Helping Patients Ease Medication-Affordability Anxiety

Today’s guest post comes from Kristina Crockett, VP, Product Management at CoverMyMeds.

Kristina shares the story of Shanette, a single mother who faced sticker shock at the pharmacy counter. Kristina then explains how manufacturers can increase patient access and affordability with a comprehensive affordability strategy.

Click here to learn about CoverMyMeds’ medication access solutions for pharma.

Read on for Kristina’s insights.

Pharmacist Salaries and Employment in 2022: The Good Times Roll for Retail Pharmacists

Time for the annual update to the Drug Channels Institute (DCI) analysis of pharmacist salaries and employment.

Pharmacist employment in retail settings rebounded to its pre-pandemic levels, while non-retail settings—hospitals, physician offices, outpatient centers, and home healthcare—continued to add positions. For 2022, nearly half of pharmacists now work in non-retail practice settings.

Average base salaries for retail pharmacists grew for the first time in three years, to about $124,000. What’s more, retail salaries grew at the fastest rate in years—reflecting the post-pandemic employment environment. Pharmacists employed by hospitals and other non-retail settings also saw higher salaries, which averaged about $139,000. Full salary data below for your enjoyment or sorrow.

The post-pandemic period has been unexpectedly positive for the salaries of retail-employed pharmacists. But I expect the retail pharmacy shakeout to resume. As Bob Marley noted: “The good times of today are the sad thoughts of tomorrow.”

Be sure to join me for my new live video webinar, PBMs and the Battle Over Patient Support Funds: Accumulators, Maximizers, and Alternative Funding, on June 23, 2023, from 12:00 p.m. to 1:30 p.m. ET. Click here to learn more and sign up.

thINc’s Specialty Networks and Patient Support Services Summit

thINc’s Specialty Networks and Patient Support Services Summit
In-Person Event | August 29-30, 2023
Lowes Philadelphia, Philadelphia, PA
www.thinc360.com/specialty

Early rates are in effect. Use promo code DC5123 to save an additional $100 off the early rates. Register Today!

View the Agenda Snapshot

Enhance Patient Service, Network Design, and Channel Strategies to Improve Patient Access and Support

In its 8th year, the Specialty Network and Patient Support Services Summit is an important event for senior leaders in patient access, trade, channel, market access, brand and account strategy. Join peers this August to discover the evolving specialty pharmacy marketplace, build multi-stakeholder partnerships, and explore frameworks to inform your 2024 distribution and patient service strategies. Hear directly from specialty pharmacies, payers, PBMs, government agencies, health systems, and industry leaders to:

• Gain insights into patient perspectives
• Explore specialty trade and distribution trends and the state of the channel
• Discover policy and regulatory reform impacting trade and channel distribution
• Analyze patient service programs that provide patient support, ensure affordability, and optimize channel strategies
• Understand the outlook on value-based agreements and contracting strategies
• Delve into partnership opportunities in the specialty marketplace
• Implement actionable strategies that establish an optimal network design and distribution model
• Uncover the evolving state of cell and gene therapies and biosimilars

Summit Chairperson: Ray Tancredi, VP, Pharma Relations and Specialty Pharmacy Development, Walgreens

SPECIAL PRE-EVENT SESSION: Explore the Intersection between 340B and Specialty Pharmacy

• Leverage 340B eligibility to create a specialty pharmacy service model
• Improve patient access and affordability
• Understand the importance of patient specialty interventions and patient follow-up

PLUS! Two Dedicated Tracks for Your Focus Area: This Summit includes tailored content on specialty network design and patient services to customize the learning experience as well as shared content to maximize collaboration and knowledge-sharing

View the detailed online agenda and register today.

Taking place the same week with the Specialty Networks and Patient Support Services Summit: Covered Entities’ and Manufacturers’ 340B Summit
Demonstrate Compliance, Implement Strategies for Successful Audits, and Address the Financial Impact of 340B Programs on Covered Entities and Manufacturers
In-Person Event | August 28-29, 2023 in Philadelphia, PA
https://thinc360.com/340B

All registrations subject to review by the thINc team. Cannot be combined with other offers, promotions or applied to an existing registration. Other restrictions may apply.

