The pharmaceutical industry is undergoing a significant transformation, driven by regulatory changes, evolving pricing structures, and the growing impact of biosimilars. Companies managing pharmaceutical purchases are under pressure to navigate these shifts while maintaining cost efficiency and ensuring access to life-saving medications. “Changes such as the removal of Average Manufacturer Price (AMP) Cap and the Inflation Reduction Act are reshaping the pricing landscape, impacting both biosimilars and brand-name drugs,” says Miranda Yeager, the newly appointed President of Gateway Health Partners (GHP). “Our clients rely on us to stay ahead of these changes and develop strategic solutions that ensure they can continue to deliver value to their customers.”

For example, low cost biosims help payers save money while reducing or eliminating what has been historically large rebates. One of the many ways GHP sets themselves apart from their competitors is by helping clients navigate these shifts with clarity, insights and expertise. GHP’s approach is tailored to these diverse client needs, ensuring they have options that align with their financial and operational goals. Additionally, when faced with competition, are now extending rebates for longer periods than before.

Founded in 2014, Gateway Health Partners has grown to become the largest independent provider of rebate and formulary management services in the United States. With a commitment to flexibility and transparency, the company offers unbundled, à la carte prescription cost management solutions, spanning rebates and retail network management. “We are built on three pillars: Clarity, Insights, and Expertise,” says Miranda. “Our goal is to serve as an extension of our clients’ teams, providing solutions that are data-driven, strategic, and tailored to their unique needs.”

GHP’s services include formulary management, data-driven decision-making, rebate management, customized reporting, and innovative technology solutions like ProOptimizer, which automates contract compliance with pharmaceutical manufacturers and NetOptimizerRx, a solution that further enhances contract management and analytics, ensuring that clients receive the best possible pricing structures. One of the company’s standout offerings is MedOptimizerRx, a comprehensive solution designed for high-cost medications administered by a healthcare provider (often infused or injected drugs used in hospitals or clinics), such as those for rheumatoid arthritis and cancer. Unlike traditional pharmacy rebates, medical rebates require stringent qualification processes. “We ensure that formularies align with policy, verify that clients are the final payers, and leverage value-based models to unlock additional savings,” explains Miranda.

In response to evolving market needs, Gateway Health Partners continues to expand its portfolio, introducing a Medical Management suite that will not only include MedOptimizerRx, but will also include a specialized solution for employers managing specialty drugs under medical benefits. Additionally, the company is actively engaged in addressing challenges within the 340B drug pricing program, advocating for fair rebate strategies and, when appropriate, helping health systems choose between rebates and 340B discounts.

A Data-Driven Approach to Contract Negotiation and Rebate Management

Gateway Health Partners is renowned for its best-in-class contract negotiation strategies, ensuring that clients receive the most competitive discounts in the market. Unlike other providers that make unrealistic projections, GHP emphasizes transparency and predictability in its contract guarantees. “Many organizations in our industry overpromise and underdeliver when it comes to rebate agreements,” notes Miranda. “At Gateway, we take a data-first approach, ensuring that every contract we negotiate is based on realistic projections and sustainable outcomes.”

The company’s proprietary ProOptimizer technology is a game-changer in rebate and formulary management. Designed to streamline contract administration, ProOptimizer features market check functionality, real-time financial reconciliation, and automated invoicing capabilities. Clients benefit from enhanced visibility into their cost structures, ensuring that rebate agreements align with their financial objectives. “Our 360-degree support model ensures that we provide the best contracts, advanced analytics, superior service, and clinical insights to help our clients make informed decisions,” Miranda adds.

Leadership Driving Growth and Innovation

Under the leadership of Miranda Yeager, Gateway Health Partners is poised for continued growth and innovation. Yeager brings over three decades of experience in both client and service-provider roles, giving her a unique perspective on the challenges and opportunities within pharmacy management.

Early in her career, she served as the Director of Pharmacy at Blue Cross and Blue Shield of North Carolina, where she spearheaded the implementation of managed pharmacy benefits at a time when such models were still emerging. This background has shaped her approach to leadership at Gateway. “My mentors always encouraged me to look to the future, and that’s exactly what we’re doing at Gateway Health Partners,” Miranda shares. “We are expanding our portfolio, forging new partnerships, and enhancing our technology offerings to provide greater value to our clients.”

The management team at Gateway Health Partners is comprised of industry veterans, many with over 20 years of experience in pharmacy management. Their collective expertise has cemented the company’s reputation as a trusted partner in the industry. In fact, 100% of clients responding to a 2024 survey stated that GHP consistently delivers on its contractual commitments.

Standing Apart in a Competitive Market

As the demand for cost-effective pharmacy management solutions continues to rise, Gateway Health Partners remains a leader in the space by prioritizing predictability, transparency, and flexibility. “At the core of what we do is a commitment to simplifying complexity,” says Miranda. “We empower our clients with the insights and tools they need to make strategic, informed decisions about their pharmacy spend.” Unlike competitors that offer rigid, one-size-fits-all solutions, GHP takes a more consultative approach, working closely with clients to tailor strategies that align with their business objectives. Whether it’s leveraging advanced analytics, designing custom formularies, or optimizing rebate structures, GHP consistently delivers results.

One of the most compelling testaments to Gateway Health Partner’s impact is the story of a former client that left to pursue direct contracts with drug manufacturers in an effort to increase rebate yields. However, after struggling to achieve the expected savings, the client returned to GHP and have experienced significant financial growth through the company’s expert rebate management strategies. “Clients who leave often realize that the promises made by other providers don’t hold up in practice,” says Miranda. “Our integrity, transparency, and commitment to delivering on our agreements set us apart. We don’t just promise results—we achieve them.”

A Vision for the Future

Gateway Health Partners was founded in 2014 to address an unmet need in the marketplace. At the time, many rebate providers did not support custom formularies, leading to suboptimal rebate yields. GHP emerged as a solution-oriented partner, offering customizable strategies that empowered clients to maximize savings and growth. “The industry has evolved significantly over the past decade, and so have we,” says Miranda. “Our focus is on providing clients with clear, actionable insights into how market changes impact them and helping them develop strategies to mitigate risks and optimize savings.”

Looking ahead, Gateway is enhancing its analytics and reporting capabilities to give clients even deeper visibility into their financial and utilization data. These insights will allow clients to identify key rebate drivers, track market share trends, and optimize formulary design. “Our roadmap includes expanded medical rebate products, self-service tools for reporting and underwriting, and advanced analytics that leverage AI and automation to drive smarter decision-making,” Miranda reveals.

As Gateway Health Partners continues to innovate and expand, the company remains steadfast in its commitment to delivering clarity, insights, and expertise. Under Miranda Yeager’s leadership, GHP is well-positioned to help clients navigate industry challenges, optimize pharmaceutical costs, and drive long-term success. “The future of pharmacy management lies in data-driven, transparent solutions,” Miranda concludes. “Gateway Health Partners will continue to be the trusted partner that clients can rely on to simplify complexities and maximize value.”