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 20,000 subscribers. Learn more...

Wednesday, July 18, 2018

Specialty Pharmacies and PBMs Penetrate the 340B Program—And How Manufacturers Should Respond

In two recent Drug Channels articles, I have documented the phenomenal growth in pharmacies participating in the 340B Drug Pricing Program and the superior profits that pharmacies earn from the program.

Today, I turn to the less well-known role of specialty pharmacies and pharmacy benefit managers, which are now significant participants as 340B contract pharmacies. Below, we present our first exclusive analysis of how independent and PBM-owned specialty pharmacies have deepened their relationships with hospitals and other 340B covered entities.

We estimate that nearly 10% of all specialty prescriptions are dispensed by 340B contract pharmacies, which makes this channel one of the fastest-growing components within the 340B program. Despite this growth, pharmaceutical manufacturers have limited transparency into the behavior of these 340B contract pharmacies. Drug makers therefore pay 340B discounts on prescriptions for which they also pay commercial, Medicare Part D, and managed Medicaid rebates.

Below, we explain why manufacturers should have access to the prescription-level data that would permit the identification of 340B claims. Playing Where’s Waldo? for 340B claims is no way for this multi-billion dollar program to operate.

Monday, July 16, 2018

CBI’s 6th Annual Coupon and Copay Summit

CBI’s 6th Annual Coupon and Copay Summit
October 2-3, 2018 | Philadelphia, PA
www.cbinet.com/coupon

CBI’s Coupon and Copay Summit begins with their Chairman, Chris Dowd, Executive Vice President, Market and Product Development of ConnectiveRx addressing the state of the marketplace – accumulator programs, drug rebates, rising out-of-pocket costs and the drug pricing debate.

This two-day summit is filled with key issues:
  • Assessing the Impact of Industry Consolidations and Cost Shifts
  • Understanding Key Trends Affecting Market Access, Patient Affordability and the Future of the Drug Pricing Ecosystem
  • Identifying Challenges in Copay Access and Reimbursement from Patient Advocacy, Pharmacy and Manufacturer Perspectives
Click here for the full agenda.
Register by August 10th 2018 and receive $500 off the standard rate with the discount code DCC500.

As the healthcare marketplace continues to evolve, CBI’s Coupon and Copay Summit convenes an exceptional group of industry experts to discuss key market factors affecting the future of copay assistance and copay program design.

Here’s a snapshot of the experts you’ll meet and with whom you’ll benchmark best practices:
  • Chris Boneham, Executive Director, Managed Markets, Aralez Pharmaceuticals
  • Fred Brownfield, Former Director, Pharma Innovative Contracting, Humana
  • David Eskew, Deputy Chief, Criminal Division, United States Attorney’s Office, District of New Jersey
  • Dina Inverso, Strategy Leader, Patient Engagement and Reimbursement, CSL Behring
  • Joseph Mack, Senior Compliance Counsel, U.S. Office of Compliance, Bayer U.S.
  • Philip W. McCreary, Pharm.D., MBA, Medication Access Program Director, Vanderbilt University Medical Center
  • Dennis Murphy, Pharm.D., Manager, Commercial Strategy, Radius Health
  • Peter J. Pitts, Former Associate Commissioner, FDA; President, Center for Medicine in the Public Interest
And much more

Please visit CBI’s site for more information. Register by August 10th 2018 and receive $500 off the standard rate with the discount code DCC500 (an additional $100 off the Advantage Pricing!).

*Discount expires 08/10/2018 and may not be combined with other offers, category rates, promotions, or applied towards an existing registration. Offer not valid on workshop only or academic/nonprofit 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.

Friday, July 13, 2018

The Trump Administration’s Blueprint: A Preview of the 23rd Annual MDRP Summit

Today’s guest post comes from Jean-Francois Denault, CEO and Owner of Impacts.CA. He discusses the Trump Administration’s Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. He outlines potential changes and their impact on pharmaceutical manufacturers.

Knect365’s 23rd Annual Summit on the Medicaid Drug Rebate Program (MDRP) in Chicago will provide an opportunity to learn more about the administration’s drug pricing plans and such other topics as government pricing, rebates, and regulation. This event is notable for including many government officials along with over 500 industry participants.

