Drug Channels delivers timely analysis and provocative opinions from Adam J. Fein, Ph.D., the country's foremost expert on pharmaceutical economics and the drug distribution system. Drug Channels reaches an engaged, loyal and growing audience of more than 35,000 subscribers. Learn more...

Tuesday, November 24, 2020

Drug Channels News Roundup, November 2020: Rebate Rule Redux, MFN (maybe), Amazon’s Pharmacy Customers, Drug Spending, GPO M&A, and RxTrace

Happy Thanksgiving, everyone! Before you stretch your stomach, stretch your mind with this extra-stuffed helping of food for thought. In this issue:
  • Rebate rule redux
  • Most Favored Nation and healthcare benchmarking
  • Amazon’s pharmacy customer opportunity
  • Drug spending realities updated
  • GPO consolidation
Plus, I congratulate Dirk Rodgers of RxTrace on his retirement.

P.S. Join the more than 10,600 followers of my curated links published on @DrugChannels on Twitter. My recent tweets have highlighted: doctors against step therapy, distribution of COVID-19 therapies, biosimilar savings, copay accumulator data, prospects for smaller PBMs, the new transparency rule, specialty pharmacy profit metrics, the future of oncology practices, and an update on Diplomat founder Phil Hagerman. You can also join my more than 13,500 followers on LinkedIn.

Join me for an exclusive live webinar, Drug Channels Outlook 2021, on December 18, 2020, from 12:00 p.m. to 1:15 p.m. ET. Click here to learn more and sign up.

Monday, November 23, 2020

Informa Connect’s 16th Annual Commercial Contracts & Chargebacks

Informa Connect’s 16th Annual Commercial Contracts & Chargebacks

December 17-18, 2020 | Virtual Event
informaconnect.com/contracts-chargebacks

Excusive Offer for Drug Channels Readers
To SAVE $300* using promo code CHR300

Informa Connect’s 16th Annual Commercial Contracts & Chargebacks, taking place virtually December 17-18, arms the industry with strategic approaches to improve contract operations, navigate class of trade complexities, streamline membership management and reduce revenue leakage to improve chargeback efficiency and the bottom line. Dynamic conference features include:
  • Two Days of Live Content, Audience Polling, Speaker Q&As and Interactive Discussions
  • View Our Library of On-Demand Content at Your Leisure, Available for 30 Days After the End of the Conference
  • High Impact Topics Transforming the Market Include:
    • Membership Eligibility and Classification — Tolmar Pharmaceuticals
    • Strategic Contracting Playbook — Pfizer Inc.
    • Expert Manufacturer/Trading Partner Exchange — McKesson
    • Class of Trade Navigation — Health Industry Business Communications Council (HIBCC)
    • EDI Think Tank — FFF Enterprises
    • Scorecarding and Metrics — Zydus Pharmaceuticals USA
    • Next-Gen Technology — Chronicled
Drug Channels readers are eligible for an exclusive savings of $300 off* the standard rate by using promo code CHR300, so download the complete conference agenda and reserve your seat today!

*Expires 12/16/2020; applies to standard rate only and may not be combined or applied to existing registrations; other restrictions may apply.


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

Wednesday, November 18, 2020

Disruption Delayed: Making Sense of Amazon’s Latest Pharmacy Moves

Amazon is getting more serious about pharmacy. ICYMI: Introducing Amazon Pharmacy: Prescription Medications Delivered.

This announcement is much less disruptive than it appears to be. Amazon is copying the GoodRx discount card model—including GoodRx’s partnership with Express Scripts. At the same time, Amazon is launching a mail pharmacy that will accept insurance and be in PBM pharmacy networks.

Amazon’s actions are another negative headwind for retail pharmacies, but not a fatal blow to the system. Perhaps Amazon will one day become a true disrupter. For now, Amazon is choosing to join the drug channel, not fundamentally change it.

Drug Channels Institute will host an exclusive live webinar, Drug Channels Outlook 2021, on December 18, 2020, from 12:00 p.m. to 1:15 p.m. ET. Click here to learn more and sign up.

