Drug Channels 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. Drug Channels reaches an engaged, loyal and growing audience of more than 20,000 subscribers. Learn more...

Friday, December 22, 2017

Remicade: A Case Study in How U.S. Pricing and Reimbursement Curb Adoption of Biosimilars (rerun)

This week, I’m rerunning some popular posts during the pre-holiday week. Click here to see the original post and comments from September 2017.

This post is good reminder that biosimilar products have unanticipated channel dynamics. CMS’s policy change will further alter the 2018 market. Effective January 1, 2018, each biosimilar will have its own J-code. See Final Policy, Payment, and Quality Provisions in the Medicare Physician Fee Schedule for Calendar Year 2018.


Drug Channels will return on January 3. Until then, have a great holiday and happy new year!


The Centers for Medicare & Medicaid Services (CMS) has just released the Average Sales Prices (ASP) reimbursement data for the fourth quarter of 2017. You can download the drug pricing files here.

Below, I use these data to explore the reimbursement and payer dynamics behind the relatively slow adoption of Inflectra, the first biosimilar of Remicade. The introduction of Renflexis, a second biosimilar, will offer additional insights about pricing and channel strategies.

The U.S. biosimilar market is highly underdeveloped compared with our European counterparts. As this case study shows, it’s pretty, pretty, pretty hard to launch a biosimilar.

Thursday, December 21, 2017

Why Manufacturers and PBMs Should Worry About the Growth of Hospital-Owned Specialty Pharmacies (rerun)

This week, I’m rerunning some popular posts during the pre-holiday week. Click here to see the original post and comments from September 2017.

Another $0.02: In 2018, providers will continue to create the next wave of specialty pharmacies. But growth may slow with the likely legislative and/or regulatory reform of the 340B Drug Pricing Program. Expect a volatile 2018 for the specialty pharmacy industry.



The American Society of Hospital Pharmacists (ASHP) has just released its latest national survey of pharmacy practice in hospital settings. (Free download) I always enjoy this annual treasure trove of insights.

This year’s survey confirms the extent to which hospitals and health systems are pursuing specialty pharmacy dispensing revenues. In 2016, about 1 in 11 hospitals had a specialty pharmacy. However, nearly half of the largest hospitals operated a specialty pharmacy.

Below, I summarize these new data and review hospitals’ motivations for growth. Pharmaceutical manufacturers and pharmacy benefit managers (PBMs) should be wary of the expansion in hospital-owned specialty pharmacies.

Wednesday, December 20, 2017

Follow the Dollar Math: How Much Do Pharmacies, Wholesalers, and PBMs Make From a Prescription? (rerun)

This week, I’m rerunning some popular posts during the pre-holiday week. Click here to see the original post and comments from August 2017. We’ll have an updated and expanded version of this analysis in the 2018 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers, which will be released on February 27, 2018.

ICYMI: The Pharmaceutical Research and Manufacturers of America (PhRMA) just released its own Follow The Dollar white paper, which is also worth reading.



Yesterday, The Wall Street Journal published an intriguing article by Jonathan Rockoff titled Behind the Push to Keep Higher-Priced EpiPen in Consumers’ Hands.

The article includes a graphic attributed to me (cited as Pembroke Consulting). It shows that the drug channel—pharmacy benefit managers (PBMs), wholesalers, and pharmacies—receive more than $37 in gross profit for a brand-name drug with a $300 list price. PBMs capture about half of this amount.

The WSJ article doesn’t describe how I arrived at the figures. But now you, Drug Channels reader, will get the inside scoop.

Below, I go inside the box and trace these crucial computations. They determine the revenues and profits of the drug channel participants that operate between a brand-name drug maker and the patient. I also reveal how the figures affect the net prescription cost for a third-party payer.

As with many things, you'll have to observe the system to figure out the superposition.

Tuesday, December 19, 2017

Drug Channels Outlook: What to Watch in 2018

Hooray! We all made it through another 12 months. This year was stuffed with mega deals, political turmoil, the drug pricing blame game, generic market disruption, an ever-inflating gross-to-net bubble, and Amazon mania.

Through it all, Drug Channels was there to help you figure it out. I’m pleased to report that we had another record year. Drug Channels now has more than 20,000 subscribers, including nearly 5,000 @DrugChannels Twitter followers. (Follow me there for daily updates.)

Thank you, dear readers, for welcoming me into your inboxes and browsers each week. I’ve had a blast writing Drug Channels and also hope you had fun reading it. I’m grateful to our many sponsors and guest writers. Special thanks to the brave souls who posted comments and joined in the spirited discussions below the articles.

Here’s a bonus stocking stuffer: the Drug Channels Outlook: Things to Watch in 2018. These slides capture ideas I shared in my recent keynote presentation at CBI's Trade and Channel Strategies conference. It’s a sneak peek at some of next year's likely hot topics. I have also tucked in a few of my favorite personal photos from the past year.

We’ll post reruns for the balance of this week. But never fear: Drug Channels will return with new content in 2018! In the meantime, please enjoy our annual holiday tradition—a video greeting below from me and Paula, my wife and business partner in Drug Channels Institute.

Wishing you and your family health and happiness,
Adam

Monday, December 18, 2017

CBI’s 5th Annual Reimbursement & Contracting Conference

CBI’s 5th Annual Reimbursement & Contracting Conference
January 24-25, 2018 | Philadelphia, PA
http://www.cbinet.com/contracting

Exclusive Offer for Drug Channels Readers:
Register Now to SAVE $400*
(Use discount code HRQ997)

CBI’s 5th Annual Reimbursement & Contracting Conference is the ideal platform for bio/pharma manufacturers to unravel complexities associated with reimbursement, pricing strategies and federal and commercial contracting.

Join industry thought-leaders and colleagues in Philadelphia on January 24-25 at this CPE accredited event, and discover the necessary insights to navigate the evolving regulatory landscapes to develop innovative and competitive pricing strategies.

Featured Sessions from Our Distinguished Faculty Include:
  • Hear the Latest Healthcare Updates and the Implications for Contracting and Reimbursement Strategies – Center for Medicine in the Public Interest
  • Align New Technologies and New Treatment Paradigms within Existing Reimbursement Systems and Utilize AI Technologies to Enhance Efficiency – Pear Therapeutics and Magellan Method, a division of Magellan Rx Management
  • Garner Best Practices to Develop Innovative Contracting and Implement Effective Pricing Strategies – Abarca Health and Alvogen Inc.
  • Explore Outcomes-Based Contracting to Facilitate Enhanced Access for Biosimilars – National Institute for Health and Care Excellence (NICE)
  • Overcome Key Challenges Facing the Specialty Marketplace – Intarcia Therapeutics
  • And more!
  • Plus, Choose Between Two In-Conference Workshops:
    • A. Commercial Pricing and Contracting Master Class – Insmed Inc. and Horizon Pharma
    • B. Navigate the Complexities of 340B and its Impact on Pricing and Contracting – 340B Health
Visit cbinet.com/contracting to view the complete agenda and speaker lineup, then register using discount code HRQ997 for this exclusive savings of $400* off.