Register by July 27 to save up to $400 off the regular registration fee. Visit medicaiddrugrebates.com for more information.

Read on for Jean-Francois’s insights.

Thursday, July 12, 2018

Our Exclusive Analysis: Nearly One in Three U.S. Pharmacies Is a 340B Contract Pharmacy; Five Chains Dominate

Pharmacies continue to profit from the 340B Drug Pricing Program’s explosive growth.

Our latest exclusive analysis finds that about 21,600 pharmacy locations now act as contract pharmacies for the hospitals and other healthcare providers that participate in the 340B program. The total number of locations has grown by 9% over the past 12 months. The five largest retail pharmacy chains—Walgreens, CVS, Walmart, Albertsons/Rite Aid, and Kroger—account for two-thirds of 340B contract pharmacy locations.

This growth is unsurprising. The U.S. Government Accountability Office (GAO) has now documented the tremendous profits available to 340B contract pharmacies. See GAO Confirms It: 340B Hospitals and Contract Pharmacies Profit from Low-Income, Uninsured Patients.

Does Congress really want the 340B program to provide outsize financial benefits to a handful of large, multi-billion-dollar, for-profit pharmacy chains? Should investors be concerned about how much pharmacies are earning from this embattled program?

Tuesday, July 10, 2018

GAO Confirms It: 340B Hospitals and Contract Pharmacies Profit from Low-Income, Uninsured Patients

The United States Government Accountability Office (GAO) has just issued a must-read report on the 340B Drug Pricing Program: Federal Oversight of Compliance at 340B Contract Pharmacies Needs Improvement.

Some of the report’s most startling revelations confirm our worst fears about how hospitals and pharmacies are abusing the 340B program.

Here are two especially dispiriting findings from the GAO’s analysis:
  • 16 out of 28 hospitals (57%!) did not provide discounted drug prices to low-income, uninsured patients who filled prescriptions at the hospital’s 340B contract pharmacy. Seriously?!?
  • Many 340B contract pharmacies can earn excessive profit margins of 15% to 20% from brand-name 340B prescriptions. As I have long suspected, large, publicly-traded pharmacies are sharing in the 340B discounts generated for covered entities.
Bottom line: Hospitals and pharmacies are making money from poor people. Are you kidding me?!? For shame!

The 340B program’s apologists will have a hard time rebutting the uncomfortable facts from this GAO report. Calling something a “drug discount program” apparently doesn’t mean that the neediest patients get access to those discounts. Read on, and prepare to be outraged.

P.S. In two upcoming articles about 340B, I’ll review the pharmacies participating in the program and then examine the role of specialty pharmacies and pharmacy benefit managers.

Monday, July 09, 2018

2nd Annual Pharma Digital Marketing & Multichannel Integration Summit

2nd Annual Pharma Digital Marketing & Multichannel Integration Summit
September 13-14, 2018 | Boston, MA
www.worldcongress.com/digitalmarketing

Join industry innovators at the 2nd Annual Pharma Digital Marketing & Multichannel Integration Summit, September 13-14, in Boston, MA as they share how to deliver information to customers in a way that is tailored to them, through their preferred channels. The agenda is structured to provide solutions to common problems felt by today’s pharma marketers and empower attendees to return to the office with innovative strategies and tangible takeaways to enhance the customer experience and drive business results.

Key Topics in 2018 include:
  • Applying innovative technologies such as virtual reality (VR) and augmented reality (AR) to your marketing campaign
  • What the pharma industry can learn from Amazon’s marketing tactics
  • Building a data-driven marketing strategy
  • Utilizing digital health to transform patient care
  • Evolving your organization’s culture to transform the customer experience.
The expert speaker faculty includes representatives from:
Amazon Web Services, AZ, GSK, Merck, Novartis, WEGO Health, eHealth Initiative, BMS, Lilly, and many more!

Register with discount code DC200 and save $200 on rates.


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

Tuesday, July 03, 2018

Democrats and Republicans Agree: Drug Channels Is Awesome!

I can’t recall any period in my life when our country has been so divided and polarized.

