The Drug Channels blog delivers timely analysis and provocative opinions on pharmaceutical economics and the drug distribution system. It is written by Adam J. Fein, Ph.D., one of the country's foremost experts on pharmaceutical economics and channel strategy. Learn more...

Thursday, October 23, 2014

Thoughts on Caremark’s No-Tobacco Preferred Pharmacy Network

On Monday, The Wall Street Journal broke the news that CVS Health’s Caremark PBM will offer a new twist on preferred pharmacy networks. Consumers will face higher co-payments at pharmacies that sell tobacco products. See Caremark to Charge Extra Co-Pay at Pharmacies Selling Cigarettes. (The article includes comments from your friendly neighborhood blogger.)

The story generated plenty of other press coverage, much of it favorable for CVS Health. Below, I consider the move’s impact, including the payer’s perspective, the future of preferred networks, likely adoption rates, potential competitive effects on other drugstores, and whether CVS will replace $2 billion of lost tobacco revenue.

As a bonus, I tell you about Thank You For Smoking, one of my favorite movies.

Tuesday, October 21, 2014

EXCLUSIVE: Walmart and Walgreens Dominate 2015 Part D Preferred Networks, With Independents Close Behind

In my previous post (For 2015, almost 9 out of 10 Medicare Part D plans will have a preferred pharmacy network), I highlighted the plans whose preferred pharmacy networks will dominate next year’s Medicare Part D prescription drug plans (PDP).

Today, I examine the pharmacy chains in the biggest plans’ networks. Walmart again leads the pack in preferred network participation. Walgreens has a big bet on preferred networks, while CVS and Rite Aid have been more cautious. Independent pharmacies feature prominently in many plans, which should—but probably won't—mute critics of preferred networks.

Read on for our exclusive look at 2015’s preferred network participants, along with some comments on DIR fees and pharmacy profits.

Monday, October 20, 2014

Specialty Data Optimization Summit

Specialty Data Optimization Summit
December 11, 2014 | Philadelphia, PA

CBI’s Specialty Data and Optimization Summit is the first and only event laser-focused on strategies for leveraging pharmacy data for the commercialization and market penetration of specialty products. This cutting-edge forum will provide you with in-depth discussions and key industry perspectives on how to maximize data to make informed, targeted decisions that take ROI to the next level.

Hear multi-stakeholder perspectives from Altometrixs, AstraZeneca, AxelaCare, Blue Fin Group, Exelixis, IMS Health, LiquidHub, Paragon, Prime Therapeutics, Vertex Pharmaceuticals, Xcenda, and more!

Drug Channels readers will save $200 off of the standard registration rate when they use code SHA526.*

Register today!

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rates. Other restrictions may apply.

Friday, October 17, 2014

Closing Gaps in Specialty Pharmacy Performance

Today’s guest post comes from Stephen C. Vogt, Pharm.D., President and CEO of BioPlus Specialty Pharmacy.

Dr. Vogt offers a thoughtful perspective on specialty pharmacies' shortfalls in managing patients with hepatitis C virus (HCV) infection. He then describes the BioPlus RxSteward™ drug management program, which uses real-time patient data to reduce unnecessary drug utilization while maintaining excellent clinical outcomes. Dr. Vogt also shares data on the program's substantial cost savings. He sees RxSteward™ transforming BioPlus from a dispenser to a partner in a patient's pharmaceutical care.

Read on for details, including a look at drug-cost savings by HCV drug regimen and HCV genotype. Please contact BioPlus for more information about RxSteward™.

Tuesday, October 14, 2014

EXCLUSIVE: For 2015, almost 9 out of 10 Medicare Part D plans will have a preferred pharmacy network

Tomorrow, Medicare Part D kicks off its open enrollment period. Through December 7, America’s seniors can keep their current plan or switch to a new one.

Who ya gonna call to understand the latest preferred pharmacy network trends? Drug Channels, of course!

For 2015, our analysis reveals that an astonishing 87% of Medicare Part D regional prescription drug plans (PDP) will have a preferred cost sharing network. That’s a big Twinkie!

Read on for our exclusive look at the 2015 Part D landscape, which includes insights on the major health plans—UnitedHealthcare, Humana, Express Scripts, et al—behind the PDPs.

Are pharmacies headed for a disaster of biblical proportions? In an upcoming article, I’ll look at pharmacy participation in the biggest plans’ networks.

