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 18,000 subscribers. Learn more...

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.

Wednesday, September 06, 2017

2016’s Fastest-Growing, Private Specialty Pharmacies (From the Inc. 5000)

Time for our annual review of the latest Inc. 5000 list, the magazine’s annual ranking of the fastest-growing private companies in the United States. The list offers a valuable snapshot of the dynamic specialty pharmacy industry. This marks our sixth annual review of the list.

We have identified 15 specialty pharmacies on the 2017 list, which is based upon revenue growth from 2013 to 2016. Annual revenues range from $6.4 million to $1.3 billion.

The pharmacies and key stats are listed below. For the nine companies returning from last year’s list, median revenues in 2016 sped ahead by 24%—impressive but slightly slower than last year’s figure.

The specialty industry’s growth is creating a set of large independent specialty pharmacies. Will they keep racing ahead or wipe out?

Tuesday, September 05, 2017

Life Sciences 2nd Annual Value-Based Contracting Summit

Life Sciences 2nd Annual Value-Based Contracting Summit
October 23-24, 2017 | Alexandria, VA
www.worldcongress.com/valuebased

The Life Sciences 2nd Annual Value-Based Contracting Summit brings together key stakeholders to examine risk sharing strategies to overcome operational challenges and execute successful value-based contracts.

Register today! Use discount code DC200 and save $200! 

How will you benefit?
  • Learn about Pfizer's approach on the move from utilization to impact
  • Examples of how Aetna operationalized value-based agreements to optimize the care experience
  • Understand how value-based arrangements impact provider organizations
  • Gain insight from payers on what they need from manufacturers when entering into a value-based arrangement
  • Analyze how RXAnte and UPMC Health Plan are implementing alternative payment models for prescription drugs
  • Understand how to leverage real world data in collaborations between pharma and payers
  • Collaborate with fellow attendees to solve challenges associated with operationalizing a value-based contract during our hands-on working group
  • Understand the implications on Medicaid, 340B Drug Discount Program, Medicare Part B Program and VA Program
  • Ensure transparency in price negotiations with payers and comply with communication guidelines
  • 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/valuebased 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.

Friday, September 01, 2017

The State of Specialty Pharmacy 2017: Reflections from #Asembia17 (rerun)

This week, I’m rerunning some popular posts while I work on the forthcoming 2017-18 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. Click here to see the original post and comments from May 2017.

FYI, Asembia's 2018 Specialty Pharmacy Summit will be held on April 29 to May 2, 2018.



Last week, Paula and I had the pleasure of attending Asembia’s 2017 Specialty Pharmacy Summit in Las Vegas, itself the summit of spectacle. We even met a new friend, as you can see from the photo on the right.

The Specialty Pharmacy Summit remains the most important forum for conducting business in the specialty marketplace. More than 5,000 people learned, networked, and connected at the wonderful Wynn Las Vegas. Thanks to Larry and Robert Irene for creating an annual event that brings the entire industry together. Click here to enjoy the social media action from #Asembia17.

Today marks the seventh year that I will violate Vegas code and tell you what happened there. Below, I offer reflections on key specialty industry trends, DIR fees, patient satisfaction controversies, and a link to the Featured Session slides. You’ll also find a few incriminating photos! Please add your own observations and photos to the comments section below.

Thursday, August 31, 2017

A Reality Check on Amazon’s Pharmacy Ambitions (rerun)

This week, I’m rerunning some popular posts while I work on the forthcoming 2017-18 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. Click here to see the original post and comments from May 2017.



CNBC reported last week that Amazon may enter the pharmacy and/or pharmacy benefit manager (PBM) market. Here’s the story: Amazon is hiring people to break into the multibillion-dollar pharmacy market.

The news made many people freak out and then begin speculating on all of the amazing ways that Amazon would change the drug channel. USA Today breathlessly mused: Could your next prescription come from Amazon?

Amazon has been successfully attacking the front-end business of chain drugstores. But could it really disrupt the pharmacy and PBM industries?

Below, I provide a reality check on how Amazon could compete—and what it is unlikely to do.