---

Sponsored guest posts are bylined articles that are screened by Drug Channels to ensure a topical relevance to our exclusive audience. These posts do not necessarily reflect our opinions and should not be considered endorsements. To find out how you can publish a guest post on Drug Channels, please contact Paula Fein (paula@DrugChannels.net).

The Drug Discount Ecosystem’s “Mission Critical”

Today’s guest post comes from Vishali Amin, Chief of Staff to the Office of the President and Senior Director of Customer Success at Kalderos.

Vishali discusses the persistent challenges of duplicate discounts between the 340B Drug Pricing Program and the Medicaid Drug Rebate Program. The Inflation Reduction Act of 2022 will further complicate duplicate discount issues.

To learn more, sign up now for priority access to Kalderos’ 2023 annual report: Mission Critical: Bringing Drug Discount Stakeholders Together so Patients Win. The 2023 report will be released on June 13, 2023.

Read on for Vishali’s insights.

Drug Channels News Roundup, May 2023: 340B Shame, OptumRx vs. Humira Biosimilars, ICER on White Bagging, Hospitals vs. Taxes, and Dr. G

Summer unofficially began over the weekend. Check out these noteworthy delicacies, seared to perfection on the Drug Channels grill:

• Fresh evidence of 340B abuses by hospitals and contract pharmacies

• OptumRx rewrites its biosimilar Humira strategy

• ICER discovers channel markups

• Tax-exempt hospitals are not holding up their end of the bargain

Plus, Dr. Glaucomflecken helps you pick an insurance plan!

P.S. Join my more than 41,000 LinkedIn followers for daily links to neat stuff. You can also find my daily posts at @DrugChannels on Twitter, where I have more than 16,400 followers. (I recommend that you follow me on LinkedIn, because the quality of comments is much higher than they are on Twitter.)

Speaking of PBMs, be sure to join me for my new live video webinar, PBMs and the Battle Over Patient Support Funds: Accumulators, Maximizers, and Alternative Funding, on June 23, 2023, from 12:00 p.m. to 1:30 p.m. ET. Click here to learn more and sign up.

Five (or Maybe Six?) Reasons that the Largest PBMs Operate Group Purchasing Organizations

In The Top Pharmacy Benefit Managers of 2022: Market Share and Trends for the Biggest Companies, I shared Drug Channels Institute's analysis showing that three pharmacy benefit managers (PBMs)—the Caremark business of CVS Health, the Express Scripts business of Cigna, and the OptumRx business of UnitedHealth Group—accounted for about 80% of total equivalent prescription claims in 2022.

In recent years, each of these companies has launched new group purchasing organizations (GPOs) to further consolidate the number of covered lives in rebate negotiations with pharmaceutical manufacturers. Today, I examine these PBM-owned GPOs and then speculate on five plausible explanations for their existence. I also highlight a sixth, alleged rationale that is currently the subject of litigation.

The Federal Trade Commission (FTC) has recently started investigating these GPOs. I wonder if this additional focus will deepen the FTC’s ongoing investigation—or slow it down even further?

For more on PBMs, sign up for my new live video webinar, PBMs and the Battle Over Patient Support Funds: Accumulators, Maximizers, and Alternative Funding, on June 23, 2023, from 12:00 p.m. to 1:30 p.m. ET. Click here to learn more and register.

The Top Pharmacy Benefit Managers of 2022: Market Share and Trends for the Biggest Companies

In 2022, the PBM market remained highly consolidated—although there were some intriguing share shifts among the largest players.

Below, you’ll find Drug Channels Institute's latest estimates of pharmacy benefit manager (PBM) market share based on equivalent prescription claims. I also provide commentary on recent market developments and offer some helpful tips for interpreting the figures.

