Thursday, March 30, 2017

Drug Channels News Roundup, March 2017: Eli Lilly, CVS Health, Novo Nordisk, and Specialty Pharmacies

Spring has finally reached Drug Channels' worldwide headquarters in lovely downtown Philadelphia! (See photo at right.) Before your allergies kick in, please enjoy this month’s selection of noteworthy news stories.
  • What has Eli Lilly revealed about its gross-to-net discounts?
  • Are CVS Health and Novo Nordisk starting to pop the gross-to-net bubble?
  • Who will win the 2017 specialty pharmacy award?
Plus, we celebrate healthcare nonreform by revisiting an innovative infinite-deductible health plan.

P.S. Follow @DrugChannels for my daily curated selection of stories and articles from the drug channels multiverse.

Eli Lilly and Company 2016 Integrated Summary Report, Eli Lily

Eli Lilly has joined Merck and Johnson & Johnson by disclosing the list and net prices of its products. (For background, see Janssen Reveals and Explains Its List and Net Drug Pricing.) Page 15 of Lilly’s latest Integrated Summary Report (ISR) reveals the following list and net price increases for its U.S. product portfolio:

[Click to Enlarge]

For 2016, Lilly’s list price increases were 14.0%, but net price grew by a mere 2.4%. Lilly stated that its average discounts for 2016 were 50% off list price. Average discounts were 28% in 2012. Its computation of discounts included “total annual rebates, discounts, and channel costs.”

According to an October Wall Street Journal article, the list price for Lilly’s Humalog insulin drug is now more than twice that of the drug’s 2011 price, but its net price had declined. The gross-to-net bubble is alive and well!

CVS Health Launches Reduced Rx™ Savings Program to Give Patients Access to More Affordable Medications, PR Newswire

And speaking of insulin, CVS Health and Lilly’s rival Novo Nordisk have partnered on a new program that will provide some older insulin products at low cash prices to uninsured patients and those with high-deductible plans. Check out the Reduced Rx website for more details. For a look at Novo Nordisk’s views on the gross-to-net bubble, see Novo Nordisk Sheds New Light on PBM Rebates, the Gross-to-Net Bubble, and Warped Channel Incentives.

From what I can tell, Reduced Rx looks like a PBM-backed discount card program that passes rebates directly to patients at the point of sale. This makes it similar to Lilly’s Blink Health program for insulin, but it has the advantage of a public PBM sponsors. (As you may know, discount cards such as GoodRx and Blink Health have a PBM behind the scenes.)

Keep an eye on these programs. As I suggest in The Weird and Wild Gross-to-Net Adventures of EpiPen and Its Alternatives, the growth of lower-priced, cash-paid products with direct-to-consumer discounts could pop the gross-to-net bubble—and reset the pharmaceutical industry’s economics. I speculated on the implications in Scott Gottlieb’s Radical Idea for Disrupting U.S. Drug Channels: Implications for PBMs, Wholesalers, and Pharmacies

Specialty Pharmacy Times® and Zitter Health Insights Announce Specialty Pharmacy Patient Choice Awards Finalists, Business Wire

In last month’s news roundup, I highlighted the new Specialty Pharmacy Patient Choice Award from Zitter Health Insights and Specialty Pharmacy Times. There are two categories of finalists:
  • PBM/Payer Specialty Pharmacies: CVS Health, Humana Specialty Pharmacy, and US Specialty Care
  • Non-PBM/Payer Specialty Pharmacies: Amber Enterprises, BioPlus Specialty Pharmacy, Credena Health, PANTHERx Specialty Pharmacy, and Senderra Rx Specialty Pharmacy
I’m on the awards committee and will be there when the winners are announced at Asembia’s Specialty Pharmacy SummitLa La Land is not in contention, so I feel pretty confident that the correct winners will be announced.

Company’s HR Manager Really Pushing Infinite-Deductible Health Care Plan, The Onion

This article from The Onion ("America's Finest News Source") is worth a few minutes of your time. It's a joke…right?

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