Tuesday, November 17, 2020

Copay Accumulator and Maximizer Update: Adoption Accelerating As Pushback Grows

Almost three years ago, I warned about the emerging trend of copay accumulators and outlined the costly consequences for patients.

I’m sad to report that the latest data show a startling acceleration in the adoption of copay accumulator adjustment and the closely related copay maximizer. 

Within the next year, more than 80% of commercially insured beneficiaries will be in plans with these benefit designs—although not all plan sponsors will have fully implemented them.

Accumulators, maximizers, and copay support programs are inefficient solutions to flaws in the U.S. drug channel system. That’s why patient groups and provider organizations are pushing back against them. 

Alas, our divided Congress seems unlikely to provide any relief. Read on for the full details.

Drug Channels Institute will host an exclusive live webinar, Drug Channels Outlook 2021, on December 18, 2020, from 12:00 p.m. to 1:15 p.m. ET. CLICK HERE TO LEARN MORE AND SIGN UP.

Monday, November 16, 2020

NEW: Drug Channels Outlook 2021 (Live Video Webinar)

This December, join Dr. Adam J. Fein, CEO of Drug Channels Institute (DCI) and the author of Drug Channels, for an exclusive live video webinar:

Drug Channels Outlook 2021 
Friday, December 18, 2020 (12:00 p.m. to 1:15 p.m. ET)

WHAT YOU WILL LEARN

Join Dr. Fein as he helps you and your team get ready for the year ahead by outlining key issues and uncertainties that will surely affect your planning. He’ll also share DCI’s latest market data to help you stay on top of new developments. This event can be both a capstone of your annual learning and a touchpoint for the future.

Dr. Fein will share his latest thinking on a wide range of topics, including:
  • COVID-19’s impact on the prescription market in 2021 and beyond
  • The likely drug pricing policy moves by the Biden administration and our new Congress
  • Retail pharmacy’s challenging future
  • What’s next for the 340B Drug Pricing Program
  • The outlook for copay accumulators, maximizers, and utilization management tools
  • Prospects for further vertical integration, consolidation, and alliances
  • How the changing U.S. payer mix will affect PBMs and insurers
  • And more!

PLUS: Dr. Fein will take your questions. CLICK HERE to submit questions in advance of the event.

Read on for full details on pricing, including substantial discounts for multiple sites. You can also watch a video invitation below.

Friday, November 13, 2020

SaveonSP's Copay Maximizer Failed Me: A Patient's Perspective

Today’s guest post comes from Anndi McAfee, a successful voice over artist. Check out her impressive IMDB credits. Your kids have definitely heard her voice.

Anndi also suffers from a rare disease and requires treatment with an orphan drug. Below, she shares her troubling experiences with SaveonSP, the mysterious company behind Express Scripts’ copay maximizer program. (ICYMI, I profiled SaveonSP in May.)

Anndi’s story illustrates how a patient taking a specialty drug can lose out, even as others—her health plan, its PBM, and a sketchy intermediary—profit from a manufacturer’s patient support funds. I suspect that very few patients with similarly complex diseases are as savvy and persistent as Anndi has been.

Read on for her disturbing story. You can reach Anndi via her professional page or on LinkedIn.

Wednesday, November 11, 2020

Employer Pharmacy Benefits 2020: Some Good Coinsurance News, But Many Still Face Prescription List Prices

It’s time for our annual deep dive into employer-sponsored coverage for prescription drugs.

Consistent with our previous analyses, coinsurance and deductibles remain common for specialty and fourth-tier drugs, leaving patients exposed to the undiscounted list price of their prescriptions. 

However, there is also some good news: The use of copayments—instead of coinsurance—grew for people with both traditional and high-deductible plans. Perhaps nothing ever lasts forever.

Read on for my overview of cost sharing tier structure, copayment vs. coinsurance, and average copayments and coinsurance rates—along with our annual Drug Channels tiers/tears puns. 

In a follow-up post, I’ll examine how today’s benefit designs continue to challenge—and confuse—patients.

