Watch New Episodes of The GTN Edge Here
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Somewhere between a finance team’s quarterly close and a patient walking away from a pharmacy counter empty-handed, $90 billion disappears. Not slowly, not quietly – it evaporates every single year – and every single day – out of pharma’s gross revenue line. Many will nod along to that statistic, say something appropriately grave about it, and then go back to “managing” it through spreadsheets and six-month lookbacks.
That’s the part that’s upsetting. We know it’s happening. We even know it’s solvable. We just haven’t had a great forum for actually talking about where, why, and how – until now.
RIS Rx co-founders Gerard Rivera, PharmD and Stephen Hom, PharmD just launched The GTN Edge Podcast. Gerard is CEO, Stephen is EVP/COO, and between them they’ve got firsthand experience as pharmacists, which means they’re not approaching GTN from a purely financial lens. They’ve stood at the pharmacy counter. They’ve seen the moment a patient does the math on their copay and decides it’s not worth it. That context matters, and it shows in how they talk about these problems.
The premise is straightforward: GTN leakage isn’t just an accounting exercise. It’s a systemic failure with real consequences for patients, for brand performance, and for the manufacturers who built affordability programs in good faith only to watch the dollars leak into a black hole of rebate structures and PBM dynamics.
Episode 1, “The $90B Leakage Problem”, sets the table. Gerard and Stephen walk through the root causes: the blind spots hiding across fragmented data ecosystems, pharmacy networks, hubs, and manufacturer systems that don’t quite talk to each other. They close with a framework built on three pillars: traceability, real-time insight, and cross-channel alignment. It sounds clean on paper, and honestly, it is.
Episode 2, “Pharma’s Land of Good Intentions: Fixing the Patient Escalation Crisis”, brings in industry veteran Tom Doyle and gets into what I’d argue is the stickier problem: what happens when the support system exists but still fails the patient. Broken escalation paths, the (welcome!) rise of Direct-to-Patient models, and a support infrastructure that wasn’t built to handle the complexity it’s now navigating. The title says “land of good intentions” and I think that’s exactly right – this isn’t an industry full of bad actors. It’s an industry where the incentives, the data, and the workflows just don’t align well enough to deliver what was promised.
This podcast is most valuable for senior executives, market access professionals, patient services leaders, and commercial finance teams who’ve spent years treating GTN as a back-office problem. If that’s been your posture, these two episodes will be a little uncomfortable. In the best way.
New episodes drop every month on the RIS Rx YouTube channel. Worth your time.
