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, December 08, 2016

Plan Sponsors Like More Transparent PBMs—Yet Not All Choose Transparency

Pharmacy benefit managers (PBMs) are facing unprecedented criticism about their business practices and levels of transparency. Which got me wondering: What do plan sponsors—the PBMs’ customers—think about their PBMs?

For the answer, I turned to Pharmacy Benefit Management Institute (PBMI) 2016 Pharmacy Benefit Manager Customer Satisfaction Report (available for purchase.) It rates 11 PBMs based on feedback from more than 500 plan sponsor customers.

The data show a strong association between a PBM’s perceived transparency and a plan sponsor’s satisfaction. As you will see in the charts below, plan sponsors are more satisfied with PBMs that are more transparent.

Yet the causality of this relationship isn’t entirely clear. Smaller plan sponsors tend to work with smaller PBMs, which are rated more highly on transparency and alignment of goals. Are more transparent PBMs truly better? Or, are we observing a selection effect, whereby plan sponsors with fewer internal resources choose PBMs with different business and profit models? And if PBM transparency is so wonderful, why don’t all plan sponsors insist on it?

Tuesday, December 06, 2016

Novo Nordisk Sheds New Light on PBM Rebates, the Gross-to-Net Bubble, and Warped Channel Incentives

Novo Nordisk just released new data on the channel economics and pricing for its insulin products. See Perspectives from NNI President Jakob Riis on pricing and affordability

Like many manufacturers of relatively undifferentiated products, Novo Nordisk is trapped by a gross-to-net rebate bubble. Its list prices soar, but the net realized price barely budges. Below, I review Novo’s evidence on channel economics and highlight the perverse incentives that keep inflating the bubble.

The debate is heating up about the warped incentives baked into our crazy drug channel. I continue to believe that traditional pricing approaches will not survive. Novo even promised that future list price increases will be "no more than single-digit percentages annually." The change will be disruptive to PBMs, wholesalers, and payers. Who knows? Maybe the patients will benefit, too.

Monday, December 05, 2016

CBI’s 8th Hub and SPP Model Optimization

CBI’s 8th Hub and SPP Model Optimization
February 22-23, 2017 | Philadelphia, PA

Don’t miss the 8th installment of the industry’s must-attend meeting for sharing breakthrough strategies surrounding service model design and enhancement to improve access and outcomes!

CBI’s Hub and Specialty Pharmacy Provider (SPP) Model Optimization boasts exceptional networking opportunities and forward-thinking content from a broad array of stakeholders. Join your peers as you prepare to launch, transition or reboot your corporate or product approach to hub services.

Hear Industry Trailblazers Speak on High-Impact Topics, Including:
  • Industry Pulse on the Specialty Marketplace and the Changing Healthcare Landscape
  • Patient Services Compliance – Zero in on the Top Risk Areas amidst an Era of Ambiguity
  • Specialty Data Discovery Dive – Finding the Missing Link in Your Product’s Value Story
  • Scorecarding Summit – Measuring Hub Performance and Value
  • Advanced SP Contracting Course – Contract Design, Execution of Contract Amendments and Benchmarks to Renegotiate Terms of Agreement
  • Payer Approach and Decision-Making Journey for Specialty Drugs
  • Beyond Prior Authorization – Syncing Stakeholder Interests for Improved Patient Access
  • Insource, Outsource, Hybrid? Utilizing the Best Hub Service Model for Your Product Portfolio and Tap the Top Transition Strategies
Showcasing a dynamic group of key stakeholders from companies including Amgen, Avella Specialty Pharmacy, Bayer Healthcare, Boehringer Ingelheim, CoverMyMeds, GlaxoSmithKline, Intarcia Therapeutics, Lash Group, a part of AmerisourceBergen, MedImpact Healthcare Systems, Nuvera Life Sciences Consulting, Ogilvy CommonHealth Worldwide, Sobi, Sonexus Health, VirMedica and Triplefin, this is an opportunity you can’t afford to miss!

For more information, please download the complete agenda or visit Drug Channels readers will save $400 off of the standard registration rate when they use discount code FAZ895.*

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

The content of Sponsored Posts does not necessarily reflect the views of Pembroke Consulting, Inc., Drug Channels, or any of its employees.

Wednesday, November 30, 2016

CVS Changes Direction With Surprise OptumRx Deal

Well, CVS Health blinked.

In July 2017, CVS Health’s retail pharmacies will become a preferred retail channel for 90-day prescriptions dispensed to OptumRx’s commercial clients. Here’s the press release: OptumRx and CVS Pharmacy Partner to Expand Consumer Choice, Reduce Costs and Improve Health Outcomes.

The surprise announcement echoes the arrangement that OptumRx established with Walgreens. The new deal signals that CVS is starting to counter Walgreens’ aggressive partnering strategies. OptumRx customers also get to choose which chain will be their preferred 90-day at retail provider.

Below, I provide some context for the agreement and outline CVS Health’s two basic strategic options as it competes with Walgreens. I’m very curious to hear how CVS Health will spin this latest move during its upcoming analyst day, on December 15.

Tuesday, November 29, 2016

Drug Channels News Roundup, November 2016: CVS Caremark, Generic Drugs, Health-System Pharmacies, and the FDA

Hope everyone enjoyed the Thanksgiving holiday! Now that you’ve stretched your stomach, stretch your mind with some food for thought. In this issue:
  • Dispensing oncology practices win their battle with PBM CVS Caremark
  • 2016 was a record year for generic drug approvals (data below)
  • The ASHP’s latest forecast for health system pharmacy
Plus: The FDA approves a new product—with a twist!