Monday, October 13, 2014

VA • DoD • PHS • Federal Pricing and Contracts for Bio/Pharma Companies

VA • DoD • PHS • Federal Pricing and Contracts for Bio/Pharmaceutical Companies
December 9-10, 2014
Philadelphia, PA

Contracting with the Big Four Federal Programs can be very complex. Pricing models and processes for complying with complicated rules and regulations are difficult for any manufacturer to master.

CBI’s VA • DoD • PHS • Federal Pricing and Contracts is a must-attend event to stay up-to-date on processes and requirements and to gain best practices from your industry counterparts. Learn how to stay profitable in this low-margin, highly complex market.

You will gain insights from experts representing: Amneal Pharmaceuticals, Eisai, Epstein Becker Green, Government Pricing Specialists, Hogan Lovells, Impax Laboratories, IMS Health, M. Lee Consulting, Medicine Access and Compliance Coalition, National Supply Service Center, Nationwide Pharmaceutical, Pernix Therapeutics, Pfizer, Reckitt Benckiser Pharmaceuticals, VA Office of Contract Review, and VA Office of Inspector General.

Drug Channels readers who register before November 7th will save $400 off of the standard registration rate when they use code JDG992.*


*Cannot be combined with other offers or used towards a current registration or applied to special category rates. Other restrictions may apply.

Friday, October 10, 2014

How Hospitals Inflate Specialty Drug Prices

Last Sunday, 60 Minutes aired a controversial anti-pharma story called The Cost of Cancer Drugs. The segment prominently featured several Memorial Sloan-Kettering and MD Anderson physicians, all of whom spoke with no self-awareness about health care costs. (Hints: Drugs are not the problem.) For your consideration, here is a rerun of a still-relevant Drug Channels article from October 2012, complete with my original 340B predictions from that period. P.S. Special pricing for our new 2014–15 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors ends today!

Many people blame pharmaceutical manufacturers for high specialty drug prices. Yet channel intermediaries also add to drug prices, via mark-ups that account for the costs, profits, and value of the channel's services. But sometimes these mark-ups are eye-poppingly outrageous, as appears to be the case for North Carolina hospitals.

According to N.C. nonprofit hospitals make big money on cancer drug markups, hospitals are routinely marking up specialty drugs far above Average Sales Price (ASP). For example, the table reproduced below shows that Duke University Hospital received nearly $23,000 for Avastin, versus an ASP of about $6,000. And as reported in Prices soar as hospitals dominate cancer market, hospitals are buying independent oncology practices and then able to charge more “for the same chemotherapy in the same office,” due to differences in payment methods.

For payers, these examples highlight the appeal of channel management strategies such as white bagging and medical benefit management. For manufacturers, the stories illustrate what happens to drug prices as providers consolidate and traditional classes of trade blur.

Read on and be outraged.

Thursday, October 09, 2014

New Findings on Oral Oncologic Spending and Hospitals’ 340B Abuse

October’s Health Affairs focuses on “Specialty Pharmaceutical Spending & Policy,” and it offers many must-read articles for anyone working with specialty drugs. Check out the table of contents. (Sorry, full articles are available only to subscribers.)

The issue includes National Trends In Spending On And Use Of Oral Oncologics, First Quarter 2006 Through Third Quarter 2011, an article I co-authored with Rena Conti, Ph.D., a health economist at the University of Chicago, and Sumita Bhatta, MD, a former oncology fellow at the University of Chicago School of Medicine.

Below, I highlight key findings from our paper. I also discuss a notable and controversial paper on hospitals’ 340B abuses.

Tuesday, October 07, 2014

Congress Grills Generic Drug Makers Over Price Inflation

Why do generic drug prices continue to rise? In theory, sky-high inflation for a particular product should encourage new suppliers, thereby lowering prices.

Looks like Congress is also curious about the mystery of persistent generic drug inflation. U.S. Sen. Bernie Sanders (I-VT) and U.S. Rep. Elijah E. Cummings (D-MD) sent information requests to 14 generic pharmaceutical manufacturers. Below, I list the companies and provide direct links to the letters.

As you can see from the questions (also listed below), the congressmen are requesting details about pricing, contracts, purchasers, costs, and other internal details.

Political grandstanding, or a potential turning point for generic inflation? Even the most interesting man in the world doesn't know.