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 26,000 subscribers. Learn more...

Tuesday, June 18, 2019

Meet the Top Ten Drugs of 2024 (Maybe)

The professional prognosticator EvaluatePharma recently released its World Preview 2019, Outlook to 2024 report, which projects prescription drug sales and R&D activity in the U.S. and abroad. (The report is free with site registration.)

You’ll find predictions for the ten best-selling U.S. drug products on page 24. Below is my handy summary chart comparing the 2024 list along with each product’s 2018 sales. For fun, I have also compared the 2018 actual sales with EvaluatePharma’s projections from 2013.

The figures should make us all humble about our ability to project the future. For many products, the EvaluatePharma figures sharply underestimated actual growth rates from 2013 to 2018. The projections to 2024 show that growth will accelerate, which to me suggests an overestimation of future growth. Notably, EvaluatePharma predicts that Humira will retain its sales lead, despite forthcoming biosimilar competition.

These projections, while useful, remind us of another valuable lesson: Good forecasters may not be smarter than everyone else—they merely have their ignorance better organized.

Monday, June 17, 2019

PBM Contracting 2019

PBM Contracting 2019
August 21-22, 2019 | Hilton Magnificent Mile Suites | Chicago, IL
www.cbinet.com/PBMContracting

Now in its 5th year, CBI’s PBM Contracting provides you a great opportunity to gather the most timely information, best practices, and innovations relating to pharmacy benefit management contracts. Unravel the many complexities surrounding the rapidly evolving PBM contracting landscape. You won’t want to miss powerful co-presentations, panel discussions, facilitated networking opportunities, and diverse perspectives on the changing industry dynamics impacting PBM contracting.

Drug Channels readers save $400 off the standard rate when you register and use discount code RXK565.

Hear the latest insights and innovations from industry thought-leaders:
  • Arlene Edlin, General Manager, Sales, Navitus Health Solutions
  • Garrett Brown, Assistant General Counsel, Employers Health Coalition
  • Natasha Davis, Senior Pharmacy Benefits Manager, North Carolina State Health Plan
  • Ben Daniels, Special Counsel, Foley and Lardner, LLP
  • Brandy Millen, Consulting Actuary, Milliman
  • Molly Breimhorst, Vice President, Financial and Analytical Services, PSG
  • And more!
Navigate the changing landscape and collaborate with peers on cutting-edge strategies:
  • Keep pace with regulatory requirements for PBM contracting
  • Benefit from a birds-eye view on the current regulatory status of drug manufacturer rebates
  • Gain tips on thinking outside-of-the-box for development of your prescription benefits plan design and contracts
  • Discover trends in what PBMs are offering in contracts
  • Review the structure of a PBM agreement and assess plans for oversight and monitoring
  • Discuss prescription drug plan pricing and PBM fees
  • Analyze how rebates are defined, potential trends and future of point of sale rebates
  • Provide actionable strategies for plan sponsors to optimize return on drug spending
Request the full agenda and reserve your seat for this important meeting today.

Plus! Drug Channels readers are entitled to an exclusive $400 discount! Just register using discount code RXK565 to receive $400 off* the standard rate when you sign up.

*Offer 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 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.

Wednesday, June 12, 2019

CVS Health: Will This Giant's Scale and Scope Confound Its Vision for Healthcare?

Last week, CVS Health held its annual investor day. (Links below.) In the aftermath of the Aetna transaction, CVS Health has become a uniquely diverse organization with revenues exceeding $250 billion.

As expected, CVS Health management explained the cost-cutting synergies that it expects from having united CVS Health and Aetna. It also laid out a long-range vision for generating value—and operating income—from making the disparate pieces of its empire work together in new ways. CVS Health called these new products and services “transformational initiatives.”

Below, I summarize investor day high points concerning CVS Health’s overall strategy, offer thoughts on the challenges facing the HealthHUB store concept, and highlight the headwinds and tailwinds affecting the company’s major business segments.

I commend CVS Health’s management for their willingness to take giant steps toward a bold vision. But I wonder if its transformation will scale with the speed and efficiency needed to generate superior returns for CVS Health and its investors. And along the way, how much margin will the company sacrifice to preserve its novel business combination?

Monday, June 10, 2019

CBI's Reimbursement and Access 2019

Reimbursement and Access 2019
August 13-14, 2019
DoubleTree by Hilton Center City | Philadelphia, PA
www.cbinet.com/Reimbursement

CBI’s Reimbursement and Access conference returns for the 7th year and takes place August 13-14, 2019 in Philadelphia, PA. This event arms attendees with real-time policy briefings, impactful managed market trends and strategies to ensure product access.

