Tuesday, December 03, 2024
Four Revelations from Minnesota’s First 340B Transparency Report
Minnesota just released the industry‘s first ever mandated financial report on the 340B Drug Pricing Program. Below, I do a wicked deep dive into the data and highlight crucial implications about spending, profits, pharmacies, plans, patients, program integrity, and more.
There are important limitations to these data. But Minnesota’s report marks a valuable first step on the yellow brick road to the wonderful world of transparency. I suspect similar reports are gonna be popular.
And don't forget to put on your ruby slippers and hear from Doctor of Thinkology Adam J. Fein. During next week’s Drug Channels Outlook 2025 live video webinar, he'll tell you what's ahead for the program that continues to defy gravity.
Monday, November 25, 2024
Drug Channels News Roundup, November 2024: Employers & Their PBMs, Medicaid vs. 340B, U.S. Drug Prices, and Dr. G Shops for Health Plans
- Intriguing data on how employers oversee their PBMs
- State Medicaid programs carve out PBMs—and get a 340B windfall
- Are U.S. drug prices really higher than other countries?
P.S. Join my nearly 60,000 LinkedIn followers for daily links to neat stuff along with thoughtful and provocative commentary from the DCI community.
Coming soon: Drug Channels Outlook 2025, our biggest live video webinar of the year. Join Adam J. Fein, Ph.D., on December 13, 2024, from 12:00 p.m. to 1:30 p.m. ET., as he helps you and your team get ready for 2025 by outlining key issues and uncertainties that will surely affect your planning. Click here to learn more and sign up.
Friday, November 22, 2024
Addressing Gaps in Access: Strategies to Optimize Your Prescription Journey
Catherine reviews the prescription lifecycle from the perspectives of patients, providers, and manufacturers. She explains how manufacturers can support patients with clear comunication about their prescriptions. Catherine then outlines five strategies to help providers have more informed conversations with patients.
To learn more, watch for PHIL’s on-demand webinar: Improving Access, Coverage, and GTN with Digital Hubs.
Read on for Catherine’s insights.
Tuesday, November 19, 2024
Large Chains’ Position in 2025’s Part D Pharmacy Networks: Supermarkets Take the Lead in a Shrinking PDP Market
Today, we examine the seven largest retail chains’ participation in the 12 major 2025 Part D networks that the five largest plan sponsors will offer. As always, we provide you with a handy table for tallying each chain’s participation and changes from 2024 to 2025.
As you’ll see, Albertsons and Publix are the only major retail chains that will be participating in all of the major PDP’s preferred and open pharmacy networks. Walmart and Walgreens will maintain strong participation, while CVS will pull back. Low-income subsidy (LIS) beneficiaries, whose ranks expanded due to the IRA, will continue to have no financial advantage for using a preferred pharmacy.
In a future post, we’ll delve into how smaller pharmacies will participate in the 2025 Part D plans, by examining the pharmacy services administrative organizations (PSAOs).
Speaking of 2025, please join Adam J. Fein, Ph.D., for his upcoming live video webinar, Drug Channels Outlook 2025, on December 13, 2024, from 12:00 p.m. to 1:30 p.m. ET. Click here to learn more and sign up.
Friday, November 15, 2024
From Integration to AI: The Data-Driven Future of Market Access
The authors outline the challenges that manufacturers face when integrating internal and external datasets to build market access and commercialization strategies. They argue that unified datasets and the addition of AI-driven analytics tools can improve decision making throughout a drug’s life cycle.
Click here to learn more about NorstellaLinQ, an integrated data asset that combines claims, labs, and EMR data with forecasting, clinical, payer, and commercial intelligence.
Read on for their insights.
Wednesday, November 13, 2024
Medicare Part D in 2025: Preferred Pharmacy Networks Fade in a Collapsing PDP Market
For 2025, DCI’s exclusive analysis of Center for Medicare & Medicaid Services’ (CMS) data reveals that the number of PDPs will drop to a historic low. What’s more, the share of plans with a preferred cost sharing pharmacy network will fall to its lowest rate in more than 10 years. Check out the distressing charts below and our review of the remaining national players (Aetna, Cigna, Humana, UnitedHealthcare, and WellCare).
The destruction of the Part D market marks yet another unintended consequence of the Inflation Reduction Act of 2022 (IRA). The IRA makes PDPs less economically viable and will drive even more seniors into Medicare Advantage Prescription Drug (MA-PD) plans—despite the challenges facing those plans. The 2025 decline will occur even after CMS gifted $7 billion to PDPs to prevent a complete collapse of the 2025 market.
Legislate in haste. Repent in leisure.
What else should you expect for 2025? Find out during my upcoming live video webinar, Drug Channels Outlook 2025, on December 13, 2024, from 12:00 p.m. to 1:30 p.m. ET. Click here to learn more and sign up. As always, we are offering special discounts if you want to bring your whole team.