Previous Attendees Acclaim:

“EXCELLENT CONFERENCE to bring the commercial and government contracting perspectives together.” - Department Director, Government Contracts & Reporting, Bayer

“EXTREMELY WELL RUN conference where ideas were shared so everyone could benefit and learn from the group!” - Business Relations Manager, Sanofi Genzyme

“The in-depth introduction of pros and cons for outcomes-based contracting OPENED THE DOOR FOR EXPLORATION.” - Senior Business Partner, Indivior

*Offer valid through 1/24/18; applies to standard rates only and may not be combined with other offers, category rates, promotions or applied to existing registration. Not valid on workshops only or academic/non-profit registration. CPE credits pending approval.


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

Friday, December 15, 2017

Life Sciences Market Access & Commercialization (LSMAC) Summit

Life Sciences Market Access & Commercialization (LSMAC) Summit
February 5-7, 2018 | Philadelphia, PA

This coming February 5th -7th industry, payers, providers, pharmacies and patient leaders will convene at the Life Sciences Market Access & Commercialization (LSMAC) Summit in Philadelphia to learn tactics for optimized commercialization.

For the first time-ever, join a Summit covering four of the hottest therapeutic areas in 2018: cell and gene therapy, rare disease, oncology, and biosimilars. Robert Popovian, Vice President, US Government Relations, at Pfizer will chair the conference.

Register with discount code DC200 and save $200! 
(That’s only $795 for life sciences executives.)

Attendees will benefit from a selection of 6 hands-on workshops on Day 1 and shared plenary sessions on Day 2 before diving deep into their specific area of interest on Day 3.

Key Agenda Highlights include:
  • OPENING KEYNOTE: A View from Washington: What’s Next for Health Reform
  • KEYNOTE PANEL DISCUSSION: Build a Strategy to Ensure Market Access & Commercialization Success in a Healthcare System with Increasing Costs and Complex Therapies
  • PAYER PANEL DISCUSSION: Gain Payer Insight into Market Access Best Practices for Reimbursement of Specialty Products in a Value-Based Healthcare Landscape
  • Drug Pricing and the Future of the Pharmaceutical Industry in an Era of Healthcare Transformation
  • Discover and Utilize the Opportunity Brought About by Big Data as it Transforms Pricing, Market Access & Commercialization
  • VALUE-BASED CONTRACTING PANEL: Overhaul Market Access & Commercialization through the Use of Value-Based Contracting
  • MARKET ACCESS 2020: The Future of Market Access & Commercialization, What You Need to Plan For
Confirmed speakers include senior-level executives representing:
Pfizer| Humana | Aetna | AMCP BBCIC | GSK | Merck | NCCN | Bayer | Enzyvant | Adocia | NY Stem Cell Foundation | Roche | Walgreens | Alnylam | Amgen | Tocagen | and many more!

Don’t miss out on this opportunity to experience unprecedented value, networking and education. Register with discount code DC200 and save $200! (That’s only $795 for life sciences executives.)

Robert Popovian and the World Congress team look forward to seeing you in February!


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

Thursday, December 14, 2017

2016 Drug Spending: The Shift from Employers to Government Payers—And Troubling Trends For Patients

In CMS Confirms It: Drug Spending Slows, Hospital and Physician Spending Grows, I showed that growth in drug spending was significantly below the growth rate of overall national healthcare spending. Today, I delve into trends in third-party and patient payment for prescription drugs.

In 2016, all payers experienced a slowdown in spending. Employers' drug spending growth was nearly flat, while consumers (on average) paid less out of pocket. And for the third year in a row, spending by government payers exceeded spending by employers. The NHE are net of rebates, so gross-to-net bubblenomics play a part in these figures.

I suspect that the very slow growth in employers’ net costs occurred partly because employees are being forced to pay debilitating coinsurance—in some cases with no limit on out-of-pocket drug expenses.

The NHE data therefore suggest a troubling gap between haves and have-nots, based on benefit design and diagnosis. Some people can make do with inexpensive generic drugs, while others end up with sky-high out-of-pocket costs.

Read on for our wonktastic deep dive into the 2016 spending data.

Tuesday, December 12, 2017

CMS Confirms It: Drug Spending Slows, Hospital and Physician Spending Grows

Last week, the econowonks at the Centers for Medicare & Medicaid Services (CMS) released the 2016 National Health Expenditure (NHE) data. Links below.

It’s politically fashionable to blame healthcare spending growth on pharmaceuticals, but it’s also inaccurate. For 2016, growth in drug spending was a mere 1.3%—significantly below the growth rate of overall national healthcare spending.

Another fun fact: drug spending has grown more slowly than NHE in seven of the past ten years. Yes, really.

Our analysis also shows that spending on hospital care and healthcare professionals continues to expand much more quickly than drug spending. For 2016, those categories accounted for six times the spending on drugs dispensed from retail, mail, long-term care, and specialty pharmacies.

These new CMS data confirm the slowdown that I have highlighted in multiple Drug Channels articles. Once again, I must be the bearer of non-fake news. Read on for the details.

Monday, December 11, 2017

sPCMA Business Forum 2018

sPCMA Business Forum 2018
March 5 & 6, 2018
Hilton Bonnet Creek | Orlando, FL

The sPCMA Business Forum attracts many executives and decision makers from PBMs and the nation's largest specialty pharmacies. The two-day event offers invaluable networking and education for individuals and companies involved in specialty drug benefit management including specialty pharmacies, PBMs, pharma/biotech manufacturers, consultants, and others.


Conference features include:
  • Timely and insightful sessions led by industry experts and decision makers;
  • The ability to receive CPE credit;
  • Dedicated time and facilities for private meetings;
  • Valuable networking; and
  • The new PCMA conference app allows users to access the attendee list, send messages to other attendees, create a personalized schedule, and access hotel maps, all in advance of the conference.
Contact PCMA

Please contact Jenny Bradham (jbradham@pcmanet.org) with questions or to request information about the Affiliate Program or conference sponsorships.


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

Friday, December 08, 2017

Triplefin: How An Independent Service Provider Is Positioning for Growth

Today’s guest post comes from Tom Doyle, Executive Vice President Commercial Solutions at H. D. Smith / Triplefin.

Tom shares his views on how an ndependent patient services provider can enhance a manufacturer’s internal efficiency and the patient experience. He discusses patient assistance programs, automation, integration, and customer engagement.

To learn more about Triplefin’s full range of solutions, visit their booth at next week’s CBI Trade and Channel Strategies conference or visit www.triplefin.com.

Thursday, December 07, 2017

Five Industry Trends for U.S. Drug Wholesalers in 2018

Modern Distribution Management recently published my article 2017 MDM Market Leaders | Top Pharmaceuticals Distributors. It is an excerpt from our 2017–18 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors.

Below, I republish the section of the article highlighting five significant industry trends affecting the U.S. drug wholesaling industry. I think Drug Channels readers will enjoy this summary as we look toward an eventful 2018. Click here to download a free overview of the full report.

Many of the trends highlighted below have been headwinds for the wholesalers. They may help you understand why H.D. Smith sold its drug wholesaling business to AmerisourceBergen. Note that H.D. Smith did *not* sell its interest in the TripleFin business and Arete Pharmacy Network.

