Pharmaceutical manufacturer contracting is a key element of account engagement to enhance and/or maintain market access; however, the contracting landscape can vary greatly by therapeutic area. HIRC's report, The Contracting Environment in 2025, assists pharmaceutical manufacturers in understanding trends in contracting with commercial payers across therapeutic categories spanning traditional, specialty and oncology. The report addresses the following questions:

• What is the status of contracts in-place or offered to commercial health plans in the last 12-18 months across 40 traditional, specialty, and oncologic therapeutic areas?
• What is the status of contracts in-place or offered to pharmacy benefit managers in the last 12-18 months across 16 broad traditional categories?
• What contract approaches are most common overall and by therapeutic area (e.g., flat access rebates, price protection, market share rebates)?
• What are the most common average discount/rebate amounts offered across 40 traditional, specialty, and oncologic therapeutic areas?
• What is the status of alternative or novel contracting approaches, such as risk/outcomes-based, portfolio, and indication-based contracts?

Key Finding: The contracting environment in 2025 is active, but varies by therapeutic area with a greater share of contracts reported in more competitive and/or crowded categories.

The Contracting Environment: Traditional Rx Categories. Across traditional Rx categories, contracts with commercial health plans are most common  airway diseases and obesity/diabetes. Over half of commercial plans (53%) have or have been offered a contract in the last 12-18 months for airway disease medications and/or GLP-1 agonists. In airway diseases, a 'combination contract' approach that includes both a flat access rebate and price protection is most common, with an average rebate amount of 31%.

The complete report includes contract prevalence, approaches, and rebate/discount amounts for a listing of 20+ additional specialty & oncology therapeutic areas/medication classes.

Alternative Contracting Approaches. HIRC also analyzes the prevalence of alternative contracting approaches, such as risk/outcomes-based contracts, portfolio contracting, and indication-based contracts. One-third of commercial health plans report at least one risk/outcomes-based contract in-place in 2025, most often in rare disease. Over 40% of plans report portfolio contracts, most often in inflammation & immunology. Indication-based contracts are less common overall. The complete report provides three-year trend data, therapeutic areas reported for each alternative contract approach, and contract examples.

Extensive Listing of Therapeutic Areas are Examined. The complete report reviews contracting prevalence, approaches/types, and most common average rebate discount amounts across the following therapeutic areas/classes:

Research Methodology and Report Availability. Special reports draw upon data across HIRC services, allowing readers to glean insights into high level topics across varying market segments, channels, and/or therapeutic areas. HIRC's report, The Contracting Environment in 2025, includes survey and qualitative follow-up interview insights from various commercial health plan and pharmacy benefit manager panels, collected in 2025. The report is available now to HIRC’s Special Report Series subscribers at www.hirc.com.