Drug Channels readers: use discount code QEF679 and save $500* off the standard rate when you register by July 19, 2019.

Below is a first look at the robust lineup of esteemed thought-leaders driving this year’s dialogue.
  • Christina Sandefur, Executive Vice President, Goldwater Institute
  • Jeff Henderson, Vice President, Head of Market Access and Government Affairs, Sobi, Inc.
  • J. Gabriel McGlamery, J.D., Senior HCR Policy Consultant, Florida Blue
  • Tami Carten, Executive Director, Market Access, Braeburn
  • Gregory Gierer, Senior Vice President, Policy, AHIP
  • Alex Keeton, Director, Policy Research and Analytics, BIO
  • Christina Simmons, Senior Corporate Counsel, Pfizer Inc
  • Ross Margulies, Associate, Foley Hoag LLP
  • Stacey Worthy, Counsel, Aimed Alliance
  • Kollet Koulianos, MBA, Senior Director, Payer Relations, National Hemophilia Foundation
  • William Daniels, Director, Business and Market Segment Development, Conduent
  • Douglas Neely, CMPE, Head, Global Market Access, Athenex Oncology
  • Rujul Desai, Of Counsel, Covington & Burling LLP
  • Colette Flack, Senior Director, Patient Support Services, Dermira
  • Jesse C. Dresser, Esq., Partner, Frier Levitt, LLC
  • Anthony Scicchitano, Assistant U.S. Attorney, U.S. Attorney’s Office for the Eastern District of Pennsylvania
  • Stuart Bell, Vice President Consulting, Medicines Access, Inceptua Ltd
  • Molly Burich, MS, Director, Public Policy – Biosimilars and Reimbursement, Boehringer Ingelheim
  • Everett Crosland, Vice President, Market Access, Reimbursement and Government Affairs, AppliedVR
  • Andy Molnar, Senior Director, Market Access, Cognoa
Request the full agenda and reserve your seat for this important meeting today.

Plus! Drug Channels readers are entitled to an exclusive $500 discount! Register using discount code QEF679 and save $500* off the standard rate when you sign up by July 19, 2019.

*Offer expires 7/19/19; 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 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.

Wednesday, June 05, 2019

Profits in the 2019 Fortune 500: Manufacturers vs. Managed Care vs. Pharmacies, PBMs, and Wholesalers

Time to dive into our 12th (!) 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.

Fortune’s 2019 list contains only six drug channel companies: AmerisourceBergen, Cardinal Health, CVS Health, McKesson, Rite Aid, and Walgreens Boots Alliance.

Consolidation and vertical integration have transformed the channel—and the Fortune rankings. Below you will see our list of the companies that disappeared from the roster. We therefore have added to our analysis the four managed care and insurance companies on the list that operate PBMs.

Using the Fortune data, I explore the profitability and shareholder returns of the largest drug channel and managed care companies. I compare these companies with the Fortune 500’s eleven pharmaceutical manufacturers and with a separate survey of independent pharmacies.

These data remind us that many multi-billion-dollar businesses profit as drugs move through the U.S. reimbursement and distribution system. Enjoy our swim through this crazy complexity.

Monday, June 03, 2019

Medicaid Drug Rebate Program Summit 2019

Medicaid Drug Rebate Program Summit 2019
September 23-25, 2019
Renaissance Chicago Downtown | Downtown Chicago, IL

Join KNect365 for the 24th year of MDRP this September 23-25, 2019 at the Renaissance Chicago Downtown in Downtown Chicago, IL. This is your opportunity to benchmark best practices and gain solutions to overcome new operational challenges brought on by AMP Final Rule, 340B, Medicare Part B, Medicare Part D coverage gap, FSS, VA, OIG, and other critical government programs.


Register Now and use Priority Code P19MDRPDRUG to
SAVE an additional $200 off the current rates (a total of $800 in savings!)

Year after year, MDRP Chicago continues to be an important gathering for everything pricing, rebates, contracting, and collaboration. Ensure you have the most comprehensive educational experience over three days with access to government officials creating regulatory rules, the industry leaders interpreting them, and the pharmaceutical executives implementing them.