Tuesday, December 05, 2017

The CVS-Aetna Deal: Five Industry and Drug Channel Implications

Surprise? CVS Health and Aetna announced their long-rumored merger. Relevant links below.

This transaction will create a healthcare organization with significant market share in the pharmacy, pharmacy benefit management (PBM), and health insurance businesses. There could be many potential opportunities for new consumer-oriented offerings. Finding the consumer value in this multi-headed $221 billion behemoth will be a major challenge.

Read on for my initial thoughts on the deal and what it means for PBMs, manufacturers, and pharmacies. I also highlight some of the implementation challenges.

Feel free to add your own thoughts on this mega-deal in the comments below. (Yes, you can comment anonymously.)

Monday, December 04, 2017

CBI’s 10th Hub and SPP Model Optimization

CBI’s 10th Hub and SPP Model Optimization
February 27-28, 2018 | Philadelphia, PA
www.cbinet.com/hubs

This February 27-28 in Philadelphia, join stakeholders from across the healthcare and life science industries to share and learn breakthrough strategies for service model design and enhancement to improve access and outcomes. You can read all about it here.

Drug Channels readers will save $400 off the standard rate when they use discount code MGK734 and register prior to December 15th.*

Led by chairperson Stella Vnook, Head of Patient and Access Services, Jazz Pharmaceuticals, the 10th installment of the Hub and SPP Model Optimization meeting features a broad range of perspectives:
  • Industry Snapshot – Roxanne Schwans, Vice President, Managed Markets, Horizon Pharma
  • Compliance Spotlight – Bradford Patrick, Division Counsel, AbbVie Inc.
  • Collaborating with Hub and SPs – Matt Zeller, Vice President and Head, Patient and Specialty Services, Novartis Pharmaceuticals
  • Hub Optimization – Meghan Szczeck, Director, Patient Services, Ipsen
  • SPP Report Card – Caroline Teachey, HUB Program Liaison, Chiesi
You’ll also benefit from three Hub Lifecycle Learning Labs:
  • Preparation Phase – Assessing Product Needs to Determine the Approach (Insource, Outsource or Hybrid)
  • Development Phase – Selecting the Right Model for Your Therapy and Disease State
  • Transition Phase – Minimizing Disruptions with Changing Partners
And three interactive and inclusive summits:
  • Auditing Third-Party Providers and Measuring Program Performance to Ensure the Highest Quality of Service
  • Contracting Course – Beyond the Data
  • Hub Enrollment – Propelling Stakeholders to Go the Extra Step for their Patients
Plus! Attend our inaugural Technology Trailblazer Showcase – Statistical and Data-Driven Insights Unveiled.

Visit www.cbinet.com/hubs for further details and to register. Drug Channels readers will save $400 off the standard rate when they use discount code MGK734 and register prior to December 15th.*

CBI will see you there!

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rate or non-profit 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 30, 2017

Why CVS Health and Express Scripts Sold—and McKesson Bought—a Specialty Hub Business

ICYMI: In early November, McKesson paid CVS Health $735 million for the RxCrossroads patient services hub business. A few weeks later, Express Scripts sold its United BioSource Corporation (UBC) hub business to a private equity firm.

These intriguing transactions make sense for all of these key drug channel players. CVS Health and Express Scripts divest businesses that could be perceived to conflict with their pharmacy benefit manager (PBM) business. McKesson deepens its investment in non-wholesaling manufacturer services for specialty products.

Below, I review the market landscape for hub service providers and explain the business issues that motivated the two PBMs to sell and McKesson to buy. I also ponder a crucial question: Did the PBMs get out at the right time?

Tuesday, November 28, 2017

Drug Channels News Roundup, November 2017: Amazon’s Updated Plans, Premier’s Push-Back, Diplomat’s PBMs, and My $0.02 on Alex Azar

Hope you enjoyed the Thanksgiving holiday! I remain ever-thankful for your support and readership.

Now that you’ve stretched your stomach, stretch your mind with some food for thought. In this issue:
  • ICYMI: Actually, Amazon will not distribute drugs (for now)
  • Premier tries to preempt worries about Amazon and GPOs
  • Have you heard? Diplomat bought two PBMs
Plus, I share some thoughts on Alex Azar, nominee to head the Department of Health and Human Services.

P.S. Follow my daily musings and links to neat stuff at @DrugChannels on Twitter.

Monday, November 27, 2017

Join Me at The PBMI 2018 Annual National Conference

PBMI 2018 Annual National Conference
March 5-7, 2018 | Palm Springs, CA

The pharmacy benefit management business is evolving rapidly. Stay current by joining me at the PBMI 2018 Annual National Conference next March.

I'll be delivering the keynote address: The Outlook for Pharmacy Benefit Management: Evolution or Disruption? 

Drug Channels readers can save $200 by using discount code PEM18 and registering before February 23, 2018.

I look forward to seeing you in sunny Palm Springs!

A MESSAGE FROM PBMI

PBMI invites you to join hundreds of industry thought leaders and benefit decision makers to its 23rd Annual National Conference. The meeting will be held at the Westin Mission Hills Golf Resort & Spa Hotel in beautiful Palm Springs, California.

Over the course of two and one-half days, attendees can get up to speed on the evolution of the pharmacy management industry and be educated on relevant issues and trends of drug cost management by industry experts.

The meeting will kick off with an opening keynote from industry expert Dr. Adam J. Fein as he provides you with his outlook for the pharmacy and PBM industries. He will:
  • Explain the crucial trends reshaping the PBM market
  • Describe key strategic responses by PBMs, payers, and other drug channel participants
  • Examine the outlook for disruption of the current PBM business model
  • Highlight implications for plan sponsors, PBMs, manufacturers, and others
New for the PBMI 2018 Annual National Conference is an expanded conference agenda. Attendees will now have the option to select from four track sessions as well as attend one of two pre-conference workshops to make the most of their conference experience. The conference tracks include:
  • Track 1: Designing the Drug Benefit
  • Track 2: Contracting and Industry Relations
  • Track 3: Clinical and Trend Management
  • Track 4: Innovation and Technology
Drug Channel readers will save $200 on conference registration fees when they use discount code PEM18 and register prior to February 23, 2018.

The PBMI team hopes you will join them in Palm Springs. To register, click here.


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

Tuesday, November 21, 2017

Will CMS Pop the Gross-to-Net Bubble in Medicare Part D With Point-of-Sale Rebates?

Last week, the Centers for Medicare & Medicaid Services (CMS) released its 713-page proposed policy changes and updates for the Medicare program. See the links below.

Buried in this document is a radical concept: Part D plans would be required to recognize the value of manufacturer rebates and pharmacy payments in retail prescription prices. These amounts are two key components of Direct and Indirect Remuneration (DIR) that are currently paid to plans. CMS is asking for feedback for future rulemaking but did not propose any specific changes. Any program modifications would not occur until at least 2020 or later.