Monday, November 09, 2020

16th Annual Life Sciences Trade and Channel Strategies

16th Annual Life Sciences Trade and Channel Strategies
December 1-3, 2020 | Virtual Event
www.informaconnect.com/trade-channel

Navigating the distribution and contracting landscape is a complex endeavor. That’s why the life science industry’s top experts will come together virtually on December 1-3 at Trade and Channel 2020. They’ll guide you through new and innovative ways to optimize channel strategies to reach patients in need and provide the necessary services based on product type, site of care and reimbursement. You’ll benefit from 3 days of live content, as well as a robust library of on-demand content – with all live and on-demand sessions available for viewing for 30 days after the event concludes.

Visit www.informaconnect.com/trade-channel for further details and to register. Drug Channels readers will save $200 off the standard rate when they use code KTP933 and register prior to November 20th.*

You can download the complete agenda here.

Gain Critical Insight from Industry Trailblazers During a Time of Transformative Change – Speakers will include:
  • Bill Roth, Founding Partner, Blue Fin Group
  • Rob Osborne, Vice President Pharma Trade Relations, Express Scripts, Accredo, CuraScript SD
  • Ray Tancredi, RPh, MBA, CSP, Divisional Vice President, Specialty Pharmacy Development & Brand Rx/Vaccine Purchasing, Walgreens
  • Eric D. Hargan, Deputy Secretary, Department of Health and Human Services (HHS)
  • Natalie Bedford, Executive Director, National Channel Account Team, AstraZeneca
  • Timothy Paine, Vice President, Pharma Strategy & Relations, Fairview Pharmacy Services
  • Dave MacLeod, Head of Patient Services and Specialty Pharmacy Operations, Amylyx Pharmaceuticals
  • Brent Warner, Vice President, Gene Therapy, Novartis Pharmaceuticals
  • Liz Minko, US Distribution and Channel Strategy, argenx US, Inc.
  • Stuart Parker, Senior Director, Trade Relations, Mayne Pharma
  • And more!
Live Keynotes Delivering Timely Updates and Insights on High-Impact Topics, Including:
  • Critical Update – Market Dynamics Drastically Impacting the Channel
  • Navigate the Evolving State of Regulatory Reform Driving Innovation and Access
  • Emerging and Future Trends in Channel Strategy, Distribution and 3PL
  • Pharmacy Spotlight – Innovative Models Redesigning Care in 2020 and Beyond
Download the agenda to plan your sessions and wrap up your week armed with critical updates and valuable takeaways.

Visit www.informaconnect.com/trade-channel for further details and to register. Drug Channels readers will save $200 off the standard rate when they use code KTP933 and register prior to November 20th.*

Informa-Connect CBI will see you there!

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rates, clinic/hospital rates, non-profit rates or other offers. Other restrictions may apply.


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

Thursday, November 05, 2020

What I told Congress about the 340B Program

ICYMI, House Energy and Commerce Committee Republican Leader Greg Walden (R-OR) and Senate Health, Education, Labor and Pensions (HELP) Committee Chairman Lamar Alexander (R-TN) recently asked for input on how to improve the 340B Drug Pricing Program. Comments were due last Friday (October 30).

Your friendly neighborhood blogger submitted an 11-page letter, which you can read below. I shared my $0.02 on the overall market, explained channel distortions from 340B contract pharmacies, and offered some policy recommendations.

For your reference, I also include links to published comments from the American Hospital Association and the Pharmaceutical Research and Manufacturers of America.

The new Congress has an ambitious agenda. Let’s hope modernizing 340B gets on the do list.

Tuesday, November 03, 2020

Independent Pharmacies Learn to Live With (and Without) Preferred Networks for 2021

Last week, I highlighted the largest pharmacy chains that will participate in the 2021 Medicare Part D prescription drug plans (PDP).

Today, I examine how independent pharmacies will participate as preferred cost sharing pharmacies via the pharmacy services administrative organizations (PSAOs) that represent these pharmacies in negotiations with plans.

As you will see here, some PSAOs are rejecting preferred networks, while others are participating cautiously. There are notable differences in strategy between the PSAOs operated by AmerisourceBergen and McKesson. Details and a handy scorecard below.