Tuesday, November 12, 2024
Drug Channels Outlook 2025 (NEW Live Video Webinar)
This event is part of The Drug Channels 2024 Video Webinar Series. (Please note that our December 2024 webinar is *not* included with next year’s 2025 Video Webinar Series.)
WHAT YOU WILL LEARN
Join Dr. Fein as he helps you and your team get ready for 2025 by outlining key issues and uncertainties that will surely affect your planning. This event can be both a capstone of your annual learning and a touchpoint for the future. DCI’s Outlook webinars have proven to be reliable and informative guides to crucial aspects of the ever-evolving healthcare industry.
During the event, Dr. Fein will share his latest thinking and projections on a wide range of topics, including:
- Latest predictions for the Inflation Reduction Act
- Expectations for the Medicare Part D market in 2025 and beyond
- Update on 340B Drug Pricing Program’s controversies
- Impact of the new Trump administration and Congress on the drug channel
- Vertical integration and consolidation trends—and prospects for dis-integration and de-consolidation
- The state of biosimilar markets
- What’s next for PBMs’ private label products and GPOs
- Retail pharmacy’s future
- Prospects for direct-to-patient channels
- What’s ahead for discount cards and cash-pay pharmacies
- The outlook for state and federal legislation on PBMs and the drug channel
- Gross-to-net bubble developments
- And much more!
As always, Dr. Fein will clearly distinguish his opinions and interpretations from the objective facts and data. He will draw from exclusive information found in DCI's economic reports .
Read on for full details on pricing and registration.
Friday, November 08, 2024
How the Perfect Storm Will Impact Patient Support Programming in 2025 and Beyond
Chris examines three key trends that will affect patient support programs: the Inflation Reduction Act (IRA), legal/regulatory battles over copay adjustment programs, and uncertainties following a national election. He then outlines three actions that should guide manufacturers' preparation.
To learn more, register for ConnectiveRx’s free webinar on December 11: The Perfect Storm? Patient Support Programming in 2025 and Beyond.
Read on for Chris’s insights.
Monday, November 04, 2024
Transparency Shocker: Biosimilars Are Getting Cheaper—But Hospitals and Insurers Can Make Them Expensive
Novel transparency information reveals that this good news doesn’t always translate into savings. Below, we rely on a unique data set from Turquoise Health to examine how much four national commercial health plans—Aetna, Anthem, Cigna, and UnitedHealthcare—paid hospitals for Avastin and its two most significant biosimilar competitors.
As we demonstrate, health plans pay hospitals far above acquisition costs for biosimilars. What’s more, plans can pay hospitals more for a biosimilar than for the higher-cost reference product. The U.S. drug channel system is warping hospitals’ incentives to adopt biosimilars, while simultaneously raising costs for commercial plans.
The namesake of my alma mater once said: “Sunlight is said to be the best of disinfectants.” What would happen if we disinfected the entire channel?
Friday, November 01, 2024
How Field Reimbursement Services Help Overcome Coverage Barriers and Improve Patient Outcomes
Kimberley highlghts the crucial roles of field reimbursement managers in removing access and reimbursement barriers. She then identifies the keys to successful implementation of field reimbursement services.
To learn more, register for CoverMyMeds' November 13, 2024, webinar: Specialty Therapies & Field Reimbursement Services: Driving Better Outcomes for Brands and Patients.
Read on for Kimberley’s insights.
Tuesday, October 29, 2024
Drug Channels News Roundup, October 2024: Humira Price War Update, PA vs. Providers, IRA vs. Physicians, My AI Podcast, New DCI Jobs, and Dr. G on Copayments
- Spooky! Blue Shield of California frightens away the gross-to-net bubble with its Humira biosimilar strategy
- Vampiric! Prior authorization sinks its fangs into providers’ time
- Wicked! How the IRA will put a stake through specialty physician practices
- Eerie! Google’s monstrous AI podcasts leave me petrified
- Zoinks! Join the vampire hunters at Drug Channels Institute
P.S. Stretch out your arms and join the ever-growing zombie horde who shamble after me on LinkedIn. You’ll find my ghostly rantings along with commentary from the undead hordes in the DCI community.
Friday, October 25, 2024
No More Delays: Accelerating Therapy Starts by Embedding Hub Services in Provider Workflows
Shabbir explains the barriers that providers face when dealing with branded portals for multiple products. He then maintains that patients can access new therapies more quickly when the manufacturer relies on a brand-agnostic hub connected to a large network of providers and integrated with the systems those providers use daily.
To learn more, download CareMetx’s new 2024 Patient Services Report: Revealing Manufacturer Priorities: Patients Naturally Take Center Stage.
Read on for Shabbir’s insights.