PBMs are facing unprecedented scrutiny from Congress, state legislatures, and the Federal Trade Commission (FTC)—although the PBMs' largest customers have not been vocally protesting the current marketplace. Tomorrow, I’ll examine one new evolution—the new group purchasing organizations that the largest PBMs have formed.

In the meantime, tune in for more PBM-bashing at today's House hearing: The Role of Pharmacy Benefit Managers in Prescription Drug Markets Part I: Self-Interest or Health Care?

Speaking of PBMs, join me for my new live video webinar, PBMs and the Battle Over Patient Support Funds: Accumulators, Maximizers, and Alternative Funding, on June 23, 2023, from 12:00 p.m. to 1:30 p.m. ET. Click here to learn more and sign up.

PBMs and the Battle Over Patient Support Funds:Accumulators, Maximizers, and Alternative Funding (NEW Live Video Webinar)

Dr. Adam J. Fein, CEO of Drug Channels Institute (DCI) and the author of Drug Channels, invites you to join him for a new video webinar:

PBMs and the Battle Over Patient Support Funds:
Accumulators, Maximizers, and Alternative Funding
This event will be broadcast live on
Friday, June 23, 2023, from 12:00 p.m. to 1:30 p.m. ET.

This page describes the event and explains how to purchase a registration. The webinar will be broadcast from the Drug Channels studio in beautiful downtown Philadelphia.

This event is part of The Drug Channels 2023 Video Webinar Series.

WHAT YOU WILL LEARN

As expensive specialty therapies come to dominate drug spending, pharmaceutical manufacturers are paying a growing share of patents’ out-of-pocket costs for these prescriptions. At the same time, plans and PBMs are turning to novel—and often controversial—benefit design tools that access manufacturers’ patient support spending.

Join Dr. Fein as he helps you and your team deepen your understanding of this complex subject and its crucial implications for drugmakers, payers, PBMs, and patients. During the event, Dr. Fein will cover a wide range of topics, including:

• What’s driving patients’ out-of-pocket obligations

• Trends in the value of manufacturers’ financial assistance

• Copayment offset programs vs. patient assistance programs (PAPs)

• Conventional pharmacy benefit management tactics

• The new tools that offset specialty drug costs: copay accumulators, maximizers, and alternative funding programs

• The latest market data on adoption of the new spending drug management tools

• Prescription economics of copay accumulators, maximizers, and alternative funding programs

• How PBMs profit from—and are challenged by—the new tools

• Plan sponsor perspectives

• State and federal legislation over pharmacy benefits

• Major lawsuits between manufacturers and vendors

• Outlook for specialty drug spending management

• Controversies and unresolved questions

• And more!

PLUS: During the webinar, Dr. Fein will give participants an opportunity to unmute themselves and ask live questions. The webinar will last 90 minutes to accommodate audience questions.

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 2023 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers.

Read on for full details on pricing and registration.

PRICING OPTIONS

You can register for this unique educational opportunity for only $380 per viewing device. Within 24 hours of your purchase, you will receive an email from Zoom with a unique link to access the live event.

We are offering substantial discounts for multiple registrations from the same organization. We know that many of you may be working remotely, so rates for multiple registrations are as low as $265 per device—a 30% savings. An unlimited number of people may watch at one location if they can watch from a single device.

Click here to order. All discounts will be automatically computed based on the number of registrations you enter in your cart. (You can reset the cart by entering 0 in the quantity field.)

PBMs and the Battle Over Patient Support Funds:
Accumulators, Maximizers, and Alternative Funding

Please contact Paula Fein (paula@drugchannels.net) if you have any questions. If you purchase access for multiple devices, we will contact you for a list of your participants and their email addresses. Or, download this spreadsheet and email your registrants’ information to Tamra Feldman (admin@drugchannels.net).

Click here to register for the full Drug Channels 2023 Video Webinar Series

Payment can be made with all major credit cards (Visa, MasterCard, American Express, and Discover) or via PayPal. Click here to email us if you would like to pay by corporate purchase order or check.