So just in time for our nation’s birthday, I’m happy to report some good news. When it comes to healthcare analysis, both Republicans and Democrats can agree on one thing: Drug Channels is the go-to source!

Each political party’s major drug pricing policy document draws prominently from our research and writing. See below for the patriotic details of this historic bipartisan validation.

Through the Drug Channels Institute, I strive to provide you with fact-based and balanced coverage. I’m proud that your friendly neighborhood blogger can be a unifying force for our troubled nation.

Monday, July 02, 2018

CBI’s 4th Annual Compliance Congress for Specialty Products

CBI’s 4th Annual Compliance Congress for Specialty Products
September 13-14, 2018 | Boston, MA
www.cbinet.com/specialtycompliance

CBI’s 4th Annual Compliance Congress for Specialty Products explores the unique compliance challenges for specialty bio/pharmaceutical companies, pre- and post-commercialization.

While specialty products are immensely valuable to patients, they also bring unprecedented risks for manufacturers. A comprehensive compliance program is essential to correctly assessing risks, including patient assistance programs, non-commercial activities, third-party relationships and pharmacy contracting.

At this meeting, take the opportunity to identify and address the top risk areas for specialty product manufacturers and compare strategies for promoting a compliant culture within your organization.

Register by 7/27/2018 and receive $400* off the standard rate with discount code SPC400.

Valuable Insights from 35+ Thought Leaders, Including:
  • Gregg Shapiro, Assistant U.S Attorney, Chief of Affirmative Civil Enforcement Unit, U.S Department of Justice (Boston)
  • Charles Graybow, Assistant U.S. Attorney, U.S. Attorney's Office, District of New Jersey
  • Bill Hrubes, Vice President, Chief Compliance Officer, ACell, Inc.
  • Shoshanna Clark, Head of Operations, NA Ethics & Business Integrity, Sanofi
  • Alessandra Ravetti, Executive Director and Assistant General Counsel, Regeneron Pharmaceuticals, Inc.
  • Trish Shorey, Privacy Officer, Global Compliance and Risk Management, Shire
  • Heidy Abreu, Vice President, Legal and Corporate Secretary, Axcella Health, Inc.
  • Kelly Pitt, Director, Legal & Compliance, Sobi, Inc.
  • Amy Wilson, MBA, MSJ, Director, Enterprise Compliance, Alexion Pharmaceuticals
  • Alessandro Martuscelli, Chief Global Therapeutics Counsel, Bioverativ
  • Chad Morin, Senior Director, Healthcare Compliance, bluebird bio
  • Brian Conner, Vice President, Head of Corporate Compliance, Strongbridge Biopharma plc
  • Sarah Whipple, Senior Corporate and Compliance Counsel, Akebia Therapeutics, Inc.
  • David Ryan, Vice President, Associate General Counsel, Chief Compliance Officer, Haemonetics Corporation
Key Reasons to Attend:
  • Create a balance between effective patient assistance programs and maintaining compliant practices
  • Address the legal issues related to “proactive” versus “reactive” presentations around disease state
  • Gain insight into operational safeguards around copay assistance and charitable donations
  • Determine if a nurse educator program is necessary and where it should sit within the organization
  • Review current and pending state transparency and disclosure legislation
  • Assess the controls that compliance or legal need to put in place to ensure that value-based agreements comply with the Anti-Kickback Statute
  • Examine the changes in E.U. privacy laws and discuss why it matters to U.S. companies
Register by 7/27/2018 and receive $400* off the standard rate with discount code SPC400.

*Offer expires July 27, 2018; applies to standard rates only and may not be combined with other offers, category rates, and promotions or applied to an existing registration.


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

Friday, June 29, 2018

Amazon Buys PillPack: Six Pharmacy and Drug Channel Implications

It’s official! After more than a year of speculation and rumors, Amazon has entered the pharmacy business with its acquisition of PillPack, a small mail pharmacy. Consider this move to be the end of the beginning for the pharmacy industry's evolution.

The stock prices of pharmacies and pharmacy benefit managers (PBMs) predictably plunged yesterday as everyone freaked out. CVS Health, Walgreens Boots Alliance, and Rite Aid collectively lost more than $11 billion in stock market value.

Below, I offer my initial observations on the transaction and its impact.

