.

[18:15] Bonnie Hui-Callahan, PharmD, CDCES: Thank you, Justin.

[18:17] Sara Izadi, PharmD: Thanks for having us.

[18:18] Justin Venneri: All right, Bonnie, I'll start with you. Two questions. First one, what would you say over the course of 2025 was the most astonishing thing you saw? One of the biggest surprises could be good, bad, just tell us a good story and why it was important.

[18:32] Bonnie Hui-Callahan, PharmD, CDCES: So the most astonishing thing for me in '25 was the trends in cardio-diabesity. And what I mean by that, as you could probably tell with the term, that refers to the co-occurrence of cardiovascular disease, obesity, and type 2 diabetes—all of which, as you can glean, would make someone at even higher risk of serious health issues.

[18:56] Justin Venneri: Is that a new term? I've actually never heard that before.

[18:59] Bonnie Hui-Callahan, PharmD, CDCES: You know, it's interesting, it sounds like a newer term. It has taken off more recently, but it actually started back around 2014 or so. So it's almost a decade old. But like I said, and to your point, I think this term is coming around more and more because of how much more we're seeing the prevalence of it. And of course, with the prevalence of the conditions, we're seeing escalated costs associated with treating and preventing them. Now, what's interesting in '25 because of all of that, is we're seeing it coupled with growing interest on the employer side to want to now offer solutions aimed towards holistic wellness, data-driven prevention, tech-enabled solutions, and one-on-one virtual care for these employees to combat this triple threat of obesity, diabetes, and cardiovascular disease.

And interestingly enough, to add to that, obesity is now recognized as of 2025 as a chronic disease with the latest American Diabetes Association guidelines. In that, you'll see that we've now integrated obesity treatment into diabetes and cardiovascular management. So all that to say, the prevalence of cardio-diabesity is not going away anytime soon. And I anticipate we'll continue to see an increase in uptake amongst employers looking for solutions to address cardio-diabesity that takes both a digital approach as well as a personalized, multidisciplinary approach to provide convenient, accessible ways for members to get their care.

[20:27] Justin Venneri: Sara, anything you'd add to that? Or do you have a separate most astonishing thing you saw this past year?

[20:31] Sara Izadi, PharmD: I'm going to piggyback off of Bonnie and say what was really astonishing was the emergence of new care models. And what I mean by that is, partially due to the increased prevalence of what Bonnie referred to as cardio-diabesity—which one might argue was a result and a reaction to the increased demand for GLP-1s—what I was really astonished by, particularly towards the end of the year, were these direct-to-consumer models that I believe resulted from increased consumer frustration with costs and barriers to care, coupled with what Bonnie was just talking about.

It's a market that is really ripe for innovation, where there is so much more emphasis on transparency, where for the first time we're having honest conversations across the board about who is making money at what intersection of the supply chain. So you have this increased prevalence, increased demand, more of a spotlight on some of the bad actors out there, and then this fast emergence for the first time of direct-to-consumer products at this great scale, where you see pharma really working alongside some of these point solutions and going and targeting patients directly. So that was astonishing, how fast they were really able to get that up and people are really taking advantage of the different options.

[22:15] Sara Izadi, PharmD: Employers want a piece of the pie. They like the simplified model. So what's really in there for employers? The question always arises, "Well, what is the benefit? Do these drugs really work? Do these drugs reduce the total cost of care?" And so I think what I would find astonishing for '26 would be bringing in medical and pharmacy and looking to see if the total cost of care is reduced.

[22:47] Justin Venneri: Oh, that's interesting. So that's definitely a trend to watch for 2026. How about we dust off the crystal ball and go for an official prediction for 2026, Bonnie?

[22:57] Bonnie Hui-Callahan, PharmD, CDCES: Sure. Yeah. So to add on to what Sara was mentioning about medical, pharmacy, and total cost of care, what I predict for '26 is that we'll see employers start to prioritize what we call site-of-care optimization strategies to manage the high administrative and drug cost burden associated with healthcare-administered drugs. So think high-cost specialty drugs like infusions moving from a patient's medical coverage to their pharmacy benefit with the goal of reducing, as Sara mentioned, total cost of care. So we're talking about not just pharmacy cost savings, but what about the medical side of the house? What savings are we seeing there? And not just in-word savings, but actual claims data and looking at the savings there. So what's super exciting as well is with Judi Health's unified claims processing platform that can now process medical claims, we're uniquely positioned to be able to make this a seamless service for our clients and members. Excited to see how this takes off in 2026 and beyond.

[23:55] Justin Venneri: I always promise not to get too salesy. I know we had a successful year with Judi Health unified claims processing—medical and pharmacy—for ourselves. As we get deeper into 2026, because it's January 2nd, do you see the potential for others to look at the three-ish years of data, maybe two with GLP-1s, and using them for weight loss and trying to look at the quote-unquote ROI and how this has impacted these businesses that have chosen to cover it? Is that kind of what you see happening as well? It's always been hard to measure, right? Because we needed more time.