However, it’s clear that CMS views the high-list-price/high-rebate system—what I term the gross-to-net bubble—to be a fundamental source of warped incentives and cascading problems. Before you check out for the holiday weekend, I unpack the complex structure of Medicare Part D to explain why CMS is proposing its pass-through solution. This will help you digest CMS’s proposal for disruptive change to pharmacy benefit managers’ (PBM) profit model and our current drug channel system.

A personal observation: Medicare Part D, like commercial pharmacy benefit plans, now operates like reverse insurance. The sickest seniors taking medicines for chronic, complex illnesses generate the majority of manufacturer rebate payments. These funds are then used to subsidize the premiums for healthier seniors. To me, this structure is the opposite of how insurance is supposed to function. It seems as if CMS concurs.

Monday, November 20, 2017

CBI’s 13th Trade and Channel Strategies

CBI’s 13th Trade and Channel Strategies
December 11-12, 2017 | Philadelphia, PA
www.cbinet.com/trade

This December 11-12 in Philadelphia, join stakeholders from across the life science industry for in-depth education on trade and channel strategy management. Trade, market access, account strategy and brand professionals will dive deep into rewriting the playbook on product-specific network design, contracting and specialty distribution strategy. You can read all about it here.

Drug Channels readers will save $300 off of the standard rate when they use discount code XHT546 and register prior to December 1st.*

Led by chairman Jeff Henderson, VP, Managed Markets, Intarcia Therapeutics, Inc., the 13th Annual Life Sciences Trade and Channel Strategies meeting features a broad range of perspectives:
  • Drug Channels Update–Things to Watch in 2018: Adam J. Fein, Ph.D., President, Pembroke Consulting, Inc.; Author, Drug Channels
  • Fragmentation and Customization Comes to Pharmaceutical Channels: William Roth, Founding Partner, Blue Fin Group
  • Payer Dynamics and Drug Utilization Management: Tracey McGuire, Specialty Services Directors, MedImpact Healthcare Systems, Inc.
  • Word on Wall Street Exchange: Goldman Sachs, Marathon Asset Management, and RBC Capital Markets
  • IDN Partnerships Affecting Patient Journey and Outcomes: Jerry Buller, Director, Specialty Pharmacy Services, Vanderbilt University Medical Center
  • State of the Industry – Politics Impacting Pharma: Gail Sibert, Director, Corporate Accounts, Ferring Pharmaceuticals, Inc.
You’ll also benefit from three tailored content tracks:
  • Specialty Distribution and Channel Optimization
  • Serialization and Traceability
  • Specialty Product Data Strategies
Plus! Develop a playbook during the first-ever product specific strategic showcase. Navigate and optimize distribution strategy based on product type, reimbursement and site of care. Visit www.cbinet.com/trade for further details and to register.

Drug Channels readers will save $300 off of the standard rate when they use discount code XHT546 and register prior to December 1st.*

See you there!

 *Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rate or non-profit 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 15, 2017

If Employers Are So Unhappy with Their PBMs, Why Can’t They Change the Model?

The National Pharmaceutical Council (NPC) recently released Toward Better Value, a fascinating survey of employers’ views about their pharmacy benefit managers (PBMs). (free download)

According to the results, employers are unhappy with PBMs’ performance on crucial services. (The PBMs were not identified by the survey.) Employers apparently also want to reform the rebate system at the heart of our complex distribution and reimbursement system.

These results imply a significant but as-yet-unexplained market failure—one that that somehow prevents employers from negotiating better deals and writing more effective contracts. Below, I review the NPC results and speculate on what they mean for the PBM industry and possible disruption of the PBM model.

Monday, November 13, 2017

Specialty Pharmacy’s New Frontier: How to Deliver and Document Therapy Outcomes

Specialty Pharmacy’s New Frontier: How to Deliver and Document Therapy Outcomes
A free webinar hosted by Therigy
Wednesday, December 13, 1pm-2pm EST
Register here.

Therigy is pleased to announce a free webinar exploring therapy outcomes on Wednesday, December 13, 1pm-2pm EST.

Therigy’s speakers will present background data and published insights to support the premise that specialty pharmacy services need further differentiation. The speakers will analyze the crucial roles of both predictive analytics and specialty pharmacy services in the actual delivery and documentation of patient outcomes.

Featured speakers include:
  • Jon Hamrick, MBA, Chief Strategy Officer, Therigy
  • Sheena Babin, Pharm D, Manager, Clinical Services and Business Development, Ochsner Specialty Pharmacy
  • Brian Smith, Pharm D, Vice President, Clinical Services and Quality, Shields Healthcare Solutions
Featured topics include:
  • Historical Specialty Pharmacy Activities and Impact on Adherence
    • The role of specialty pharmacy in Outcomes
    • Differentiating specialty pharmacy services
  • The Evolution of Specialty Pharmacy Services
  • Two case studies
    • Lipid Identification and the Diabetic Patient
    • Specialty Pharmacy’s Role in Disease Activity in Rheumatoid Arthritis
Case studies will provide examples of specialty pharmacy services which go beyond basic patient onboarding, adherence support and reporting to the next level of identifying at-risk patients. The case studies will identify opportunities for specialty pharmacies to actively impact patient outcomes.

Visit Therigy’s registration page for additional information and to register.


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

Friday, November 10, 2017

Drug Spending in 2017: The CEO of Prime Therapeutics Responds to Drug Channels

A few weeks ago, I highlighted the latest drug spending data in Reality Check: New Prime Therapeutics Data Show Very Low Drug Spending Growth in 2017. As I see it, these data contradict the public rhetoric about excessive growth in drug spending and prices. I concluded that drug spending is not actually "out of control."

Jim DuCharme, president and CEO of Prime Therapeutics, emailed me with an alternative and much more critical interpretation of the drug spending situation. Fortunately, he didn’t seem to mind my artistic choices.

Jim was kind enough to allow me to share his thoughts with the Drug Channels audience. Read on for his perspective.

Thursday, November 09, 2017

Shopping for Prescriptions: How Deductibles Will Reshape the Pharmacy Industry

In a previous analysis (Employer Pharmacy Benefits in 2017: More Cost-Shifting to Patients As Tiers and Coinsurance Expand), I examined the structure of employers’ 2017 pharmacy benefit plans.

Today, I examine the growing role of deductibles. The growth of separate prescription deductibles has become a significant change in patient cost sharing for prescription drugs.

For 2017, about 8 out of 10 U.S. workers must meet a general annual deductible before their plan pays for most healthcare services. Prescriptions are typically excluded from the deductible.

However, this year’s survey shows that one-third of workers in high-deductible plans now faces a separate prescription drug deductible. These plans shift 100% of the prescription cost to the patient until the deductible is met.

After reviewing the latest data, I offer some observations on how deductibles are altering the pharmaceutical and pharmacy industries. The bottom line: Patients who must cover the costs of their drugs shop for better deals and cheaper pharmacies. Get ready for the consumerization of the pharmacy industry!

Tuesday, November 07, 2017

Employer Pharmacy Benefits in 2017: More Cost-Shifting to Patients As Tiers and Coinsurance Expand

It’s time for our annual analysis of the Kaiser/HRET 2017 Employer Health Benefits Survey, which you can read online for free. The survey delves into employer-sponsored health coverage at more than 2,000 companies.

