Developing a direct-to-employer strategy for gross-to-net optimization

Identifying partners, discounting, support services, and customer engagement strategy

The challenge

A large pharmaceutical manufacturer sought to evaluate how its specialty pharmacy portfolio could align with emerging direct-to-employer (DTE) models. The organization wanted to better understand the evolving DTE landscape, identify partnership opportunities, assess employer expectations, and determine the operational requirements necessary for successful implementation.

The goal was to evaluate opportunities to improve gross-to-net (GTN) performance while developing a scalable strategy for engaging employers through innovative contracting and service models.

Our approach

Acumetis conducted a comprehensive assessment of the DTE ecosystem to understand stakeholder expectations, partnership opportunities, and implementation considerations.

This included:

Leveraging our network:

• Engaging DTE technology enablers to evaluate operational feasibility and partnership opportunities
• Connecting with transparent pharmacy benefit managers (PBMs) to understand contracting structures and reimbursement considerations
• Connected directly with employers and major U.S. self‑funded employer coalitions to understand economic expectations and service‑level needs for successful contracting

Building the strategy:

• Synthesized insights from network engagements to develop a phased DTE implementation strategy
• Focused on product fit, pricing, GTN improvement expectations, and partner deployment sequencing
• Established a structured roadmap to support a successful DTE contracting approach

Insights were synthesized into a strategic framework focused on product fit, pricing considerations, GTN improvement opportunities, contracting strategy, and deployment planning.

The solution

Through this engagement, the client gained a clearer understanding of the evolving direct-to-employer (DTE) landscape, including the stakeholders, partnership models, and market dynamics shaping future opportunities. By engaging with key players across the ecosystem, the organization was able to identify potential partnership opportunities and better understand the capabilities required to support a successful DTE strategy.

The engagement also resulted in a detailed playbook and strategic roadmap designed to guide future decision-making. The roadmap provided a structured framework for evaluating assets, assessing potential partners, and planning a phased deployment approach with vendors and employers. These insights helped position the client to evaluate DTE opportunities more strategically while creating a practical path toward future implementation.

Why it worked

Successfully evaluating emerging commercialization models requires a deep understanding of stakeholder priorities, market dynamics, and operational realities.

By engaging organizations across the DTE ecosystem and translating those perspectives into actionable recommendations, the client gained the clarity needed to evaluate opportunities, reduce uncertainty, and make more informed strategic decisions.

The outcome

• Developed a clear understanding of the DTE ecosystem and market dynamics
• Identified potential partners across technology, PBM, employer, and support service organizations
• Delivered a strategic roadmap to support implementation planning
• Established a framework for evaluating contracting and discounting opportunities
• Supported future GTN optimization and commercialization decisions

Commercial strategy solutions that support smarter business decisions

Commercial success requires connected thinking across brand, asset, portfolio, and enterprise priorities. We combine competitive intelligence, customer insights, market dynamics, and commercial expertise to help organizations make confident decisions from asset evaluation and portfolio strategy through launch and in-market optimization. Drawing on experience across 200+ launches, we help clients challenge assumptions, align stakeholders, and turn strategy into execution.

Looking to evaluate direct-to-employer opportunities?

Acumetis helps pharmaceutical manufacturers assess emerging commercialization models, identify strategic opportunities, and develop actionable roadmaps that support growth, market access, and long-term success.

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