P.S. ON SALE! Our 2016 Economic Report on Retail, Mail, and Specialty Pharmacies is now 40% off. The 2017 edition will be released in early February. (FYI: I announced the sale yesterday on @DrugChannels.)

Monday, November 28, 2016

Expanded Access Programs 2017

Expanded Access Programs 2017
March 9-10, 2017 | Washington, DC

The evolving political landscape is transforming and expanding patient access to experimental and unapproved drugs. CBI’s Expanded Access Programs is dedicated to the nuances and intricacies of designing and implementing early access programs. This multi-stakeholder event is focused on U.S. and global models for a variety of access management programs, including, but not limited to:

Expanded Access Programs, Early Access Programs, Compassionate Use Programs, Named Patient Programs and Managed Access Programs.

This is your opportunity to take a deep dive into the implications, prevailing policies, and current industry approaches to expanded access programs. Join industry thought-leaders and share key concepts around providing investigational, pre-launch or end-of-lifecycle drugs to patients for treatment purposes.

Visit for more information.

Drug Channels readers will save $400 off of the standard registration rate when they use discount code EAPDCH.*

*Applies to standard rates only and may not be combined with other offers, category rates, promotions or applied to an existing registration. Offer not valid on workshop only or academic/non-profit registrations.

The content of Sponsored Posts does not necessarily reflect the views of Pembroke Consulting, Inc., Drug Channels, or any of its employees.

Monday, November 21, 2016

CBI’s 12th Life Sciences Trade and Channel Strategies

CBI’s 12th Life Sciences Trade and Channel Strategies
December 13-14, 2016 | Philadelphia, PA

Don’t miss the must-attend event for industry trade, channel, account and pharmacy strategy professionals!

CBI’s Annual Trade and Channel Strategies Conference boasts incomparable networking opportunities and unmatched, forward-thinking content from a broad array of stakeholders.

Drug Channels readers are eligible for a Thanksgiving week discount. Save $400 off of the standard registration rate when you use code MUT953.* Hurry! You must register by Friday, November 25th!

Can’t Miss Keynotes Featuring:
  • Adam J. Fein, Ph.D., President, Pembroke Consulting, Inc.; Author, Drug Channels
  • William Roth, Founding Partner, Blue Fin Group

Industry Trailblazers Speak on High-Impact Topics Transforming Trade Strategy, Including:

Pharmacy and Wholesale Business Economics | Organized Commercial Customers | Payers’ Channel Management Strategies | Government Regulations and Policy | Shift to IDNs and HMOs | Network Strategies and Distribution Trends | Pharmacy and Provider Models | Valeant/WBA Relationship | Reimbursement | Site-of-Care Reform | Vertical Integration | Globalization | Channel Considerations for Brands, Generics, Specialty and Biosimilar Products | Serialization | Co-Pay Programs

Over 50 participating companies thus far:

AbbVie | Alcon | Alexion | Alkermes | AmerisourceBergen | Amgen | Astellas | AstraZeneca | Bayer HealthCare | Biogen Idec | Blue Fin Group | Boehringer Ingelheim | Bracco Diagnostics | Bristol Myers Squibb | BTG International | Daiichi Sankyo | Depomed | Diplomat | Eli Lilly | Elwyn Pharmacy Group | Emmaus Life Sciences | FFF Enterprises | Genentech | Gilead | Goldman & Sachs | Hospital of the University of Pennsylvania | Indivior | Jazz Pharmaceuticals | Johnson & Johnson | Lilly USA | Mallinckrodt | Merck | Mylan | Novartis | PDX | Pembroke Consulting | Pfizer | Purdue Pharma | Radius Health | Relypsa | Rx Sourcing Strategies | Sanofi| Smith Drug Company | Sunovion | Takeda | Teva | Texas Oncology | Therigy | UCB | ZS Pharma

For more information, please download the complete agenda or visit

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

The content of Sponsored Posts does not necessarily reflect the views of Pembroke Consulting, Inc., Drug Channels, or any of its employees.

Thursday, November 17, 2016

A Post-Election Projection: The 2025 Payer Market for Prescription Drugs

In Latest CMS Forecast Shows Big Drug Spending Growth Through 2025, I examined the July 2016 drug spending forecasts from the Centers for Medicare & Medicaid Services (CMS).

Alas, last week’s election exploded these projections. Today, I analyze CMS’s official pre-election insights about payment for outpatient prescriptions drugs in 2025. I then speculate on how these figures might change under the new administration, which wants to repeal and replace the Affordable Care Act (ACA). Based on the most well-known Republican proposals, I project a rebound in the employer-sponsored market compared with the CMS baseline projections.

But never forget a truism of the projection business: A good forecaster is not necessarily smarter than everyone else—he merely has his ignorance better organized.

Tuesday, November 15, 2016

Genentech’s Shocking $2 Billion 340B Revelation

ICYMI, the Roche Group recently made a startling disclosure: For the first half of 2016, the 340B Drug Pricing Program accounted for 18% of Genentech’s volume.

I estimate that at that rate, hospitals and other 340B-covered entities claimed discounts on about $3.4 billion in purchases annually from Genentech. With profit margins averaging 58%, that figure translates into about $2 billion in financial benefits.

Where did the money go? Who benefited from these funds? Did financially needy patients have to pay their Part B coinsurance for 340B-purchased drugs from Genentech? We have no idea, because hospitals and their lobbyists fight any call for them to disclose or account for how they use their 340B profits.

I suspect that the Trump administration will take a dim view of the lack of transparency and excesses that have occurred in the 340B program. Expect significant change in 2017 and beyond.