In the charts below, I summarize employers’ 2017 pharmacy benefits by examining (1) cost sharing tier structures, (2) average copayments, by formulary tier, (3) type of cost sharing (coinsurance and copayment), and (4) coinsurance structures. I’ll investigate the growing role of deductibles in a follow-up article.

This year’s results show massive cost-shifting for specialty drugs. For the first time, a majority of plans have four tiers. Economically-debilitating coinsurance—in some cases with no limit on out-of-pocket expenses—is common.

When people complain about “drug costs,” they are actually thinking about the share of costs that they pay. Last week, I highlighted Prime Therapeutics’ data showing very slow growth in post-rebate drug spending. Given the new Kaiser/HRET survey, it looks like patients may not always be getting the benefit of lower costs.

Read on for my analysis along with another annual Drug Channels tradition: tiers/tears puns!

Monday, November 06, 2017

CBI’s 15th Specialty Therapies – A Forum for Payers

CBI’s 15th Specialty Therapies – A Forum for Payers
January 25-26, 2018 | Las Vegas, NV
www.cbinet.com/specialtytherapies

CBI announces that registration is open for the Specialty Therapies Forum!

Join stakeholders from across the healthcare industry – health plans, PBMs, pharmacies, and drug manufacturers – to take a deep dive into managing cost, expanding access and improving patient services and care delivery for specialty therapies.

Exchange ideas on:
  • Latest trends for conquering diseases that were once considered untreatable
  • Addressing the challenges of controlling costs
  • Providing access for new therapies
  • And more!
Sign up to receive the agenda here. Visit www.cbinet.com/specialtytherapies for further details and to register.

Drug Channels readers will save $500 off of the standard rate when you use discount code QQQ952 and register prior to November 22nd.*

CBI will see you there!

More reasons to attend!

“Class act!” - Director of Specialty Pharmacy Programs, Blue Cross Blue Shield South Carolina

“I found the program to be well-designed and stimulating, well worth my time.” -Executive Director, MidAtlantic Business Group on Health

“The specialty pharmacy arena is constantly evolving. Quality Conferences like CBI’s Specialty Therapies Forum for Payers allows payers and industry alike to hear from KOL’s and prepare for the challenges that they are currently dealing with or will be facing in the near future.” -Director, Clinical Pharmacy, Blue Cross Blue Shield of Tennessee

“The conference provided a unique insight into the payer viewpoint and allowed attendees to observe complex discussions between interested parties.” -Manager of Specialty Clinical Services, Fairview Specialty Pharmacy

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rate or non-profit 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 02, 2017

The Latest on Amazon’s Pharmacy Ambitions—And a Possible Express Scripts Collaboration

Speculation about Amazon’s intentions for the drug channel has reached a new high. Below, I briefly review the recent news and hype.

Amid the hubbub, you may have missed intriguing comments from Tim Wentworth, president and CEO of the pharmacy benefit manager (PBM) Express Scripts. On an earnings call last week, he explained how Amazon could partner with the largest (for now) PBM via Inside Rx, the Express Scripts-GoodRx drug discount partnership. I explain the economic logic for both companies below.

Amazon will reportedly decide on its pharmacy and/or PBM strategy by Thanksgiving. We’ll see if I have been talking turkey or am just full of stuffing.

Tuesday, October 31, 2017

Drug Channels News Roundup, October 2017: FTC Workshop on PBMs, HDHPs, OOP Spending, Hospital Profits, and FDA Biosimilar Cartoons

Eeek! Time for my Halloween roundup of Drug Channels news stories. In this issue:
  • Spooktakular! An FTC competition workshop will include a terrifying panel on pharmacy benefit managers (PBMs)
  • Scary! The pros and cons of frightful high-deductible health plans
  • Creepy! JPMorgan Chase conjures up surprising new data on consumer out-pocket costs
  • Spooky! Ghastly hospital markups on outpatient drugs
Plus, the FDA treats us to a new educational campaign on biosimilar drugs—complete with groovy shareable GIFs for millennials.

P.S. For a daily haunting, join the zombie horde who shamble after me here: @DrugChannels on Twitter. (ICYMI: Over the past week, I have sent multiple tweets with my $0.02 on Amazon and CVS-Aetna.)

Monday, October 30, 2017

CBI’s Drug Pricing Transparency Congress

CBI’s Drug Pricing Transparency Congress
December 5, 2017 | Philadelphia, PA
www.cbinet.com/drugpricing

With numerous states across the country ramping up on introducing and passing laws aimed at drug pricing transparency and reporting, is your organization prepared to act? And fast? The recent passage of California’s drug pricing bill and a number of other states passing laws earlier in 2017 leaves many unanswered questions and the opportunity to steer the course is now.

Exclusive Offer for Drug Channels Readers: Save $300 when you use discount code DCP125 and register by November 17, 2017.

CBI’s one-day Drug Pricing Transparency Congress, taking place December 5th in Philadelphia, convenes stakeholders across the healthcare ecosystem, including state and federal government regulators, manufacturers, health plans, PBMs, associations and other industry experts to learn how the future of drug pricing transparency regulation impacts commercialization, reimbursement and drug pricing models with a focus on state pricing and transparency regulation.

This monumental shift will undoubtedly impact so many functions across the healthcare system. If your responsibilities touch any facet of your organization's pricing, transparency or commercialization efforts, you'll need to be on the pulse of the rapid developments and this conference will serve as an unparalleled uniting place for the industry to assess the future landscape and gain clarity on the many unanswered questions from industry experts and regulators.

Don't be left out of the critical conversation.

Exclusive Offer for Drug Channels Readers: Save $300 when you use discount code DCP125 and register by November 17, 2017.

*Offer expires November 17, 2017; applies to standard rates only and may not be combined with other offers, category rates, and promotions or applied to an existing registration.


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


Thursday, October 26, 2017

How Independent Pharmacies Will Participate (Or Not) in 2018's Part D Preferred Pharmacy Networks

In a previous analysis (CVS Bets Big: Our Exclusive Analysis of Pharmacy Chain Participation in 2018's Part D Preferred Pharmacy Networks), I highlighted how the largest pharmacy chains will participate in next year’s Medicare Part D prescription drug plans (PDP).

Today, I examine independent pharmacies’ participation in 22 major 2018 Part D preferred networks. Our analysis focuses on the pharmacy services administration organizations (PSAOs) that represent these pharmacies in negotiations with plans.

As you will see below, the profit pressures from narrow networks have made smaller pharmacies much choosier about contracting for preferred status. For three of the four largest PSAOs, smaller pharmacies will have preferred status in fewer than half of the major plans. By contrast, members of AmerisourceBergen’s Elevate PSAO will not have preferred status in the largest plans, although they will be preferred in some smaller plans.

I wonder: Will 2018’s surprising pharmacy participation patterns trigger a rethink of preferred networks in Medicare Part D?

Tuesday, October 24, 2017

Reality Check: New Prime Therapeutics Data Show Very Low Drug Spending Growth in 2017

Prime Therapeutics, the fifth largest pharmacy benefit manager (PBM), has just released its first look at drug spending data for 2017. The results strongly contradict the public rhetoric about excessive growth in drug spending and prices.