The Centers for Medicare & Medicaid Services (CMS) continues to take a hands-off approach to pharmacy networks. One notable consequence: Independent pharmacies have formed their own Part D plan, in which only independents are preferred. We’ll know in January if the new plan is sitting pretty—or on a bed of nails.

Monday, November 02, 2020

Rare Disease Innovation and Partnering Summit 2020

Rare Disease Innovation and Partnering Summit 2020
December 1-4, 2020 | Virtual Event
www.raredisease-summit.com

This December, tackle challenges faced in ensuring patient access and furthering therapeutic and curative progress at the Rare Disease Innovation & Partnering Summit. Held in a 100% virtual format, this four-day meeting convenes diverse stakeholders to discuss opportunities for continued innovation, advancement of impactful patient advocacy and acceleration of commercial strategy success. Benefit from live sessions, keynotes and panels, plus a library of on-demand sessions ready to watch as your schedule allows. All sessions are available for viewing for 30 days post event.

Visit www.raredisease-summit.com for further details and to register. Drug Channels readers will save $200 off the standard rate when they use code ZZX688 and register prior to November 13th.*

You can download the complete agenda here.

Unparalleled Insights, Impactful Keynotes and Luminary Addresses from Industry Trailblazers, including:
  • Patient Perspective - Chasing My Cure
    David Fajgenbaum, M.D., Co-founder and Executive Director, CASTLEMAN DISEASE COLLABORATIVE NETWORK
  • Technology Spotlight - Using AI to Speed Discovery and New Treatments
    Tim Guilliams, Founder, CEO, HEALX LTD
  • Scientific Luminary - Targeting the Morphological Impact of Disease
    Marzieh Haghighi, PH.D., Postdoctoral Associate, BROAD INSTITUTE OF HARVARD MIT
  • Novel Funding - Accelerate Rare Disease Therapeutic Development
    Andrew Lo, Ph.D., Charles E. and Susan T. Harris Professor, MIT SLOAN SCHOOL OF MANAGEMENT
  • FDA Address – Navigating Regulatory Pathways and Evidentiary Requirements
    Kerry Jo Lee, MD, Acting Associate Director for Rare Diseases, FDA/CDER/OND
PLUS! Hear from the most innovative industry organizations, including Acceleron, Alexion, Alkeus Pharmaceuticals, Argenx, Biogen, Castle Creek Biosciences, Centogene, Collaborations Pharmaceuticals, Foundation Medicine, Perseo Pharma, Relypsa, Sanofi Genzyme and more.

Customize Your Virtual Experience with Powerful Program Offerings:
  • Two Strategic, One-Day Forums:
    • Global Drug Development and Access
    • Patient Engagement, Advocacy and Alliance Management
  • Four Targeted Track Offerings:
    • Patient-Driven Progress
    • Reimbursement, Value and Access
    • New Launch and Commercialization
    • Partnering, Investment and Portfolio Strategy
Download the agenda to plan your sessions and wrap up your week armed with critical updates and valuable takeaways.

Visit www.raredisease-summit.com for further details and to register. Drug Channels readers will save $200 off the standard rate when they use code ZZX688 and register prior to November 13th.*

Informa Connect-CBI will see you there!

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rates, clinic/hospital rates, non-profit/advocacy rates or other offers. 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 29, 2020

Drug Channels News Roundup, October 2020: Accumulator Nonsense, GoodRx Fees, 340B Dollars, and Our Simulated World

Halloween is truly scary this year. Since we can’t trick-or-treat, spend some time with our spooky roundup of Drug Channels news stories:
  • Creepy! UnitedHealthcare expects physicians to enforce its copay accumulator policy
  • Vampiric! How GoodRx sucks money from the channel
  • Shocking! 340B haunts even more of the industry than you envisaged
Plus, a scary reason to be cheerful: Chances are 50/50 that we are living in a simulation!

P.S. Stretch out your arm and join the zombie horde who shamble after me at @DrugChannels on Twitter. My recent tweets have highlighted: UnitedHealth’s DivvyDose acquisition, independent analyses of Rutledge vs. PCMA, importation problems in Wyoming and Florida, Medicaid enrollment, fake news from NASHP, and unexpected public policy cameos by Drug Channels. (You can also join my followers on LinkedIn.)