Executive Outputs
Pre-built executive views and exports. Built directly from the forecast engine — no separate spreadsheet to maintain.
Scenario comparison · Peak year
| Scenario | Peak yr | Filled pts | Access cut | Gross rev | Rebates | Net rev | Δ vs Base |
|---|---|---|---|---|---|---|---|
| Base Case | 2034 | 1.73M | 57.8% | $35.94B | ($15.62B) | $19.64B | — |
| Access Compression | 2034 | 667K | 69.6% | $13.81B | ($6.00B) | $7.55B | -61.6% |
| CV Label Expansion | 2034 | 2.87M | 48.2% | $59.39B | ($26.06B) | $32.19B | 63.9% |
Recommended actions · ranked by 10-yr impact
vs. Base Case baselineSix plays the engine can quantify today. Each is applied independently to the live forecast; the bar shows cumulative net revenue swing vs. doing nothing. Run the top picks through the simulator to test combinations.
What changes by scenario
Same forecast engine, three worlds. Each scenario pairs the revenue delta with a directional playbook — what to lean into (↑), hold (↔), or pull back from (↓).
Hold course — invest in evidence and outcomes contracting to defend the median.
- ↑Contracting. Lean into outcomes-based deals with top 3 PBMs.
- ↑Evidence. Fund RWE for employer ROI ahead of 2026 RFP cycle.
- ↔Price. Hold WAC; deepen rebates selectively.
Defend access — patient support, evidence, and channel focus take priority over price.
- ↑Patient support. Income-tested copay assistance to protect persistence at high OOP.
- ↑Evidence. Pragmatic CV-subgroup trial to harden the value story.
- ↑Channel. Pivot to employer-direct and cardiology to bypass PBM tightening.
- ↔Supply. Prioritize commercial allocation to protect highest-net-yield lives.
Monetize the opening — capture upside via price posture, indication-based contracting, and Medicare-eligible supply.
- ↑Price. Hold WAC and flatten rebates as access tailwinds reduce concession pressure.
- ↑Contracting. Indication-based pricing to capture CV value.
- ↑Supply. Prioritize Medicare-eligible patients ahead of broader Part D opening.
Payer economics view
Two lenses on the same scenario. Manufacturer net = gross − rebates − PBM admin fees. Payer net cost = gross − rebates passed through (PBM-retained $ and admin fees never reach the plan).
| Scenario | Peak gross | Manufacturer net | Payer net cost | PBM retained | PBM admin fees | PBM total capture |
|---|---|---|---|---|---|---|
| Base Case | $35.94B | $19.64B | $22.98B | $2.65B | $679M | $3.33B |
| Access Compression | $13.81B | $7.55B | $8.83B | $1.02B | $261M | $1.28B |
| CV Label Expansion | $59.39B | $32.19B | $37.76B | $4.43B | $1.14B | $5.57B |
Use this to pressure-test contracting strategy: a deeper rebate that the PBM largely retains — plus admin fees on top — delivers less payer-side value than the topline GTN suggests.
Payer economics by channel · Base scenario · Peak year
Where the dollars actually land. Pass-through to the plan vs. PBM capture varies dramatically by channel — Medicaid passes nearly everything through; commercial PBMs retain a meaningful share.
| Channel · Base Case | Mix | Gross | Manuf. net | Payer net cost | PBM retained | PBM admin fees | PBM capture |
|---|---|---|---|---|---|---|---|
| Commercial | 46% | $22.13B | $11.53B | $14.29B | $2.21B | $553M | $2.76B |
| Self-insured / carve-out | 12% | $3.17B | $2.00B | $2.17B | $111M | $57M | $168M |
| Medicare Part D | 14% | $1.79B | $1.25B | $1.37B | $93M | $27M | $119M |
| Medicare Advantage | 8% | $1.25B | $743M | $835M | $73M | $19M | $92M |
| Medicaid (FFS+MCO) | 16% | $4.66B | $1.33B | $1.52B | $165M | $23M | $189M |
| Cash / 340B | 4% | $2.93B | $2.78B | $2.78B | $0M | $0M | $0M |
| Total | 100% | $35.94B | $19.64B | $22.98B | $2.65B | $679M | $3.33B |
Demand → Filled funnel · Peak year
The brief calls out "any access cuts between HCP demand and filled utilization." This funnel shows where patients leak — HCP demand → access-cut to filled new starts → plus continuing patients carried in.
Available outputs
Every tile here is wired — either to a live module in the app or to a real download grounded in the current model state.