Podcast Summary: Becker’s Healthcare Podcast – Michael Evans, Chief Pharmacy Officer at Geisinger

Date: January 17, 2026
Host: Ella Jeffries, Becker’s Healthcare
Guest: Michael Evans, RPh, MBA, FASHP, Chief Pharmacy Officer, Geisinger

Episode Overview

This episode explores Geisinger's leading pharmacy initiatives, priorities, and challenges as the organization navigates the evolving healthcare landscape into 2026. Michael Evans discusses major operational shifts, including biosimilar adoption and the impact of policy changes, and shares his perspective on emerging opportunities and the most difficult decisions pharmacy leaders face today.

Key Discussion Points & Insights

1. Introduction and Geisinger's Pharmacy Structure

[00:30 - 01:50]

• Michael Evans introduces himself as a pharmacist with over 30 years at Geisinger, leading a pharmacy team of over 500 pharmacists and 1,000 technicians.
• Geisinger described as a comprehensive integrated delivery network (IDN) with 11 hospitals, numerous clinics, and a broad spectrum of pharmacy services: retail, specialty, home infusion, mail order, and embedded hospital and clinic pharmacists.

Notable Quote

"We have about everything you can think of from delivering pharmaceutical services... Truly blessed to have the support of our leaders at Geisinger to have such a robust team of pharmacy experts to serve our patients and our communities."
— Michael Evans [01:43]

2. Major Pharmacy Initiatives in 2025

[02:01 - 04:25]

• Inflation Reduction Act (IRA): Significant impact on Geisinger's managed care, notably Medicare benefits, requiring a near reset of their Medicare product.
• Biosimilar First Strategy: Organization-wide push to transition to biosimilars, regardless of line of business (Medicare, Medicaid, commercial, ACA), targeting drugs like Humira and Stelara.
  • Achieved 90%+ member adoption of Humira biosimilar and successful transition for Stelara and treatments for wet macular degeneration.

Notable Quote

"We set up ourselves to be biosimilar first ... transitioning all of our patients for any of the available biosimilars. Over 90% of our members are on the biosimilar Humira."
— Michael Evans [03:10]

3. Rationale Behind Biosimilar Adoption

[04:34 - 05:17]

• Main driver: Making healthcare more affordable while ensuring clinical efficacy and safety.
• Emphasis on lowering member cost-sharing without compromising clinical outcomes.

Notable Quote

"We look at clinical efficacy first ... they were as efficacious and not harmful to any of our members. We took on the task of making the transition to make health care affordable for our patients and communities."
— Michael Evans [04:54]

4. Priorities & Headwinds for 2026

[05:26 - 07:15]

• Continued IRA Impact: Negotiated government pricing for the first ten drugs; introduces significant payer-strategy complexity.
• 340B Rebate Model: Legal uncertainties complicating rebate implementation for high-cost medications.
• Cell and Gene Therapy: Growing complexity in both clinical management and revenue capture as high-cost therapies ($0.5–10M per application) emerge.
  • Focus on balancing access, revenue management, and risk (clinical and financial) for transformative therapies.

Notable Quote

"The transition from small molecule therapy to now cell and gene therapy and just the complexity ... these therapies, as we know, are half a million to 7, 8, 9, $10 million per application."
— Michael Evans [06:15]

5. Most Difficult Leadership Challenges

[07:24 - 08:47]

• Hardest part: Making difficult access decisions about new, high-cost therapies where clinical effectiveness is limited to specific disease subtypes or genetic variations.
• Emotional challenge of having to deny hope when evidence or eligibility does not support therapy.

Notable Quote

"The hardest decision is going to say no to someone when we know the therapy is lifesaving, but ... their genetic mutation or their variation of disease or their age is beyond where we see efficacy."
— Michael Evans [08:06]

6. Team Preparedness and Leadership

[08:56 - 09:55]

• Success built on an enterprise pharmacy leadership team with deep expertise across hospital, ambulatory, managed care, strategy, and regulatory domains (340B, etc.).
• Cross-functional leadership vital for responding to rapid changes and new challenges.

7. Opportunities for Organizational Growth

[10:07 - 13:36]

• Addressing Pharmacy Deserts:
  • Significant closures of retail pharmacies (600 in Pennsylvania over 2–2.5 years) have created pharmacy deserts, affecting rural populations.
  • Geisinger adapts through distribution innovation: extended mail order, specialty, and home infusion services.
• Value of Distribution Channels:
  • Ensuring medication access correlates with better adherence, disease control, and reduced ER/hospital visits.
• Pharmacy Revenue Integrity:
  • End-to-end revenue management for high-cost therapies: payer contracting, prior authorization, payment assurance, cost control, and safe administration.
  • Need for pharmacy-specific revenue expertise in navigating complex payment and authorization environments.

Notable Quote

"The value that we gain ... by having a retail pharmacy is not just any margin ... it's about keeping the patient compliant ... so they're not having to go to the emergency room or having their disease progress."
— Michael Evans [11:34]

"From a pharmaceutical perspective and all the complexities and the loopholes ... having the expertise in pharmacy revenue integrity is going to be vital 2026 and forward."
— Michael Evans [13:15]

Memorable Moments & Quotes

• On biosimilar implementation:
  "We transitioned all of our patients ... Over 90% of our members are on the biosimilar Humira." [03:10]
• On difficult decisions:
  "The hardest decision is going to say no to someone when we know the therapy is lifesaving..." [08:06]
• On team collaboration:
  "I'm truly blessed to have an enterprise pharmacy leadership team ... involved in driving any of the initiatives or priorities..." [09:10]
• On the future of revenue management:
  "Having the expertise in pharmacy revenue integrity is going to be vital 2026 and forward." [13:15]

Timestamps for Key Segments

• 00:30 – 01:50: Michael Evans' Background & Geisinger's Pharmacy Profile
• 02:01 – 04:25: Top 2025 Initiatives (IRA Impact, Biosimilars)
• 04:34 – 05:17: Biosimilar Strategy Rationale
• 05:26 – 07:15: 2026 Priorities & Headwinds (IRA, 340B, Cell/Gene Therapy)
• 07:24 – 08:47: Hardest Leadership Challenges (Therapy Access Decisions)
• 08:56 – 09:55: Team Preparation & Cross-Functional Leadership
• 10:07 – 13:36: Opportunities for Growth (Pharmacy Deserts, Revenue Integrity)

Overall Tone

Michael Evans is candid, practical, and clearly passionate about patient access and quality. His tone blends realism about industry headwinds with an optimistic, solutions-focused approach to transformation—grounded in team collaboration, adaptability, and commitment to patient care.

Summary

This concise, insightful conversation charts the path ahead for Geisinger’s pharmacy operations—highlighting both the practical achievements of 2025 and the formidable challenges and opportunities on the pharmacy horizon in 2026. Michael Evans shares valuable lessons on strategic biosimilar adoption, revenue integrity, and the essential role of pharmacy leaders in addressing healthcare’s most urgent access and affordability challenges.