Wednesday, August 30, 2017

Which PBM Best Managed Drug Spending in 2016: CVS Health, Express Scripts, MedImpact, or Prime? (rerun)

This week, I’m rerunning some popular posts while I work on the forthcoming 2017-18 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. Click here to see the original post and comments from March 2017. 

ICYMI, I published a follow up analysis that includes OptumRx in Which PBM Best Managed Drug Spending in 2016: How Did OptumRx Compare?



Four of the largest pharmacy benefit managers (PBMs)—CVS Health, Express Scripts, MedImpact, and Prime Therapeutics—have raised their swords and released their 2016 drug trend reports. (Links below.) That means it’s time for some Drug Channels-style fun! Below, I review what the reports reveal about drug spending—and which questions remain unanswered.

Drug trend measures the year-over-year changes in a plan sponsor’s pharmacy benefit drug spending. As you will see, all four PBMs reported that their drug trend percentages for 2016 were in low single digits. The unweighted average among them was a mere 3.5%. About one-third of PBM clients experienced year-over-year declines in drug spending.

Put more simply: The U.S. doesn’t have a drug spending problem. It's fake news.

Specialty drugs have doubled as a share of plan sponsors’ benefit costs. Since these products account for only about 1% of claims, pharmacy benefit management is increasingly focused on handling these patients and their complex, hard-to-treat diseases. Unfortunately, payers seem set on discriminating against people who receive these therapies.

Keep in mind that the PBMs’ reports are primarily marketing documents, not peer-reviewed research studies. But as many PBM executives have said: What we do in life echoes in eternity!

Tuesday, August 29, 2017

Profits in the 2017 Fortune 500: Manufacturers vs. Wholesalers, PBMs, and Pharmacies (rerun)

This week, I’m rerunning some popular posts while I work on the forthcoming 2017-18 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. Click here to see the original post and comments from June 2017. 

ICYMI, I published a corresponding per-prescription analysis in Follow the Dollar Math: How Much Do Pharmacies, Wholesalers, and PBMs Make From a Prescription?



Time for my annual review of the Fortune 500 list. Every year, this is one of my most popular posts, because it helps us “follow the dollar” and understand how drug channel intermediaries make money.

The 2017 list contains the same seven drug channel companies that the 2016 list did: AmerisourceBergen, Cardinal Health, CVS Health, Express Scripts, McKesson, Rite Aid, and Walgreens Boots Alliance.

Using the Fortune data, I explore the profitability and shareholder returns of the largest public drug wholesalers, chain pharmacies, and pharmacy benefit managers (PBMs). I compare these companies with the Fortune 500’s ten pharmaceutical manufacturers and a separate survey of independent pharmacies.

The Fortune data remind us that many multi-billion dollar businesses profit as drugs move through the U.S. reimbursement and distribution system. We must recognize this complex system in order to tackle the price and affordability of drugs.

Monday, August 28, 2017

4th Annual Rare Disease Market Access and Commercialization Summit

4th Annual Rare Disease Market Access and Commercialization Summit
October 23-24, 2017 | Boston, MA
www.worldcongress.com/raredisease

Join your peers at the 4th Annual Rare Disease Market Access and Commercialization Summit for a deep examination of the challenges, innovations and techniques for achieving commercial success and navigating the payer landscape.

How will you benefit?
  • Establish best practices when approaching value-based contracting, specifically for rare therapies
  • Analyze recent policy and industry changes, paired with the rising status of the patient voice as a stakeholder, and their joint effect on the drug development lifecycle
  • Payer guidance (Blue Cross Blue Shield of Minnesota) on the reimbursement conundrum
  • Review Amgen and Harvard Pilgrim's outcomes-based contract for Repatha
  • Explore Shire andPatientsLikeMe's collaboration expanding traditional clinical trial monitoring towards the use of real world data and consolidation in a single digital platform
  • Gain insight from manufacturers' and Walgreens on how to develop a specialty pharma channel strategy for a rare disease product launch
  • Hear specific examples of successful marketing strategies for recent rare disease product launches that satisfied stakeholders' needs
Register today – Use discount code DC200 and save $200!