Collaborate with your peers and benchmark best industry practices:
  • Navigate Regulatory Hurdles with Comprehensive Coverage of Topics including:
    • State Drug Pricing Transparency
    • Case Study on Value-Based Contracting
    • Innovative Bundling
    • Calculations & Reporting Requirements: Challenges and Innovative Solutions
    • Principles of Reimbursement & Contracting Strategy
    • GTN: Finance, Accounting & Accruals
    • 340B Policy and Process
    • Analytics and Technology
    • Rebate Operations and Disputes
    • Generics and Biosimilars
  • MDRP’s top-notch speaking faculty includes industry leaders you need to hear from:
    • Krista Pedley, PharmD, MS, CAPT, USPHS, Director, Office of Pharmacy Affairs, Healthcare Systems Bureau, Health Resources & Services Administration (HRSA)
    • John D. Shakow, Partner, King & Spalding will provide insights into Medicaid and the changing landscape with the current Administration.
    • Alice Valder Curran, Global Regulatory Practice Group Leader, Hogan Lovells
    • Scott Atlas, MD, David and Joan Traitel Senior Felloe, Hoover Institution, Stanford University
    • External Counsel Roundtable: The State of MDRP - featuring Christopher H. Schott with Hogan Lovells, John D. Shakow with King & Spalding, and Jeff Handwerker with Arnold & Porter Kaye Scholer LLP.
MDRP offers attendees the opportunity for face-to-face meetings between states and manufacturers during our exclusive Dispute Resolution Meetings. These one-on-one meetings can help you realize millions in potential savings!

For 2019, MDRP have a record 21 confirmed states and counting: Alaska, Arizona, Arkansas, Colorado, Georgia, Idaho, Indiana, Kentucky, Maryland, Michigan, Nevada, New Hampshire, New York, North Carolina, Oregon, South Carolina, Tennessee, Texas, Utah, Virginia, Wisconsin.

Stay ahead of the curve by getting the best networking, education, and technology at MDRP Summit 2019

Click Here to Register Now and SAVE an additional $200 off the current rates. Be sure to use Priority Code: P19MDRPDRUG.


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

Thursday, May 30, 2019

Drug Channels News Roundup, May 2019: Express Scripts’ New GPO, More on Amazon/PillPack, a BS Update, and Vegas Video

Summer is unofficially here! Before you break out the grill, check out these officially noteworthy items:
  • Why did Express Scripts launch a GPO … in Switzerland?
  • Behind the scenes of Amazon’s deal for PillPack
  • More on BS in healthcare
Plus, a fun video recap from Asembia’s 2019 Specialty Pharmacy Summit—including some footage of your friendly neighborhood blogger!

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

Wednesday, May 29, 2019

CVS, Express Scripts, and the Evolution of the PBM Business Model

Over the next week, CVS Health and Cigna will hold their annual investor days. (Links below.) They will offer business and financial overviews of their diverse companies, including an update on the outlook for their pharmacy benefit managers (PBMs).

It’s a tough time to be a PBM. Compensation models are shifting, due to increased scrutiny by payers, regulators, and politicians. Plan sponsors are more sophisticated and seek greater pass-through of rebates, admin fees, and other manufacturer-provided revenues. Network spreads are under pressure, while specialty pharmacy dispensing accounts for a growing share of profits. Plus, the entire drug channel system could move toward a world without rebates.

Below, I update Drug Channels Institute’s look at PBM market share and reflect on four crucial areas in which PBMs’ compensation will be evolving. No PBM discloses detailed information about the sources and composition of its profits, so consider my observations as general guidelines for evaluating the upcoming investor day commentary from management.

Tuesday, May 28, 2019

Partnering with IDNs BioPharma Strategy Summit East

Partnering with IDNs BioPharma Strategy Summit East
August 21-22, 2019 | Sonesta Rittenhouse Square | Philadelphia, PA
www.cbinet.com/IDN

Healthcare is undergoing unprecedented transformation driven by payer reform, consumer demands and scientific advancements. The shift from volume- to value-based payment and care delivery has driven healthcare providers to reshape their approach and many have answered the call for personalized, convenient and coordinated patient care by forming large organizations such as IDNs and ACOs. Understanding these complex health systems and how they interact with the industry’s stakeholders is crucial for manufacturers to better support and meet the needs of these growing networks.

REGISTER TODAY! Drug Channels readers will save $400 off the standard registration rate when they use discount code MGX763* by July 12, 2019.

To address the challenges and opportunities ahead, join a distinguished group of industry pioneers at CBI’s Partnering with IDNs BioPharma Strategy Summit East, for a highly collaborative meeting on refining care coordination, increasing patient engagement and adherence, and ultimately, improving patient outcomes.

