The first four installments of "The Great Repricing" series showed how the U.S. pharma market has split into three payer economies, commercial, government, and cash, each with its own rules, incentives, and pricing logic. These markets no longer operate in isolation; manufacturers must now commercialize across all three at once.

That raises the real question: how do manufacturers maximize a product's enterprise value across its full life cycle? The old playbook, launch through commercial insurance, secure formulary access, absorb government business as it comes, support patients with affordability programs, and manage the long decline post-exclusivity, was built for a commercial-insurance-dominated market. It no longer works.

The next era of commercialization strategy has to account for products moving across payer economies over time. The goal isn't just access anymore, it's enterprise value.