Changes at FDA, HHS Ranked No.1 Development, Survey Finds | MHE 2025 Pharmacy Survey, Part 1

We conducted our annual Managed Healthcare Executive Pharmacy Survey from March 10 through April 9, 2025. With some help from our colleagues at The American Journal of Managed Care, we had results from 123 respondents. The respondents were spread fairly evenly across the segments of the U.S. healthcare sector, with approximately a quarter indicating that they worked for a provider, a quarter indicating that they worked for a payer, and a slightly smaller proportion (22%) indicating they worked in higher education. The rest of the respondents said they worked for the government, a vendor or an unspecified “other” category.

The survey was conducted before the sweeping executive order on April 15 that calls for new regulations, guidance or hearings on everything from CMS drug price negotiations to pharmacy benefit manager (PBM) transparency to anticompetitive behavior of drug manufacturers. Even so, the survey reflects the impact of the Trump administration, with approximately half (48%) of the respondents indicating that changes at the FDA and other HHS agencies would be the most important development in the pharmaceutical sector in 2025. Biosimilars gaining market share were a distant second (12%), with declining vaccination rates following close behind (11%)

A third of the respondents ranked Alyftrek (vanzacaftor, tezacaftor and deutivacaftor), the cystic fibrosis treatment that is priced to cost $370,000 per year, as the drug that will have the largest effect on payer budgets, followed closely by Datroway (datopotamab deruxtecan), an antibody-drug conjugate that was approved by the FDA as a treatment for breast cancer in January 2025.

The results were different when the question was about which new drug will make the biggest difference in patient health. A solid plurality (40%) picked Cardamyst (etripamil), a drug used for acute episodes of paroxysmal supraventricular tachycardia, a type of abnormal heart rhythm. While we were collecting responses to our survey, the FDA issued a complete response to the drug’s maker, Milestone Pharmaceuticals, because of problems at its manufacturing facilities. After Cardamyst came Datroway (20%) and Alyftrek (18%) in the votes for the drug likely to make the biggest difference in patient health.