Visit www.worldcongress.com/raredisease 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, August 22, 2017

Drug Channels News Roundup, August 2017: Amazon, Express Scripts, Walgreens, PharMerica, Rebates, and Bezos Business Wisdom

The eclipse has passed! Now it’s time to enjoy this blinding collection of curious questions, filtered through the all-seeing Drug Channels viewfinder.
  • What are Amazon’s actual prospects in the drug channel?
  • What does Express Scripts think about Amazon's prospects?
  • Why did Walgreens partner with KKR to buy PharMerica?
  • What happens to patients when plans favor brand-name drugs over generics?
Plus, Jeff Bezos shares words of wisdom for budding entrepreneurs.

P.S. If everything under the sun is in tune, then you'll follow @DrugChannels on Twitter for my daily links to all that you love.

Monday, August 21, 2017

CBI’s Gross-to-Net Summit

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

A recent Drug Channels blog post focused on a QuintilesIMS report, discussing how the total value of pharmaceutical manufacturers’ off-invoice discounts, rebates, and other price concessions has more than doubled over the past five years, from $59 billion 2012 to an astonishing $127 billion in 2016.

What is the best way to position your organization to manage this increase? How are your colleagues from across the industry achieving success? Find out at CBI’s GTN Summit! Drug Channels readers will save $400 off of the standard registration rate when they use discount code SDP676.*

The 7th annual meeting covers a broad range of subjects related to strategic GTN forecasting, accounting estimates, data analytics and financial reporting specifically for life science companies. Some hot topics will be addressed, such as health care reform, GTN impacts of coupons and copay programs, revenue recognition based on the new standard, pipeline reserve accruals and much more! There are also session breakouts specifically for Pharma/Established Brands, Generics and Emerging Biotech/New Launch.

Featured Sessions
  • Redefining Gross-to-Net – Moving Beyond Theory for Profitability, Streamlined Data, Organizational Transparency and Control
  • Business Process Excellence – Instituting Best in Class Processes, Communication Flows and Data Frameworks for GTN
  • Talent, Leadership and Organization Design – Prioritizing GTN
  • Beyond Excel — GTN Data, Technology and Documentation: Sound-Off, Size-Up and Scale with Various Approaches to Systems and Automation
Workshops and Learning Streams on:
  • Profitability and Managed Markets Strategy
  • Inventory and Channel Forecasting
  • Robotics and Artificial Intelligence in GTN
  • Internal Controls and SOX Compliance
  • Accounting and Reporting
  • Financial Planning and Analytics
  • Contract Strategy and Operations
Be one of the first to see the agenda here, and visit www.cbinet.com/GTN for further details and to register. Drug Channels readers will save $400 off of the standard registration rate when they use discount code SDP676.*

*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, August 16, 2017

Diplomat Sees Declining DIR Fee Impact—and Perhaps Readies a PBM Strategy

Last week, Diplomat Pharmacy released its quarterly earnings, which included new details about the financial impact of Direct and Indirect Remuneration (DIR) fees. I provide some background on DIR fees below.

Diplomat, as a public company, is the only entity that is obligated to publish truthful information about DIR fees. While reviewing its data, let’s recall our Drug Channels philosophy, courtesy of the late senator Daniel Patrick Moynihan: "Everyone is entitled to his own opinion, but not his own facts."

As you will see below, Diplomat’s exposure to DIR fees remains relatively modest. DIR fees as a share of its gross profit has even declined since last year. This shift is driven by an evolving business mix along with better accounting of and management control over DIR fees.

In part to counter DIR fees and other payer pressures, Diplomat is signaling its intention to play a more significant role in the pharmacy benefit management (PBM) business. Let the rumors begin!

Monday, August 14, 2017

Electronic Benefit Verification & Prior Authorization Summit

Electronic Benefit Verification & Prior Authorization Summit
October 24-25, 2017 | San Francisco, CA
www.cbinet.com/eBenefit

CBI’s Electronic Benefit Verification & Prior Authorization Summit provides attendees with an understanding of key issues and developments in electronic patient services, including electronic benefit verification, real-time benefit verification, prior authorizations, health records and prescribing services.