But let’s all keep some perspective here. This is a small first step that will let Amazon begin growing a pharmacy dispensing business.

We are still a long, long way from a fundamental restructuring of the complex U.S. drug channel. The incumbents still have opportunities to defend their position, capture value from internet technologies, and streamline distribution. However, the prospects of a retail pharmacy shakeout over the next 10 years have just increased.

Thursday, June 28, 2018

Why Retail Pharmacies Still Overcharge Uninsured Patients—And What That Means for Amazon (rerun)

This week, I’m rerunning some popular posts before the holiday week. Click here to see the original post and comments from April 2018.

Consumer Reports recently published a fascinating survey of pharmacies’ cash prices for five common generic drug prescriptions.

The results were startling. Prescription prices ranged from $66 to $1,351—a nearly 2,000% difference. The big three retail drugstore chains—CVS, Walgreens, and Rite Aid—consistently had higher average prices compared with those of other pharmacies. Independent pharmacies had some of the lowest prices, but also some of the highest prices.

Our analysis of prescription profits highlights the pharmacy industry’s unfortunate pricing strategy for cash-pay prescriptions. Average profit margins ranged from $8 to $264 per prescription for the five drugs. We can only hope that consumers didn’t pay the pharmacies’ sky-high cash prices.

The results expose the insane soak-the-poor mentality baked into the U.S. pharmacy industry’s historical pricing models. The data also highlight the potential pharmacy opportunity for Amazon.

P.S. Before other states follow Maryland and pass laws against price gouging by generic manufacturers, perhaps they should take a closer look at the behavior of their own states’ pharmacies.

Wednesday, June 27, 2018

Meet The Power Buyers Driving Generic Drug Deflation (rerun)

This week, I’m rerunning some popular posts before the holiday week. Click here to see the original post and comments from February 2018.

Wholesalers and retailers have deepened their relationships via generic purchasing consortia—and generic drug makers are feeling the pain. Example: Novartis’ Sandoz business unit reported that its fourth-quarter 2017 sales dropped by 17% "due to increased industry-wide pricing pressure and continued customer consolidation.” (source)

Below, we examine the four generic drug mega-buyers behind this pressure: Red Oak, Walgreens Boots Alliance, McKesson and ClarusOne, and Express Script’s EconDisc.

We estimate that in 2017, these four organizations accounted for an astounding 90% of total U.S. generic drug purchases from manufacturers. Read on for our market share estimates, business profiles, and the outlook for 2018. Spoiler alert: The forecast calls for generic pain.

Today’s post is a sneak peek at our forthcoming 2018 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. The new edition will be bigger than better than ever. Look for it on February 27!

Tuesday, June 26, 2018

The Gross-to-Net Bubble Topped $150 Billion in 2017 (rerun)

This week, I’m rerunning some popular posts before the holiday week. Click here to see the original post and comments from April 2018. 

You can also reach this post at www.GrossToNetBubble.com. ;)

In 2017, the gross-to-net bubble—the ever-growing pile of money between a manufacturer’s list price for a drug and the net price after rebates and other reductions—hit a new high.

Based on new data from IQVIA, manufacturers of brand-name drugs in 2017 reduced list price revenues by an astonishing $153 billion. Those reductions came primarily from rebates, discounts, and other payments to the drug channel. That figure has grown by 10% from the 2016 figure, even though net prices for brand-name drugs grew by only 1.9%.

We can no longer ignore the warped incentives created by our bubble buddy. As regular readers know, I think plan sponsors and insurers should be more transparent about what they do with the billions collected via pharmacy benefit managers (PBMs) from manufacturers—or even be forced to pass through these rebates to point of sale. Read on and let me know what you think.

Monday, June 25, 2018

CBI’s Bio/Pharma Forum on the State of Medicare Reform

CBI’s Bio/Pharma Forum on the State of Medicare Reform
August 21, 2018 | Arlington, VA
www.cbinet.com/Medicare

Exclusive Offer for Drug Channels Readers: Register Now to SAVE $300* using discount code REF300

CBI’s CPE and CLE accredited Bio/Pharma Forum on the State of Medicare Reform is a one day intensive providing tangible knowledge and strategies necessary to gain clarity on the current political landscape impacting bio/pharma manufacturers with regards to Medicare.

