The 2025 Asembia Specialty Pharmacy Summit brought together industry leaders, innovators, and decision-makers to address the rapidly evolving landscape of specialty pharmaceuticals and market access. Nexus Health Group engaged in forward-looking conversations on everything from the Inflation Reduction Act’s long-term implications to innovative approaches for value communication, affordability, and patient support. Our team participated in panels, attended high-impact sessions, and engaged in client meetings that shed light on emerging trends and practical solutions, designed to help our client partners stay ahead of industry shifts and make informed decisions that drive market access.

1. Inflation Reduction Act (IRA) continued to be front-and-center at Asembia this year, given the implications of negotiated maximum fair prices (MFPs) being implemented in January 2026. With a lot still unknown about the negotiation process, sessions focused on the importance of how manufacturers should prepare for negotiations, potential market consequences, and anticipated CMS guidance about how the MFP will impact Medicare payments.
2. At the heart of all market access efforts is the patient, and patient access and affordability remain a critical focus in the healthcare landscape. Across the pharmacy and medical benefit channels, multiple access barriers persist, shaped by regulatory shifts, evolving payer strategies, and patient-specific needs. Improving patient access also depends on more patient-centric models of engagement, with tailored patient support services, consideration of mode and timing of patient engagement, and a clear need for patient education and navigation support to gain familiarity with financial assistance programs and to understand insurance coverage.  
3. Appropriate implementation of AI in market access continues to be a hot topic, with AI agents becoming part of process integration, focusing on ensuring compliant and safe use. With 78% of payers currently using AI to support access strategies, use will continue to increase in the next 2-3 years, including the use of AI in patient services to allow for optimization of patient engagement, pricing and access modeling, real-world data and HEOR analyses, payer negotiation strategies, segmentation, and competitor landscape analyses.
4. Earlier market access investment and planning are gaining traction. As the market landscape continues to evolve, driven by increased pricing pressures, policy changes, and heightened payer scrutiny, companies are shifting their approach to market access launch planning. There is a clear trend toward earlier integration of access strategy within the product development lifecycle, initiating planning as early as Phase 1. During mid- to late-stage development, a critical element in the launch planning process is a compelling value story. At the Asembia session led by Nexus Health Group, we explored “Three Ways to Tell a Payer Value Story,” emphasizing how this narrative must evolve to meet the expectations of today’s stakeholders. Our panel discussion focused on redefining the traditional value message and moving beyond data-heavy presentations to craft a story with a strong foundation in science, strategically tailored to resonate across diverse stakeholder audiences, and creatively delivered to be clear and engaging.
5. Cell and gene therapies continue to be a focus due to high costs and uncertainty over long-term outcomes. Projections suggest that more than 100,000 patients may be treated with cell and gene therapy (CGT) by 2030. With CGT costs ranging from $500,000 to more than $4 million per patient, solutions to justify the long-term value of the treatments and innovative payment models are needed. Important considerations include optimal supply chain and channel designs for product complexity, establishment of a network of qualified treatment centers ahead of launch, and value-based payment solutions.

About Nexus Health

The Nexus Health Group provides an integrated, simplified approach to comprehensive market access strategies, offering solutions in strategic
consulting, value communications, and patient access and affordability. Nexus experts combine deep market access experience in complex therapies with a foundation in science to provide the strategic advantages manufacturers need to launch and differentiate their products in today’s marketplace. Launched in 2025, Nexus may be a new company, but with an average of 21+ years of experience, the team is far from new to market access.

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