Gain Critical Insights and Strategies to Improve Patient Access
  • Examine challenges associated with ePA implementation, and understand planning and operational considerations associated with technology adoption
  • Understand the implementation steps needed to achieve real-time benefit verification
  • Compare innovations in electronic patient service technology to identify what solutions fit within company strategies
  • Determine how to leverage patient support programs to overcome formulary barriers, help patients stay on therapy and drive positive physician coverage perception
  • Discuss how to streamline electronic benefit verifications and prior authorization solutions into a hub model
  • Facilitate efficient information exchange between key stakeholders, including manufacturers, health plans, health systems, PBMs and physicians

Visit www.cbinet.com/eBenefit for more information. Drug Channels readers will save $400 off the standard registration rate when they use discount code PSK783*

*Discount expires October 24, 2017; 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.

Thursday, August 10, 2017

Generic Deflation Roils the Channel—And Will Get Worse

Deflation in generic drug prices dragged down second quarter earnings for drug wholesalers and generic manufacturers. Here’s a useful summary from The Wall Street Journal, which captures the grim marketplace realities in Falling U.S. Generic Drug Prices Hurt Manufacturers, Wholesalers. Yesterday, Mylan's earning release noted "high-single-digit erosion expected in North America."

Below, I review the state of the generic drug market. As you will see, the overall market for mature generic drugs is deflating by about 10% per year. Many generic drugs have dropped significantly in price over the past four years.

Surprisingly, the prices for about one in five generic drugs remain elevated. Scott Gottlieb, M.D., the new head of the Food and Drug Administration (FDA), has prioritized actions that should squeeze the remaining generic inflation out of the system. I expect generic drug deflation to continue—and possibly accelerate—over the next 12 to 24 months.

Payers and consumers will be the ultimate winners, but the drug channel faces significant disruption. In the meantime, let’s all hope that these price declines don’t trigger shortages if generic drug makers flee this sinking market.

Tuesday, August 08, 2017

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

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.

Monday, August 07, 2017

CBI’s PAP Legal Update

CBI’s PAP Legal Update
September 25-26, 2017 | Arlington, VA
www.cbinet.com/PAPUpdate

PAP Legal Update 2017 - Please join the patient assistance and access community for this critical update meeting which will provide important insight into key legal issues, including recent advisory opinions from the OIG, developments in the changing healthcare and regulatory landscapes, and opportunities for industry collaboration in the face of an increased need for risk mitigation. Learn more here.

Compelling Discussions, Pivotal Insights and Interactive Sessions for Forward-Thinking Compliance
  • Hear an analysis of recent OIG advisory opinions related to PAPs
  • Examine the legal and enforcement environment impacting the relationships between manufacturers and 501(c)(3)s
  • Hear insights from advocates on efficient and effective PAPs and identify ways to strengthen your PAP with stakeholder engagement
  • Improve brand image and messaging for PAPs in the era of public scrutiny
  • Discuss policies for reducing risks associated with working with Medicare and Medicaid patients
  • Remain compliant with design and development of co-pay assistance programs
Download the complete agenda here. Visit www.cbinet.com/PAPUpdate for further details and to register. Drug Channels readers will save $300 off of the standard registration rate when they use code RKN333.*

*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, August 03, 2017

What’s In, What’s Out: The New 2018 CVS Health and Express Scripts Formulary Exclusion Lists (Plus: A Sneak Peek From Prime)

This week, the two largest pharmacy benefit managers (PBMs)—Express Scripts and the CVS/caremark business of CVS Health—released updates to their 2018 formulary exclusion lists. They are available below for your downloading pleasure.

For 2018, Express Scripts was more aggressive, expanding its list to 159 excluded products. At CVS Health, however, the total number of excluded remained steady. The Prime Therapeutics list won’t be available until September, but it will apparently exclude more drugs that either of its PBM peers.

Read on for my 2018 head-to-head comparison, including comments on inflammatory conditions, multiple sclerosis, epinephrine, biosimilars, and more. I also review the reported savings from formulary exclusions. I conclude with some questions about patients. Remember them?