Taking place on August 21 in Arlington, VA, CBI invites you to take this opportunity to come face-to-face with government, associations, health plans and bio/pharma professionals to get the answers to your most pressing questions about navigating uncertainty. You and your team will walk away from the conference with solid tactics for overcoming Medicare policy challenges and an online playbook filled with presentations to utilize as a best practices resource.

Distinguished Speaking Faculty Includes:
  • Cynthia G. Tudor, Ph.D., President, The Tudor Group, LLC, Former Deputy Director, Center for Medicare, CMS
  • Kelly Brantley, Vice President, Avalere Health
  • Andrew Zebrak, Executive Director, Public Policy, Therapeutic Areas, and Advocacy, Boehringer-Ingelheim
  • Loren Adler, Associate Director, Center for Health Policy, The Brookings Institution
  • John Gorman, Founder, Gorman Health Group
  • Steven Pitts, Senior Director, Payer Accounts, Jazz Pharmaceuticals
  • Mallory O’Connor, Director, Healthcare Policy & Federal Programs, Biotechnology Innovation Organization – BIO
  • And more!
Visit www.cbinet.com/Medicare to view the complete speaker and session lineup, then register using discount code REF300 for this exclusive savings of $300* off.

*CPE and CLE credits pending approval. Discount expires 8/21/18; cannot be combined or applied to existing registration. 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, June 21, 2018

Drug Channels News Roundup, June 2018: Fake News from AHIP, Azar Blasts Rebates, Sanofi’s Pricing, Asembia in Vegas, and Justice for Gingers

Summer is here! Before you launch your incredible vacation, please enjoy these super Drug Channels stories:
  • AHIP misrepresents drug spending data
  • HHS Secretary Azar tells Congress about “a system without rebates”
  • Sanofi discloses a major gross-to-net gap and declining drug prices
  • Asembia shares video highlights from Las Vegas
Plus: a major social justice win for your humble correspondent.

P.S. Follow my daily links to neat stuff at @DrugChannels on Twitter. Recent tweets have covered new drug spending data, M&A news, pharmacy benefit manager (PBM) activities, retail clinics, copay accumulators, track-and-trace, and more.

Tuesday, June 19, 2018

How Walgreens Got Taken: Read This Fantastic New Book About Theranos

Here’s your must-read summer book: Bad Blood: Secrets and Lies in a Silicon Valley Startup. It’s the thought provoking and gripping cautionary tale of Theranos, a business that raised $900 million to “disrupt” the lab testing business.

Alas, Elizabeth Holmes, the company’s founder and CEO, and her former chief commercial officer appear to have misrepresented and falsified almost everything about the company and its technology. Last week, they were both indicted by the Justice department.

Bad Blood is one of the best non-fiction business books I have ever read. Drug Channels readers may enjoy some schadenfreude about the hapless behavior of Walgreens’ previous management team. I’ve selected a few choice highlights below. But trust me: The whole book is a great read.

Monday, June 18, 2018

CBI’s 340B Manufacturer Summit

CBI’s 340B Manufacturer Summit
August 21-22, 2018 | Arlington, VA
www.cbinet.com/340B

2018 brings an unprecedented focus by Congress and the Trump Administration on the size, purpose and integrity of the 340B program. At CBI’s 340B Manufacturer Summit, hear from national experts as the policy discussions and opportunities for input continue to evolve. From the President’s Blue Print on Drug Prices to the recently released HHS RFI, 340B remains a hot topic.

Break down and clarify impending regulations, gain strategies to develop comprehensive self-disclosure response and auditing processes, while establishing best practices to collaborate with contract pharmacies and covered entities.

You can read all about it here. Drug Channels readers will save $300 off the standard rate when they use discount code YDR528 and register prior to July 20th.