IMPORTANT THINGS TO KNOW

• Watch and listen via any device with a web browser (computer, iPad, iPhone/Android, etc.) There is no access via telephone.

• We use Zoom technology for this webinar. Every registrant will receive an email from Zoom with a link to watch the event. This link is unique to the registrant and can only be accessed once. We recommend that every registrant download the Zoom client software/app.

• Within one day of purchasing a registration, each registrant will receive an email from Zoom with a link to access the event and add it to their calendar. Every registrant will also receive reminder emails from Zoom one week, one day, and one hour before the event.

• This event is part of The Drug Channels 2023 Video Webinar Series. If you have already purchased the full series, then you should have received an email from no-reply@zoom.us with your unique link to access the June event.

• Purchase of the webinar series includes a replay video of Drug Channels’ March 31, 2023, webinar Discount Cards, Cost-Plus Pharmacies, and PBMs: Trends, Controversies, and Outlook. Within 24 hours of purchasing the 2023 series, you will receive an email from Zoom with a link to access that video replay.

• Organizations that purchased corporate access for The Drug Channels 2023 Video Webinar Series will receive a custom, branded signup link so employees can easily register. We will automatically refund payments from anyone at a company with corporate access who purchases a single registration using their corporate email account.

• Unfortunately, we are unable to offer refunds.

Four Ways for Field Teams to Tackle Drug Utilization Management and Optimize Patient Access

Today’s guest post comes from Patrick Leary, Chief Commercial Officer at Phil, Inc.

Patrick describes how barriers to medication access affect manufacturers and patients. He offers four tactics that can help field teams unlock coverage for patients.

To learn more about Phil’s access and commercialization solutions, download their free whitepaper, Modernize the Patient Access Experience: Transform Your Pharmaceutical Brand. You can also visit https://phil.us/life-sciences/.

Read on for Patrick’s insights.

Employers Expand Use of Alternative Funding Programs—But Sustainability in Doubt as Loopholes Close

Last August, I warned you about alternative funding programs (AFPs)–the shady schemes by which commercial plan sponsors drop drug coverage in order to grab charity support intended for uninsured and indigent patients.

I’m sad to report that the manipulation of charitable patient assistance programs continues to expand. As you will see below, employers have significantly ramped up their adoption of AFPs, while health plans seem more skeptical. Meanwhile, a new AbbVie lawsuit sheds light on the alleged activities of a major AFP vendor.

Read on for our update on these suspect programs—and the growing risks to their sustainability. Caveat payer.

Adapt or Fall Behind: The Need for Agile Copay Programs in Today's Shifting Payer Landscape

Today’s guest post comes from Nasir Ali, Chief Product Officer at CareMetx

Nasir discusses manufacturers’ strategies for mitigating the patient impact of copay accumulators and maximizers. He then outlines two key tactics that manufacturers should include in hub programs.

To learn more how digitally-enabled hub programs help patients, download CareMetx’s report: The Evolving Landscape of Digital Healthcare Hubs.

Read on for Nasir’s insights. .

Mapping the Vertical Integration of Insurers, PBMs, Specialty Pharmacies, and Providers: A May 2023 Update

Yesterday’s reflections on Asembia’s Specialty Pharmacy Summit included a link to the general session slides. My portion of the deck included an updated mapping of vertical integration among insurers, PBMs, specialty pharmacies, and providers within U.S. drug channels. Many readers asked for a standalone version of this infamous chart.

So, for your viewing and slide making pleasure, below you’ll find my latest illustration of the major vertical business relationships among the largest companies.

I estimate that at least half of all public and private U.S. healthcare spending flows through these seven familiar entities: Blue Cross Blue Shield, Centene, Cigna, CVS Health, Elevance Health, Humana, and United Health Group. Just like the heroes in Dawn of the Seven, they are here to serve and protect you.

Enjoy the artwork. In the meantime, I suspect that vertical integration may come up during today's Senate hearing on insulin.