Prime analyzed three groups of third-party payers: commercial (employers and health plans), Medicare Part D, and Medicaid.
  • For all payers, overall drug spending growth was negligible—below 1% or negative.  
  • Post-rebate costs for traditional drugs declined compared with 2016. Specialty drug costs grew by only 3.7% for commercial payers and declined for Medicaid. 
  • Utilization—more people taking more prescriptions—was more important than pricing for drug spending growth.
The data demonstrate that public perception of outrageous drug spending growth has not caught up with 2017’s realities. Sorry to be the bearer of non-fake news.

Alas, I am probably naive to believe that these facts will cause our politicians to transform their thinking before complaining, tweeting, or bloviating.

Monday, October 23, 2017

CBI’s Patient Journey Mapping 2017 Conference

CBI’s Patient Journey Mapping 2017 Conference
December 12-13, 2017
Wyndham Historic District | Philadelphia, PA
www.cbinet.com/patientjourney

CBI is pleased to announce the agenda for the Patient Journey Mapping 2017 Conference.

This conference will begin with Keynote Speaker, Rolf Benirschke, a former placekicker in the NFL before he was struck down with a major illness that nearly cost him his life. He emerged from his experience with a unique patient perspective, which he will share in his presentation.

Patient Journey Mapping attendees will save $300
off the standard rate when you register by October 27th.*

Here’s a quick glance at what’s to come with CBI’s dynamic, distinguished speaking faculty:
  • Alan Balch, CEO, Patient Advocacy Foundation
  • Maria Kirsch, Executive Director, Head Patient & Specialty Services Strategy, Operations and Finance, Novartis
  • Maria Pandolfo MS., Field Director, Patient Services, Shire
  • Kristina Sullivan, Senior Manager Patient Access & Nurse Engagement, Actelion
  • Catherine Blansfield, MA, BS, RN, Vice President of Patient Services, National Organization for Rare Disorders (NORD)
  • Cheryl Allen, Vice President, Industry Relations, Diplomat Specialty Pharmacy
  • Melanie Powell, Field Logistics Manager, Relypsa, Inc.
  • Brittany Mani, Global Medical External Relations, Eli Lilly and Company (invited)
Follow the product from diagnosis to treatment and discuss critical issues:
  • Determine the important factors for specialty agents in decreasing or maintaining optimal time to fill
  • Transform the patient experience into data drive insights with actionable improvement
  • Foster prescriber and patient loyalty
  • Identify and prevent missteps in patient journey mapping
Visit www.cbinet.com/patientjourney for further details and to register. Patient Journey Mapping attendees will save $300 off the standard rate when you register by October 27th.*

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rate or non-profit 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, October 19, 2017

CVS Bets Big: Our Exclusive Analysis of Pharmacy Chain Participation in 2018's Part D Preferred Pharmacy Networks

In a previous analysis (Preferred Pharmacy Networks Will Dominate 2018 Medicare Part D Plans), I highlighted how preferred pharmacy networks will dominate next year’s Medicare Part D prescription drug plans (PDP).

Today, I examine chain pharmacies’ participation in 22 major 2018 Part D preferred networks. Our analysis shows significant changes from last year:
  • CVS has changed strategy and will go all in as a preferred pharmacy in many 2018 networks. It's also the exclusive chain in some plans. 
  • Walgreens remains an active participant, but CVS has displaced it in some plans.
  • Kroger has raised its bet on being a preferred pharmacy. Walmart has held steady, maintaining a position similar to that of 2017.
  • Rite Aid continues to play a losing hand. It will be a preferred pharmacy only in the single plan offered by its EnvisionRx subsidiary.
Our 2018 Part D analysis demonstrates the pharmacy industry’s new period of hypercompetition. Seniors are willing to switch pharmacies to reduce out-of-pocket expenses. Chains must therefore reduce their prescription profit margins to compete for a spot in narrow networks. Expect the dominance of preferred networks to the wild card for pharmacies’ 2018 profits.

Tuesday, October 17, 2017

EXCLUSIVE: Preferred Pharmacy Networks Will Dominate 2018 Medicare Part D Plans (Plus: We Review the Top Plan Sponsors)

The Centers for Medicare & Medicaid Services (CMS) has just released the initial raw data on the 2018 Medicare Part D plans.

Our exclusive analysis of these data reveals that preferred cost sharing pharmacy networks have officially won. For 2018, 99% of Medicare Part D regional prescription drug plans (PDP) will have a preferred network. This figure exceeds those of the past four years. The three largest open network plans from 2017—CVS Health’s SilverScript Choice and WellCare’s Classic and Extra plans—have given up and will have preferred networks.

Below, I provide historical data on preferred networks’ growth and then discuss the top eight companies behind the 2018 plans. As I predicted many years ago, narrow pharmacy networks—whether preferred or limited models—have become an unstoppable force in benefit design.

Monday, October 16, 2017

CBI’s Specialty Product Data Strategies Summit

CBI’s Specialty Product Data Strategies Summit
December 12, 2017 | Philadelphia, PA
www.cbinet.com/specialtydata

CBI is pleased to announce the agenda for the Specialty Product Data Strategies Summit. CBI hopes you can join them on December 12th in Philadelphia for cutting-edge case studies and forward-thinking presentations. Take a look at the sessions and speakers CBI has lined up!

Highlights include:
  • Assess the different data sources and look at the associated strengths and weaknesses
  • Discuss incentive compensation implications for buy-and-bill products
  • Implement a feedback loop between trade and data teams to enhance value, including ownership of data agreements
  • Discover key data insights that support product placement on formulary and enhance strategic contracting with stakeholders
  • Share strategies for a differentiated specialty patient experience
  • Gain key concepts for commercial strategies and operational improvements
  • Investigate the utilization, effectiveness and clinical outcomes of specialty drugs in real-world settings to foster evidence-based discussions
  • Utilize data to drive specialty therapy revenue
  • Hear innovative insights on the path forward toward interoperability
  • Discuss forward-thinking approaches for leveraging data across sales, marketing and managed care to drive business performance
  • Enhance compliance and ensure patient privacy
  • Hear best practices to enhance pharmacy network design and SP data utilization
Plus! Takeda Pharmaceuticals leads a session on Building a Specialty Data Culture to Optimize Operations.

Visit www.cbinet.com/specialtydata for further details and to register. Drug Channels readers will save $200 off of the standard rate when they use discount code DSU834.*

If you would like to upgrade your registration to include attendance at the Trade and Channel Strategies Summit, please contact Juliet Nelson at Juliet.Nelson@cbinet.com. You can download that particular agenda here.

CBI will see you there!

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rate or non-profit 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, October 11, 2017

Thanks, California! SB17 Will Trigger Massive Speculative Buying, Windfall Pharmacy Profits, and Supply Chain Disruption

California governor Jerry Brown has just signed SB-17 – Drug Price Transparency into state law. Click here for the official summary.

This law is truly nutty. It won’t accomplish much of what it purports to do.

Below, I focus on the provision that requires manufacturers to provide 60 days’ advance notice of increases in a prescription drug’s Wholesale Acquisition Cost (WAC) list price.