Critical Updates, Interactive Discussions and Valuable Takeaways:
  • Hear from industry experts as they navigate 2018 legislative, regulatory and legal attempts to course correct 340B
  • Uncover best practices to respond to covered entities and initiate “good faith” financial remediation
  • Explore the impact of patient definition outlined in the repealed Mega-Guidance
  • Recognize scenarios which lend themselves to miscommunication due to inconsistency in the terminology used by manufacturers versus other stakeholders
  • Determine what manufacturers are protected against related to diversions and duplicate discounts
  • Ask questions and engage in discussion to explore solutions to top manufacturer challenges
  • Plus, observe a Point/Counter-Point Patient Definition Debate between a manufacturer attorney and a covered-entity attorney
Speakers include representatives from the The Alinea Group, Apexus, Arnold & Porter, AstraZeneca, Bristol-Myers Squibb, CiiTA, LLC, Feldesman Tucker Leifer Fidell LLP, Gilead Sciences, High Point Solutions, King & Spalding, North Carolina Department of Health and Human Services, Pfizer, Sidley Austin, University of Rochester Medical Center and more.

Visit www.cbinet.com/340B for further details and to register. Drug Channels readers will save $300 off the standard rate when they use discount code YDR528 and register prior to July 20th.

CBI will see you there!

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rate or non-profit rates. 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.

Friday, June 15, 2018

Specialty Pharmacy Management of Migraine Patients

Today’s guest post comes from Lily Duong, Chief Clinical Officer at Therigy.

Lily discusses new migraine treatments that treat or prevent chronic and episodic migraine headaches. She highlights how these therapies will challenge specialty pharmacies.

Therigy has developed a migraine therapy management solution to assist specialty pharmacies with patient management. To learn more, schedule a live demo of the TherigySTM™ migraine care plan.

Read on for Lily’s insights.

Tuesday, June 12, 2018

Profits in the 2018 Fortune 500: Manufacturers vs. Wholesalers, PBMs, and Pharmacies

Time for my 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. Our analysis also provides crucial background for understanding the Trump administration's drug pricing blueprint.

Fortune’s 2018 list contains the same seven drug channel companies that the 2017 list did: AmerisourceBergen, Cardinal Health, CVS Health, Express Scripts, McKesson, Rite Aid, and Walgreens Boots Alliance.

Using the Fortune data, I explore the profitability and shareholder returns of the largest public drug wholesalers, chain pharmacies, and pharmacy benefit managers (PBMs). I compare these companies with the Fortune 500’s eleven pharmaceutical manufacturers and with a separate survey of independent pharmacies.

Alas, this may be our final review of the list, because by this time next year two companies—Express Scripts and Rite Aid—may no longer exist as independent public companies. In the meantime, let’s enjoy the crazy complexity of the U.S. drug distribution and reimbursement system.

Monday, June 11, 2018

ExL Events' 2nd Real-World Evidence Forum

2nd Real-World Evidence Forum
July 16–17, 2018 | Philadelphia, PA

ExL Events invites you to the 2nd Real-World Evidence Forum, taking place on July 16–17 in Philadelphia. This intimate forum will bring together leading marketing experts and senior-level executives to discuss patient and HCP engagement strategies to build effective disease awareness campaigns to disseminate educational information.

Register here and use Discount Code C1040DC to save $200 off your registration!

Attendees will gain a better understanding of how electronic data sources are changing the way real-world data are collected. This conference will offer attendees insight on how real-world evidence will help decrease costs and development timelines, define innovative outcomes, and minimize the number of patients exposed to less useful medications.

The forum’s elite-speaking faculty will discuss how to utilize real-world evidence to demonstrate both clinical effectiveness and cost-effectiveness of your product.

[Click to Enlarge]

Speakers Include:
  • Christopher Boone, Ph.D., FACHE,Vice President, Real-World Data and Analytics Center of Excellence, Patient and Health Impact, PFIZER
  • Bart Barefoot, Director, VEO and RWE Policy, Advocacy, and External Collaboration, GLAXOSMITHKLINE
  • Nneka Onwudiwe, Pharm.D., Ph.D., MBA, PRO/PE Regulatory Review Officer, FOOD AND DRUG ADMINISTRATION
  • Elizabeth (Betsy) MacLean, Pharm.D., Ph.D., Director Global Health and Value/U.S. Outcomes and Evidence — Oncology, PFIZER
Register here and use Discount Code C1040DC to save $200 off your registration!

ExL Events looks forward to meeting you in Philadelphia in July!