If I have missed anything important, please comment below.

Tuesday, August 01, 2017

New Part B Buy-and-Bill Data: Physician Offices Are Losing to Hospital Outpatient Sites

The Medicare Payment Advisory Commission (MedPAC), the independent agency that advises Congress on the Medicare program, recently released its June 2017 Data Book: Health Care Spending and the Medicare Program. The report is a 201-page wonktastic data dump. Chapter 10 focuses on prescription drugs.

In 2015, the most recent year available, Part B spending on drugs reached $25.7 billion. Hospital outpatient sites now constitute more than one-third of Medicare spending and have been crowding out physician offices. Part B payments to physician practices are growing much more slowly than payments to hospitals.

For some time, I have been tracking the evolution of the buy-and-bill system for provider-administered drugs. These new data confirm my predictions that physician offices’ will account for a declining share of the buy-and-bill market. Still unknown: Is this good or bad for patients?

Monday, July 31, 2017

CBI’s 5th Annual Coupon and Copay

CBI’s 5th Annual Coupon and Copay
September 14-15, 2017 | Philadelphia, PA
www.cbinet.com/CouponAndCopay

Exclusive Offer – Register by 8/25/2017 and save $500*
Use discount code COUPDC

In the midst of a turbulent healthcare system, with drug prices continuing to escalate, patient affordability and access programs have become more critical than ever. Coupon and copay programs are one of the most effective tools for life sciences manufacturers to minimize patient out of pocket costs, while driving access and adherence.

As such, CBI's flagship Coupon and Copay conference, taking place September 14-15 in Philadelphia, PA, serves as the life sciences industry’s foremost event devoted exclusively to manufacturer-driven coupon and copay programs. Join the best of the best in life sciences and discover pioneering strategies to maximize ROI by leveraging these powerful discount opportunities.

The 2017 agenda boasts a diverse, experienced faculty from Otsuka Pharmaceuticals, United Healthcare Pharmacy, Healthwell Foundation, Coherus Biosciences, BioPlus Specialty Pharmacy, Community Health Network, UVA Cancer Center and many more!

Don't miss your chance to unite with leading innovators in copay design to discuss the future of patient assistance and access:
  • Hear multi-stakeholder perspectives on the future of assistance and access for patients needing high-cost specialty therapies
  • Discuss key analyses (abandonment, redemption, competitive offerings) used to improve the value of copay programs
  • Identify new challenges in an evolving environment including deductible reset, LOE, real-time measurement for launches, distribution channel, OIG risk, denial conversion and e-coupons
  • Navigate the OIG modifications on contributions to charitable patient programs
  • Learn more about copayment assistance funds for Medicare patients
  • Alignment of offer strategy with contracting efforts to avoid “double-dipping” of rebate and copay offerings
  • Consider strategies for fast tracking prior authorization and copay assistance for specialty prescriptions to increase speed to therapy


*Discount offer valid through 8/25/2017; applies to standard rates only and may not be combined with other offers, categories, 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, July 27, 2017

Drug Channels News Roundup, July 2017: CVS, Anthem, Specialty Pharmacy, INSYS, and Big Box Pharmacy

Cut through the steamy summer haze with our refreshing selection of articles and insights. In this issue:
  • CVS drugstores aim for a healthier look
  • Anthem dissects specialty pharmacy management
  • Takeaways from an Insys employee’s guilty plea over prior authorization
  • Profiling pharmacies inside supermarkets and mass merchants
Plus, The Onion reports on the launch of generic internets following patent loss. Scary!

P.S. Follow @DrugChannels on Twitter for my daily curated selection of news and commentary.

Tuesday, July 25, 2017

What Will Happen to Rite Aid’s Struggling EnvisionRx PBM?

Let’s revisit the Walgreens Boots Alliance—Rite Aid deal. Instead of an acquisition, the revised transaction calls for Walgreens Boots Alliance (WBA) to buy 2,186 Rite Aid stores and three distribution centers for $5.2 billion. WBA will also pay a $325 million termination fee to Rite Aid.

