Spotlight: Heather Sundar, CEO, Archimedes™

Before Archimedes™, you held senior leadership roles at major health care organizations and built your career as a pharmacist. You have deep experience in benefit strategy. How did your experience shape your decision to join Archimedes?

I made the move to Archimedes to align with the plan sponsors. Given the skyrocketing cost of pharmacy benefits and the expectation that specialty drug spend could exceed 50% of the benefit, it was evident that it was time to challenge the status quo. At Archimedes, I have been able to work with billions of dollars of drug spend across both the pharmacy and the medical benefits, providing guidance and solutions for plans looking for ways to maintain high-quality clinical care at an appropriate price. Taking this pragmatic, health economic and aligned approach, we have been successful at saving clients millions of wasted dollars in specialty drug management. I am passionate about leading market-changing solutions and paving the way for more sustainable pharmacy and medical specialty drug benefits.

Why was Archimedes founded, and why is that mission even more critical today?

Archimedes was founded in 2016 to transform specialty drug management. Specialty drug cost trends have risen year-over-year for more than a decade. The category is difficult to control for two key reasons. First, specialty drugs are managed in fragmented ways. They are split between pharmacy and medical benefits with limited coordination or accountability. Second, traditional PBM models are not incentivized to lower costs, as their business models profit from high-cost medications.

These challenges have intensified. But Archimedes was built to close those gaps by bringing technology, clinical expertise and data together to manage specialty as one connected category. This helps plan sponsors, health plans and health systems to reduce risk and control costs in this category, while staying ready for what comes next.

Specialty drug costs continue to rise year after year. What does it take to control that trend?

The challenge is that specialty costs do not rise at once, they add up over time. Every year brings new therapies, expanded indications and broader use. We also see more high-cost drugs processing under the medical benefit, where oversight is limited.

Effectively managing trend requires taking both proactive and reactive approaches across the pharmacy and medical benefit. If you’re only reacting after costs accumulate, you are already behind. When decisions are made up front to define guardrails, spend is monitored holistically and clinicians are engaged early and often, patterns can be mitigated or identified and addressed before they become baked in. That’s what allows organizations to stay ahead of specialty cost growth instead of constantly playing catch-up.

Traditional PBM models are often criticized for misaligned incentives. What do plan sponsors most need to understand about how those conflicts drive higher specialty drug costs?

In specialty, incentives matter because they shape decisions. When revenue is tied to rebates or drug prices, it can push choices that raise costs without improving care.

Specialty drugs require clinically grounded decisions, balancing care and affordability. When incentives are misaligned, it becomes harder to focus on what truly benefits patients and plan sponsors. Aligning goals around evidence and outcomes creates clearer accountability and more sustainable specialty cost control over time.

Plan sponsors often say they don’t have a clear picture of what’s driving specialty drug costs. How does Archimedes help bring clarity and accountability to that spend?

Specialty drugs are often managed under the medical benefit, which makes it difficult for plan sponsors to understand usage and control costs. The medical benefit simply wasn’t designed to manage prescriptions at this level of detail.

By managing specialty drugs across both the pharmacy and medical benefits, Archimedes is able to provide drug level oversight. Plan sponsors gain clear insight into utilization, cost drivers and performance — along with confidence that specialty spending is being actively managed and savings are measurable.

As health care becomes more data-driven, there’s a real risk of losing the human connection. How does Archimedes ensure their members receive personalized care?

Data is essential, but specialty drug management does not work without staying focused on the people central to treatment. This includes both patients and prescribers. Patients (our members) are facing serious, often life-changing conditions, and algorithms alone cannot support that level of complexity. Prescribers want the best for their patients yet are not always familiar with how to best navigate the realities of insurance.

Our clinical teams stay directly involved with both members and prescribers throughout the treatment journey, not just with approval. They help guide decisions, ensure follow-through and stay engaged as therapies change.

That kind of personalized, guided care at scale is central to delivering strong outcomes while maintaining trust with members, prescribers and clients.

Looking ahead, what must change across the PBM industry to make specialty drug benefits sustainable long term, and what role do you see Archimedes playing in that transformation?

The industry must move beyond fragmented management and misaligned incentives. Sustainable specialty drug benefits require integrated oversight across pharmacy and medical, evidence-based clinical decisions and clarity to drug costs, holding everyone accountable.

Archimedes is helping to lead that transformation. We’ve shown it’s possible to manage specialty drugs holistically, maintain the human connection and control trend over time without relying on opaque, misaligned financial models.

As the specialty landscape continues to evolve, our focus remains the same: disciplined management, aligned incentives and care that puts patients first.

What final thoughts would you like to share?

What excites me most is the opportunity for our enterprise — Archimedes, Navitus and Lumicera — has to change how specialty drugs are managed. By combining transparent PBM practices, deep clinical and medical benefit expertise, and cost-plus specialty pharmacy, we’re able to manage specialty drugs more proactively, control trend over time and deliver better outcomes for members and plan sponsors.

Plan sponsors do not have to accept the status quo; there are solutions to help keep the specialty drug benefits affordable and sustainable.

Getting Started

See how Navitus and Archimedes can help you take control of your medical specialty spend. Contact us at [email protected].