Featured Speakers include:
  • Matthew Malachowski, PharmD, BCPS, Supervisor, Specialty Pharmacy Services, UAB Medicine
  • Gerard Taglianetti, Director, Biosimilars Contract Strategy, U.S. Payer & Channel Access, Pfizer Inc.
  • Rebekah Hanson Anguiano, Clinical Assistant Professor, Pharmacy Practice, Clinical Pharmacist, Ambulatory Pharmacy Services, University of Illinois – Chicago
  • Michelle Steinfest, National Accounts and Payer Relations Director, Xeris Pharmaceuticals, Inc.
  • Sarah Johnson Conway, MD, Assistant Professor of Medicine, Johns Hopkins School of Medicine; Medical Director, Accountable Care, Office of Johns Hopkins Physicians; Medical Director, Johns Hopkins Hospital/Infusion Center; Associate Medical Director, Johns Hopkins Medicine Alliance for Patients, LLC
  • Christopher Boone, Vice President, Global Medical Epidemiology & Big Data Analysis Lead, Pfizer Inc.
  • Shibani Sharma, Project Manager, Population Health Management – OCIO, Northwell Health
  • Nisha Shah, PharmD., Research Pharmacist, Health Outcomes and Research Program, Vanderbilt University Medical Center
  • And more!
Visit www.cbinet.com/IDN for more information. Drug Channels readers will save $400 off the standard registration rate when they use discount code MGX763* by July 12, 2019.

 *Offer expires 7/12/19, 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.

Wednesday, May 22, 2019

Which PBM Best Managed Drug Spending in 2018: CVS Health, Express Scripts, MedImpact, or Prime Therapeutics?

It’s time for our annual Drug Channels’ examination of drug spending reports. For 2018, we again aim our magnifying glass at the annual trend reports from four large pharmacy benefit managers (PBMs): CVS Health, Express Scripts, MedImpact, and Prime Therapeutics. (See their report links below.) The other large PBMs—Humana and OptumRx (UnitedHealth)—provide no public transparency into their performance.

Using these data, which account for most of the commercial market, we detect the following key trends for 2018:
  • Once again, we find that drug spending is not skyrocketing—contrary to what you often hear from journalists and politicians. Spending grew by about 2% in 2018, continuing a multiyear decline in the growth rate. Total drug spending at some plan sponsors even declined.
  • Spending on traditional drugs dropped by mid-single digits, continuing a multi-year trend driven by generic drug deflation.
  • For specialty drugs, higher utilization—not drug costs—was the biggest factor driving specialty spending growth. This wasn’t true for all specialty categories, however.
Patients—in the aggregate—gain from the slower growth in drug spending. What’s missing from the PBM reports is a transparent accounting of how much patients pay out of pocket for highly rebated drugs that are sold to insurers and PBMs at deep discounts. The hidden subsidies of the gross-to-net bubble remain—for now.

Monday, May 20, 2019

Reimbursement and Access 2019

Reimbursement and Access 2019
August 13-14, 2019 | DoubleTree by Hilton Center City | Philadelphia, PA
www.cbinet.com/Reimbursement

For all companies within the life sciences arena, staying on the pulse of emerging trends, ensuring favorable reimbursement and justifying product prices are core pillars of overall product success. Whether your organization is pre-commercial or managing multiple products,
CBI’s Reimbursement and Access conference convenes stakeholders from across the life sciences community to provide insight into real-time policy briefings, impactful managed markets trends and strategies to ensure product access.

Drug Channels readers can register using discount code QEF679 to receive $500 off* the standard rate when you register by July 19, 2019.*

Gain critical insights from a distinguished speaking faculty representing AHIP, AppliedVR, Athenex Oncology, BIO, Boehringer Ingelheim, Cognoa, CSI Specialty Group, Foley Hoag LLP, Inceptua, National Hemophilia Foundation, Sobi Inc and many more!

Transform Access Strategies with Expert Insight and Compelling Discussions:
  • The Current State of Safe Harbor Protection for Rebates – Where Are We Now?
  • Realign Access Strategies to Overcome Challenges of Copay Assistance and PBM Restrictions
  • Trends in Benefit Design and the Continued Shift to High Deductible Plans
  • Medicare and Marketplace Coverage Policies Impacting Access
  • Patient Assistance Compliance and Oversight
  • The Role and Growing Use of Digital Therapeutics by Payers, IDNs and Health Systems
  • New Product Commercialization and Launch Scenario Planning
Drug Channels readers can register using discount code QEF679 to receive $500 off* the standard rate when you register by July 19, 2019.*

*Offer expires 7/19/19; 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 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.

Friday, May 17, 2019

A New Starting Point for Patient Support: Technology-Driven Hub Services

Today’s guest post comes from Erica Conroy, VP of Specialty at CoverMyMeds and Bill Nolan, VP/GM of Access and Adherence at RxCrossroads by McKesson.

Erica and Bill discuss the challenges that specialty pharmacy patients encounter when accessing and utilizing hub services. They also present evidence showing that how hub services positively affect patient outcomes.

To learn more, download CoverMyMeds’ whitepaper: Revolutionizing Patient Access and Support for Specialty Therapies: Multiple Sclerosis.

Read on for their insights.