If the deal receives regulatory approval, Rite Aid will shrink to a multi-regional pharmacy chain with about half as many stores. It will, however, hold onto EnvisionRx, the pharmacy benefit manager (PBM) that it acquired in 2015.

Unfortunately, EnvisionRx remains a small, struggling regional PBM with limited growth. Its revenues in 2017 have been declining. There also appears to be no material synergies between Rite Aid’s retail pharmacy business and its Envision PBM.

Last week, Rite Aid disclosed that it will use $4.9 billion of its $5.5 billion windfall to repay debt. (Pro forma financials below.) Given the performance troubles that I outline below, I wonder whether investors will trust the current management team to spend the cash wisely.

Monday, July 24, 2017

PBMI 2017 Specialty Rx Forum

PBMI 2017 Specialty Rx Forum
September 12, 2017
Hyatt Regency Hotel | Downtown Chicago

You’re invited to join PBMI for its first regional Specialty Rx Forum in downtown Chicago at the Hyatt Regency Hotel. This one-day meeting is focused on discussing what's keeping plan sponsors up at night—specialty drug trend.

PBMI has gathered speakers representing different perspectives on the specialty drug industry including senior leaders from the largest PBMs, national employers, specialty drug manufacturers, and specialty pharmacies.


Take advantage of lowest rates before they expire. Early bird rates end 8/1!

For more information about the Forum and sponsorship opportunities, please contact Linda DeChant at ldechant@pbmi.com.

PBMI looks forward to seeing you!


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

Thursday, July 20, 2017

2016’s Top Retail Pharmacy Chains, According to Drug Store News

Drug Store News (DSN) has just released its latest rundown of the top pharmacy retailers in the mightily-titled PoweRx 50. (Links below.)

I recommend the PoweRx list to anyone who competes with, sells to, or otherwise interacts with retail pharmacy chains. This useful resource also provides brief profiles of most organizations.

Below, I show DSN's top 25 retailers. This year, CVS Health tops the DSN list, with $60.8 billion in retail prescription sales. Colorado-based chain Pharmaca Integrative Pharmacy is no. 50, with $73 million in prescription sales—0.1% of CVS Health’s retail revenues.

Note that the DSN list is not a complete look at the U.S. pharmacy industry. It excludes many large mail and specialty pharmacies. It also inconsistently (and IMHO, inaccurately) aggregates independently-owned pharmacies by wholesaler and buying group. I highlight how the list differs from our broader but shorter list shown in The Top 15 U.S. Pharmacies of 2016.

Tuesday, July 18, 2017

Understanding CMS’s Surprising Reimbursement Cut for 340B Hospitals

Last Thursday, the Centers for Medicare & Medicaid Services (CMS) shocked everyone with a proposal altering a small part of the 340B Drug Pricing Program. CMS proposed reducing reimbursement for certain Medicare Part B drugs purchased by 340B-eligible hospitals: from Average Sales Price (ASP) plus 6% to ASP minus 22.5%. Hospitals will also have to identify 340B claims with a new modifier.

Below, I highlight the most important 13 pages of CMS’s 664-page proposal. I also offer some observations and commentary on the proposal.

For context, I also include the new background memo for today’s House Energy and Commerce Committee hearing: Examining HRSA’s Oversight of the 340B Drug Pricing Program. The memo highlights the many negative findings from government watchdog agencies.

Like it or not, change may finally be coming to the out-of-control 340B program. Let’s hope Congress can get the program refocused on genuine safety-net providers and financially needy patients.

Monday, July 17, 2017

CBI’s Life Sciences Outcomes-Based Contracting Summit

CBI’s Life Sciences Outcomes-Based Contracting Summit
October 3-4, 2017 | Philadelphia, PA
www.cbinet.com/OutcomesContracting

Exclusive Offer for Drug Channels Readers:
Register Now to SAVE $400* using promo code DCR400
Hurry! This Offer Expires August 14, 2017.

CBI’s 2nd Annual Life Sciences Outcomes-Based Contracting Summit provides critical strategies into the process of outlining, structuring and negotiating risk-sharing agreements between bio/pharma manufacturers and payers.