As I explain, this requirement ignores crucial drug channel and supply chain economics. Consequently, mandating advance notice of price increases will benefit pharmacies and hospitals, not third-party payers. The new law also ignores what we’ve learned from the wholesale channel’s evolution more than a decade ago.

To mitigate some of the disruption, manufacturers should pay special attention to trade agreements with wholesalers and pharmacies. Everyone else should shake their head in wonder and despair for healthcare policy making in our country.

Tuesday, October 10, 2017

CBI’s 3rd Annual Patient Registries Summit

CBI’s 3rd Annual Patient Registries Summit
December 5-6, 2017 | Philadelphia, PA
cbinet.com/patientregistries

Exclusive Offer for Drug Channels Readers:
Register Now to SAVE $400* using discount code JXT535

CBI’s 3rd Annual Patient Registries Summit convenes registry experts representing bio/pharmaceutical, medical device and non-profit organizations in a multi-stakeholder forum, uniting all facets of the healthcare ecosystem. Discover critical methodologies to design new patient registry models and explore the future of these essential platforms.

Join us for Solutions-Oriented Sessions, Powerful Industry Insights and Illuminating Panels:
  • Global Regulatory Perspectives on Registries for Clinical Development and Post-Approval Assessment – Alexion Pharmaceuticals
  • Panel: Promoting and Executing Sustainable Registry Models through Collaborations between Public, Private and Industry Partners – Amicus Therapeutics, Immune Deficiency Foundation, AHRQ, PMSIR
  • Evolving Rare Disease Registries – One Company’s Experience – Actelion Pharmaceuticals
  • Paving the Way for Meaningful Outcomes and Better Treatment – Designing Patient-Centric Registry Models – The Life Raft Group
  • Fireside Chat: Getting It Right from the Get-Go – Best Practices for Starting a Registry – Merck, Actelion Pharmaceuticals, Sanofi Genzyme
  • Best Practices in Designing Sustainable Registry Models – Agios Pharmaceuticals
  • And more!
View the complete agenda then register today using discount code JXT535 for this exclusive savings of $400* off.

*Discount offer valid through 12/5/17; applies to standard rates only and may not be combined with other offers, category rates, promotions or applied to existing registration. Offer not valid on workshops only or academic/non-profit registration.


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

Tuesday, October 03, 2017

NEW: The 2017–18 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors

I am pleased to announce our new 2017–18 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors, available for purchase and immediate download.
We’re offering special discounted pricing if you order before October 15, 2017!

The 2017–18 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors—our eighth edition—remains the most comprehensive tool for analyzing the economic and business realities of U.S. pharmaceutical distribution.

This year's edition has been thoroughly updated, revised, and expanded. It contains the most current market and industry and data. The report is the only resource of its kind available anywhere.

See below for more info and some behind-the-scenes tidbits. Happy reading!

Monday, October 02, 2017

Join Me At CBI’s Trade and Channel Strategies 2017 Conference

CBI’s 13th Trade and Channel Strategies
December 11-12, 2017 | Philadelphia, PA
www.cbinet.com/trade

Are you ready for some channel strategy? Then join me at CBI’s 13th Trade and Channel Strategies Conference, being held this December in Philadelphia. CBI’s annual event has become our industry’s premier event focused on bio/pharma trade management.

I’ll be kicking things off with a keynote address titled Drug Channels Update – Things to Watch in 2018. I'll highlight the key trends for the year ahead.

Drug Channels readers can save $500 when you
register with discount code GDB273 by October 13th*

I hope you’ll join me in Philadelphia this December.

Regards,
Adam

A MESSAGE FROM CBI

CBI is thrilled to announce the agenda for the Life Sciences Trade and Channel Strategies Conference! The theme for 2017 is "rewriting the playbook on product-specific network design, contracting and specialty distribution strategy." You can read all about it here.

Led by chairman Jeff Henderson, VP, Managed Markets, Intarcia Therapeutics, Inc., the 13th annual meeting features a broad range of perspectives:
  • Drug Channels Update – Things to Watch in 2018: Adam J. Fein, Ph.D., President, Pembroke Consulting, Inc.; Author, Drug Channels
  • Fragmentation and Customization Comes to Pharmaceutical Channels: William Roth, Founding Partner, Blue Fin Group
  • Payer Dynamics and Drug Utilization Management: Tracey McGuire, Specialty Services Directors, MedImpact Healthcare Systems, Inc.
  • Word on Wall Street Exchange: Goldman Sachs, Marathon Asset Management and RBC Capital Markets
  • IDN Partnerships Affecting Patient Journey and Outcomes: Jerry Buller, Director, Specialty Pharmacy Services, Vanderbilt University Medical Center
You’ll also benefit from three tailored content tracks:
  • Specialty Distribution and Channel Optimization
  • Serialization and Traceability
  • Specialty Product Data Strategies
Plus! Develop a playbook during the first-ever product specific strategic showcase. Navigate and optimize distribution strategy based on product type, reimbursement and site of care.

You’ll hear from such companies as Acorda • Apobiologix • Aralez Pharmaceuticals • Axendia • Blue Fin Group • BTG plc • Cardinal Health Specialty Solutions • CoverMyMeds • Eli Lilly • Ferring Pharmaceuticals • Goldman Sachs • Intarcia Therapeutics • IntegriChain • Mallinckrodt • Marathon Asset Management • MedImpact Healthcare Systems, Inc. • Pharma Logic Solutions, LLC • Prometrics • RBC Capital Markets • Takeda Pharmaceuticals • Therigy • ValueCentric • Vanderbilt University Medical Center and more!

Visit www.cbinet.com/trade for further details and to register. Drug Channels readers will save $500 off of the standard rate when you register with discount code GDB273 by October 13th.*

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rate or non-profit 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, September 28, 2017

Drug Channels News Roundup, September 2017: A Walgreens-Rite Aid Deal Postmortem, Impax Likes Amazon, Health Insurance History, and Gross-to-Net Bubble Emojis

Autumn is here! Curl up with your favorite pumpkin spiced blog and savor these stories plucked from the Drug Channels patch:
  • Stefano Pessina of Walgreens Boots Alliance reflects on the successful Rite Aid deal
  • A generic drug maker speculates on using Amazon as a direct-to-patient channel
  • A great history lesson on why the U.S. has employer-sponsored insurance
Plus, the Pharmaceutical Research and Manufacturers of America (PhRMA) attacks pharmacy benefit managers (PBMs)…with emojis!

P.S. For my daily cornucopia of interesting news stories, follow @DrugChannels on Twitter.

Tuesday, September 26, 2017

Drug Wholesalers Struggle: Slower Revenue Growth and Lower Gross Margins for 2017

Next week, Drug Channels Institute will release our updated 2017–18 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors.

Below, we highlight the report’s revenue and gross margin trends for the U.S. drug distribution businesses of the Big Three wholesalers—AmerisourceBergen, Cardinal Health, and McKesson.

As you will see, we project that revenue growth in 2017 will be the slowest since 2013. We estimate that core U.S. drug distribution gross margins peaked in 2015 and have declined ever since.

