In this issue:
- Zombie Attack: Why Fortune got its Express Scripts "exposé" wrong
- Don’t Fear the Reaper: Walmart lobbies for preferred networks…in Medicaid!
- 340Boo: A superb article on the 340B drug discount program
- Spooky: 10 megatrends for specialty pharmacy
Pharma muckraker Katherine Eban tackles pharmacy benefit managers (PBMs) in this sloppy Fortune article. The article focuses on Meridian Health Systems, a non-profit six-hospital chain that hired Express Scripts to manage its pharmacy benefits. Express allegedly overcharged Meridian, which then switched to Envision Pharmaceutical Services. Unfortunately, Eban misses the payer's reality: Caveat emptor. Meridian shopped around and got a better deal, without the government or anyone else getting involved. This is how markets work. If that's the "news," then I look forward to learning how Mass General saved on landscaping costs thanks to the bravery and vision of Joe the Gardener. Please note that I am not defending ESI or PBMs, nor am I being anti-pharmacist. I am merely defending markets and freedom. Big, big difference. Read the article and see what I mean.
State panel hears Medicaid drug distribution proposals, including one from Wal-Mart
Preferred pharmacy networks are kind of a big deal in Medicare Part D plans, and no company is a bigger deal than Walmart. So, it’s no surprise that Walmart is lobbying Alabama’s Medicaid program to create a similar program for the state. From the article: “Wal-Mart representative Kevin McCarter presented a different offer: Make Wal-Mart the main dispenser of Medicaid drugs, and the department store chain would offer a cut in prices for the drugs Medicaid buys.” Walmart claims that the switch would save $120 million in the first year, and $205 million annually by the eighth year. Expect to see similar pitches as states look to control Medicaid costs.
340B: Helping Patients or Enriching Hospitals?
Clinical Oncology News takes critical look at the 340B drug discount program. If you are confused about the controversy or how 340B contract pharmacies like Walgreens operate, then you should definitely read the article. The article includes my $0.02. As I told the reporter: “There are some legitimate entities that really do require additional financial support. However, there are also many profitable, large, well-funded health systems that are taking advantage of the program by using the funds in ways that can’t be linked in any way to its initial purpose.” The article includes the following chart explaining the mysterious world of contract pharmacies:
10 Top Trends in Specialty Pharmacy
The insightful Randi Hernandez of Specialty Pharmacy Times wrote this thought-provoking article on specialty drug megatrends. Use this article—and its many linked sources—as a great pre-read for your next strategy session.
Kathleen Sebelius provides tips for coping with the healthcare website
In case you missed it, here’s Saturday Night Live’s mildly amusing takedown of healthcare.gov. (Warning: Some NSFW language.) As President Obama said: “If I’ve lost SNL, I've lost Middle America.” Click here if you can’t see the video.