This timely event will address the continuous challenges the industry faces to lower drug costs and increase patient access, all while demonstrating the value of their drugs to insurers by providing best practices and key insights from thought-leaders regarding the nuances surrounding outcomes-based contracting.

Join us for Solutions-Oriented Sessions, Powerful Payer Insights and Illuminating Case Studies:
  • Gain an understanding of the risk-sharing challenges from the payers perspective, featuring Michael Sherman, MD, Sr. Vice President and Chief Medical Officer of Harvard Pilgrim Health Care
  • Bridge the gap between real-world evidence and health economics outcomes research
  • Manage legal, compliance and regulatory concerns surrounding value-based contracts
  • Examine the benefits and challenges of outcomes-based contracts for target population (orphan/rare disease) therapies
  • Translate successful European managed entry agreements into actionable opportunities for the U.S. marketplace
  • Discuss the challenges and rewards of co-developing drugs and diagnostics for enhanced outcomes
  • And more!
Be the first to view the complete agenda, then register today using promo code DCR400 for this limited time savings of $400* off.

*Discount offer valid through 8/14/17; 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.

Thursday, July 13, 2017

10 Hospitals With 340B Contract Pharmacy Mega-Networks

For a follow-up to The Booming 340B Contract Pharmacy Profits of Walgreens, CVS, Rite Aid, and Walmart, let’s examine covered entities’ contract pharmacy networks in the 340B Drug Pricing Program.

Many covered entities have relatively small 340B contract pharmacy networks. However, some have built large networks seemingly designed not to help needy and uninsured patients, but to enrich hospitals and pharmacies.

The top 10 hospitals, listed below, have built mega-networks averaging 277 pharmacies. The largest retail chains and pharmacy benefit managers (PBMs) are active participants in these networks. That’s right: PBMs have joined the 340B party!

Yesterday, the House Energy and Commerce Committee announced a July 18 hearing: Examining HRSA’s Oversight of the 340B Drug Pricing Program. Also below, I pose four questions that committee members should consider about 340B contract pharmacy mega-networks.

Tuesday, July 11, 2017

The Booming 340B Contract Pharmacy Profits of Walgreens, CVS, Rite Aid, and Walmart

Pharmacies continue to ride the 340B Drug Pricing Program’s explosive growth.

Our latest exclusive analysis finds that nearly 20,000 pharmacy locations now act as a contract pharmacy for the hospitals and other healthcare providers that participate in the 340B Program. Fewer than 3,000 pharmacy locations were in the program in 2010.

Large retail pharmacy chains' rapid expansion (per the fourth chart below) into 340B suggests superior profits.
  • Six large chains account for two out of three 340B contract pharmacy locations in 2017. 
  • Walgreens remains the dominant participant, with nearly 6,400 locations in the 340B program. 
  • Over the past four years, CVS, Walmart, and Rite Aid have also deepened their engagement. These three chains collectively now have 5,400 340B contract pharmacy locations. 
Every year, I question the economics behind this astounding growth. How many prescriptions do contract pharmacies provide at discounted prices to uninsured, underinsured, and low-income patients? Are pharmacies engaged in profit-sharing agreements with 340B hospitals? Are they earning fees that far exceed fair market value standards? Who is really benefiting from the contract pharmacy boom?

Monday, July 10, 2017

Medicaid Drug Rebate Program Summit 2017

Medicaid Drug Rebate Program Summit 2017
September 11-13, 2017
Marriott Magnificent Mile | Chicago
www.knect365.com/MDRP

Medicaid Drug Rebate Program Summit 2017 is a platform to:
  • Network with 600+ government officials, industry leaders, and pharma executives
  • Gain insights on the upcoming 340B Drug Ceiling Price and Civil Monetary Penalties Final Rules
  • Address the potential implications of “repeal and replace” on Medicaid
  • Hear lessons learned following the implementation of the AMP Final Rule
Use discount code XP2258DRUG for $200 off the current rate.

Earn CPE and CLE Credits!

A Universal Continuing Legal Credits (CLE) Certificate of Attendance will be applied for the State of Illinois. Continuing Professional Credits (CPE) will be provided in accordance with the National Association of State Boards of Accountancy (NASBA). State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. All credits will be provided following the conclusion of the conference.