For a sneak peek at the complete report and its content, download the free overview. Enjoy!

Monday, September 25, 2017

Life Sciences ACO & IDN Collaboration Summit

Life Sciences ACO & IDN Collaboration Summit
October 23-24, 2017 | Alexandria, VA
www.worldcongress.com/acocollab

The Life Sciences ACO & IDN Collaboration Summit provides a forum for collaboration to advance ACO, IDN, and life sciences partnerships in population health management.

How will you benefit?
  • CMS to provide guidance on regulations, future modeling, and best practices in working within the current system
  • Hear firsthand from the C-Suite at ACOs and IDNs as they clearly lay out the opportunities for collaboration in order to improve population health
  • Merck Case Study: How ACOs and IDNs are using outcomes research to make decisions on pharmaceutical products
  • Geisinger Case Study: Create a systems approach to redesigning primary and specialty care
  • Identify key changes that are impacting the sales approaches of manufacturers
    Understand how to align value considerations of ACOs, IDNs, and manufacturers to improve patient outcomes and care coordination
  • 6-for-1 ticket pricing! As part of your registration, gain access to any of the co-located events part of the Value-Based Health Care Congress - a 6 track event covering value-based network and contract management, MACRA strategy, ACO strategy, ACO & IDN collaboration, and value-based contracting.
Register today – Use discount code DC200 and save $200!

Visit www.worldcongress.com/acocollab for more information.


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

Tuesday, September 19, 2017

Remicade: A Case Study in How U.S. Pricing and Reimbursement Curb Adoption of Biosimilars

The Centers for Medicare & Medicaid Services (CMS) has just released the Average Sales Prices (ASP) reimbursement data for the fourth quarter of 2017. You can download the drug pricing files here.

Below, I use these data to explore the reimbursement and payer dynamics behind the relatively slow adoption of Inflectra, the first biosimilar of Remicade. The introduction of Renflexis, a second biosimilar, will offer additional insights about pricing and channel strategies.

The U.S. biosimilar market is highly underdeveloped compared with our European counterparts. As this case study shows, it’s pretty, pretty, pretty hard to launch a biosimilar.

Monday, September 18, 2017

CBI’s Gross-to-Net Summit

CBI’s Gross-to-Net Summit
November 15-16, 2017 | Philadelphia, PA
www.cbinet.com/GTN

With the total value of off-invoice discounts and rebates increasing over the last few years, it is pivotal that pharmaceutical and biotech manufacturers stay on the forefront of gross-to-net management. CBI’s GTN Summit, now in the 7th year, is the first step toward positioning your organization for success in the years ahead.

Sessions will focus on strategic GTN forecasting, accounting estimates, data analytics and financial reporting specifically for life science companies. You’ll also hear about health care reform, GTN impacts of coupons and copay programs, revenue recognition based on the new standard, pipeline reserve accruals and much more! You can download the complete agenda here.
In-Depth Workshops and Deep Dive Learning Streams Include:
  • Fundamentals of Payer Contracting and Profitable Negotiations
  • GTN Channel Profitability and Performance Monitoring
  • Models and Simulations for Determining ROI and GTN Impacts
  • GTN Efficiency – Digital Capabilities and Robotic Process Automation
  • Internal Controls and SOX Compliance
  • Accounting & Reporting
  • Financial Planning & Analytics
  • Contract Strategy & GTN Forecasting
PLUS! Benefit from company-specific content tracks for branded pharma, generics and emerging biotech/new launch.

Visit www.cbinet.com/GTN for further details and to register. Drug Channels readers will save $400 off of the standard rate when they use discount code YKU729 and register prior to October 20th.*

CBI will see you there!

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rate or non-profit 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, September 14, 2017

What’s Behind the Slowdown in Specialty Pharmacy M&A Deals?

It looks like specialty pharmacy merger & acquisition (M&A) activity has slowed down.

In 2017 so far, only seven deals involving specialty pharmacies and infusion services companies have been announced. Each is listed below, along with the 10-year M&A trends.

What’s going on? Are buyers skittish over slower specialty industry revenue growth? Are they nervous about the still-unsettled impact of Direct & Indirect Remuneration (DIR) fees? Are the big dealmakers on the sidelines, digesting their previous purchases? Or will we see a surge of deals before year’s end?

Tuesday, September 12, 2017

Why Manufacturers and PBMs Should Worry About the Growth of Hospital-Owned Specialty Pharmacies

The American Society of Hospital Pharmacists (ASHP) has just released its latest national survey of pharmacy practice in hospital settings. (Free download) I always enjoy this annual treasure trove of insights.

This year’s survey confirms the extent to which hospitals and health systems are pursuing specialty pharmacy dispensing revenues. In 2016, about 1 in 11 hospitals had a specialty pharmacy. However, nearly half of the largest hospitals operated a specialty pharmacy.

Below, I summarize these new data and review hospitals’ motivations for growth. Pharmaceutical manufacturers and pharmacy benefit managers (PBMs) should be wary of the expansion in hospital-owned specialty pharmacies.

Monday, September 11, 2017

CBI’s 9th Federal Pricing and Reporting Summit – VA * DoD * PHS

CBI’s 9th Federal Pricing and Reporting Summit – VA * DoD * PHS
November 16-17, 2017 | Philadelphia, PA
www.cbinet.com/fedpricing

CBI is pleased to invite you to attend the Federal Pricing and Reporting Summit, being held November 16-17, 2017 in Philadelphia, PA. Drug Channels readers will save $400 off of the standard registration rate when they use discount code JQJ962.*

This must-attend event includes updates from government officials and key stakeholders, plus the opportunity to network and learn from industry counterparts. Stay current on processes and requirements of the VA, DoD and PHS to achieve contracting excellence and develop strategies to enhance stakeholder value and engagement in this highly complex market.

You’ll gain actionable insights from in-depth sessions that cover the most compelling topics related to federal pricing and contracting. Some highlights include:
  • Updates and insights on VA Structure and OIG Audit Expectations
  • Deep Dive into TAA Non-Compliant Covered Drugs Policy
  • Key Decisions and Considerations for New FSS Products and Devices
  • VA and DoD Risk-Share Agreement Updates and Explorations
  • DLA Troop Support Initiatives and best Practices for Medical Stakeholders
  • Trends and Development in DoD Pharmacy Benefit Management
  • TRICARE Dispute Resolution, Calculations and Refund Management
  • Industry Insights on 340B Reporting Challenges and Best Practices for Program Implementation
Perspectives will include updates from the Department of Veteran Affairs, VA Office of Inspector General, DoD DLA Troop Support, and Former DoD Pharmacoeconomic Center, along with strategies and guidance from Acorda Therapeutics, Amneal Pharmaceuticals, Bayer Healthcare, Chiesi, Eisai, Eli Lilly, Genentech, Horizon Pharmaceuticals, Pfizer, King & Spalding, Sidley Austin and Dave Rice Group.

Download the agenda here, and visit www.cbinet.com/fedpricing for further details and to register. Drug Channels readers will save $400 off of the standard registration rate when they use discount code JQJ962.*

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rate or non-profit 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.