[24:30] Bonnie Hui-Callahan, PharmD, CDCES: Yes, absolutely. I think that is going to be something that employers are really going to press on—more and more validation around outcomes, true outcomes, not just clinically speaking, but from a cost perspective, tying in both the pharmacy and the medical side. We're already seeing it this year. So for sure, to your point, Justin, we will see more and more of that in '26, and we're building out an infrastructure to be able to account for that here at Judi Health.

[24:55] Justin Venneri: Sarah, anything you'd add to send us off?

[24:57] Sara Izadi, PharmD: Completely unrelated, Justin, my prediction, maybe not surprising, is the increased use of AI in some of the clinical workflows. And I'm very careful to say workflows and not clinical decision-making.

[25:12] Sara Izadi, PharmD: Because we're still waiting on some guidance from Medicare and others on the actual clinical decision-making component, and we want to do that very responsibly. But I definitely see a future where we use AI to facilitate a lot of the redundant clinical workflow tasks.

[25:31] Justin Venneri: That sounds awesome. Well, I thank you both very much for your time and I look forward to staying in touch over 2026.

[25:36] Bonnie Hui-Callahan, PharmD, CDCES: Thank you, Justin.

Ryan Kelly on Shifting Power Dynamics in the Pharma Supply Chain

[25:38] Justin Venneri: And finally, I'm in the virtual studio with the one and only Ryan Kelly, our chief technology officer and co-founder, who I try not to bother about content because he's responsible for building Judi®, the "brains of our organization," as AJ likes to say. I can give a mini-kudos here. I don't really have to bug him because he's got people like Kevin Sundquist and Liya Lomsadze on his team, just to name two of the many product folks who have been on the show for episodes like "The Story of a Claim," "Building Judi," etc. Ryan, thank you for joining me today.

[26:05] Ryan Kelly: Justin, thank you so much. It is a pleasure to be here.

[26:08] Justin Venneri: So back on episode nine, a long time ago, you were on the podcast. First 10-episode guest. You said you were going to build the first-ever unified claim adjudication platform, and we did. So I'm pumped to hear your most astonishing thing for 2025 and then a prediction or two from you for 2026. So first question: what's the most astonishing or surprising thing you saw, read, or experienced in 2025 related to the business or industry? Can be good, bad, thought-provoking, whatever. Tell us a good story.

[26:36] Ryan Kelly: So for me, the thing that is most astonishing over the past year has really been this swing, as it were, of the pendulum of power away from PBMs and in favor of pharma. I noticed a trend, especially related to the rise of GLP-1s, where the viewpoint in general public perception, and pharma included, is that pharma's negotiating power and their tactics are much improved versus where they were a year ago. And I think this trend is a necessary and natural trend. Pharma had been beaten up, I guess, and abused by PBMs for perhaps far too long. And it'll be interesting to see where in 2026 the ultimate balance of power lies.

[27:29] Justin Venneri: That's a good one. It definitely seemed like some things finally happened in the last 12 months that sort of fueled that shift. I think our previous guest on this episode talked a lot about the dissatisfaction with costs and access and how those things finally came to a head. So it's a good one.

[27:45] Ryan Kelly: The other thing that I do want to kind of pull a little thread on... You had mentioned unified claims that we had talked about so long ago. I'm not going to say that I'm astonished because I do have a great team and we do build really great products, but it has been so far a very successful first year with unified claims, and I'm super, super excited to see what that brings us in 2026.

[28:08] Justin Venneri: I know we always have our annual watch party, which Liya mentioned a couple of episodes ago, and there were no medical claims. She must have been like, "Wait, when is this going to come in, right? Like, how is this going to work?" So it must have been nice to see one cross and process. So give us a prediction for 2026. Dust off your crystal ball. And if you want to give us two since Lloyd offered up a sports one, that's totally fine. Fair game.

[28:31] Ryan Kelly: I have two predictions for 2026. I think that the national conversation around drug pricing is going to grow even stronger. And as I mentioned before, the balance of power is going to continue to swing back towards pharma. The launch of oral GLP-1s I think is going to be a very important factor in this overall conversation. A recent article that I read indicated that under a new definition of obesity, 75% of Americans would be considered obese. So if interest in a new definition like that does happen to take hold, these products become even more important to the overall health of the nation. And I really think that the big conversation piece, much as it was this year with injectables, is going to be oral GLP-1s come 2026.

Now for my fun prediction. Okay, I am going to make a sports prediction. I'm not a huge sports fan, but the Bills have been having a really great season so far. I'm going to knock on wood as I say that. And my prediction is that the Bills will win the Super Bowl. And that's a tribute to my mom, who was always a big Bills fan.

[29:41] Justin Venneri: All right, Josh Allen gets a ring. Good stuff. Ryan, thank you so much for joining me in the studio for this special episode of Astonishing Healthcare. And thank you all for listening over the last two years. We look forward to an exciting 2026.

[29:52] Ryan Kelly: Pleasure to be here and thank you so much.

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Disclaimer

This podcast is for informational and entertainment purposes only. The views expressed are those of our guests, do not constitute professional advice, and may not represent Judi Health's/Capital Rx's position on any matters discussed. We make no representations or warranties regarding the accuracy or completeness of the content; information is subject to change and may not be updated.

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