Get guidance from key federal officials to ensure compliance on government program mandates
  • Medicaid Reform in the Trump Era – Scott W. Atlas, MD, David and Joan Traitel Senior Fellow of the Hoover Institution, Stanford University; Member, Hoover Institution’s Working Group on Health Care Policy
  • MDRP: Once a Good Idea, Now Not “Good Enough” – Jeff Myers, President and Chief Executive Officer, Medicaid Health Plans of America
  • Part I: General Overview of the Medicaid Drug Rebate Program: History, Core Elements, and Manufacturer Requirements and Part II: Understand How to Calculate Critical Price Types Such as AMP, URA, Best Price, Base Line AMP – Miree Lee, Principal at M. Lee Consulting LLC
  • Authorized Generics Price Calculations – John Gould, Partner at Arnold & Porter Kaye Scholer LLP
  • Fireside Chat: External Counsel – Moderated by John Shakow, Partner at King & Spaulding, with KPMG, Arnold & Porter Kaye Scholer LLP, Sidley Austin, and Hogan Lovells
Download the Brochure Here for Full Agenda and Speaker Details

Get a Front Row Seat Today and Participate LIVE at the Event!
Register Now to SAVE $200 off the Current Rate. Use discount code XP2258DRUG.


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

Friday, July 07, 2017

What I Told HHS Secretary Tom Price About the 340B Drug Pricing Program (rerun)

This week, I’m rerunning some popular posts while I'm on vacation. Click here to see the original post and comments from May 2017.

This post is especially timely given President Trump’s draft Executive Order. In Section 4, the Order directs Secretary Price to ensure that the program benefits "the lower income or otherwise vulnerable Americans for which the program was intended." Shortly after the article below was published, I discovered that the 340B program has been growing by more than 30% annually. (See The 340B Program Hits $16.2 Billion in 2016; Now 5% of U.S. Drug Market.) It's time to moderninze the 340B Drug Pricing Program.




Last Friday, I had the privilege of meeting with Secretary of Health and Human Services (HHS) Tom Price. I was invited to meet with Secretary Price for one of his listening sessions with industry experts and stakeholders. I appreciated the opportunity to share my perspectives.

In our meeting, I highlighted four ways that the 340B Drug Pricing Program is raising drug costs. I then offered eight specific recommendations for improving the program by addressing the widespread channel distortions the program has caused.

Read on for the recommendations and a summary of my comments to Dr. Price.

I have no idea if my suggestions will have any impact. Regardless, your friendly neighborhood blogger enjoyed spending time among some Washington insiders.

Thursday, July 06, 2017

Cardinal Health’s Unhappy Profit Surprise: The Coevolution of Pharmacy Buying Groups and Wholesaler Economics (rerun)

This week, I’m rerunning some popular posts while I'm on vacation. Click here to see the original post and comments from April 2017.



Yesterday probably didn’t turn out as well as Cardinal Health had expected.

The good news: The company announced the acquisition of Medtronic's Patient Care, Deep Vein Thrombosis and Nutritional Insufficiency businesses for $6.1 billion in cash.

The bad news: Cardinal sharply lowered its outlook for future profits from its pharmaceutical distribution business.

The company cited lower generic drugs prices and “sell-side" pressure from pharmacy customers as two primary causes of its financial woes. Wall Street was unhappy: Cardinal stock closed down a whopping 11%. McKesson and AmerisourceBergen stocks fell in sympathy.

Cardinal Health’s projected profit downturn illuminates a dilemma facing drug wholesalers:
  • Generic buying consortia of wholesalers and pharmacies have reduced wholesalers’ acquisition costs for generic drugs
  • Independent pharmacies—the most profitable customers of wholesalers—are successfully using their own buying groups to extract lower prices from wholesalers
Independent pharmacies have been backed into a corner—and have responded by pushing back against their wholesale suppliers. Cardinal’s warning highlights the coevolution of profits within the pharmacy channel ecosystem. Expect wholesalers to be increasingly desperate to make up these lost funds.