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

Thursday, June 07, 2018

Hidden Policies: The Search for Copay Accumulator Policies in Florida Qualified Health Plans

Today’s guest post comes from Carl Schmid, Deputy Executive Director of the AIDS Institute.

The AIDS Institute studied health plans in Florida and uncovered a troubling reality: Patients are often unable to find out if their plan has a copay accumulator adjustment program.

Even when the information was somehow available, it was vague and ambiguous.

The AIDS Institute’s research shows how unsuspecting patients can get stuck with exorbitant out-of-pocket expenses for specialty drugs that have no generic or therapeutic alternatives. That’s why I told CNBC this week that accumulators are “as much of a cash grab from patients as I can possibly imagine.”

It’s an important article about the misleading marketing and incomplete disclosure of a crucial benefit detail. Read on and see what you think.

Tuesday, June 05, 2018

McKesson’s Choppy Cs: Consolidating Customers and Challenging Contracts

Pharmaceutical wholesalers are no longer growth companies. They are struggling with ever larger customers, ongoing generic deflation, and the downsides of specialty pharmacy.

McKesson has illustrated these challenges in the financial results for its 2018 fiscal year. (See the links below.) The company projects that its 2019 fiscal year distribution profits will be flat to negative, due to customer losses and/or lower margins from contract renewals.

Below, I consider McKesson’s challenges with many of its largest customers, including:
  • CVS Health
  • Rite Aid
  • Albertsons
  • Ahold Delhaize
  • Cigna
Like its peers, McKesson faces an uncomfortable conflux of uncommon customer crosswinds. Investors are surely hoping that rough seas make good sailors.

Monday, June 04, 2018

CBI’s 4th Annual PBM Contracting

CBI’s 4th Annual PBM Contracting
August 22-23, 2018 | Chicago, IL
www.cbinet.com/pbmcontracting

Now in its 4th year, CBI’s PBM Contracting event is dedicated to the complexity and challenges of negotiating and implementing contracts between PBM’s and payers, employee groups, government entities, specialty pharmacies and manufacturers. Delegates will gain insights into the latest market and legal complexities affecting PBM contract negotiations, learn how to enhance the value of contracts by gaining a deeper understanding into issues like contractual terms and negotiated obligations, specialty drugs, value based contracts and much more.

Register by 6/29/2018 and receive $400* off the standard rate 
with discount code DCS400.

Hear the latest insights and innovations from industry thought leaders:
  • Cheryl Larson, President and CEO, Midwest Business Group on Health
  • Matthew Gibbs, Chief Commercial Officer, EnvisionRx
  • Natalya Ormanzhy, Director Performance Improvement, AIDS Healthcare Foundation
  • Dan DiStefano Pharm, Vice President, Curexa Pharmacy
  • Nick Page, PharmD, Vice President Specialty & Clinical Operations, US Specialty Care
  • Tariq Butt, M.D., Vice President of Health Affairs, Access Community Health Network (ACCESS)
  • Sean Walsh, Vice President of Pricing Strategy, BeneCard PBF
  • Garrett Brown, J.D., Assistant General Counsel, Employers Health Coalition
Featured Topics Include:
  • Value Based vs Reference Based Contracts
  • RFPs — Establishing Categories for Comparison of Vendors including Strategy, Objectives and Requirements
  • Innovative Models for Managing Pharmacy Benefits
  • Value Based Drug Pricing — Using the ICER Value Price Threshold of $150,000 per Quality Adjusted Life-Year (QALY)
  • Impact of Acquisitions and Horizontal Integration in the PBM Industry
  • Maintain Mutual Organizational Goals through Implementation of Regular PBM Assessments
  • Strategies for Controlling Costs of Specialty Therapeutics
  • Specialty Clinical Management — Evaluating PBM versus Third-Party Managers for Savings on Drug Spends
Don't be left out of the critical conversation. Register by 6/29/2018 and receive $400* off the standard rate with discount code DCS400.

*Offer expires June 29, 2018; applies to standard rates only and may not be combined with other offers, category rates, and promotions or applied to an existing registration.


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

Friday, June 01, 2018

The Pursuit of Excellence: Implementing an Integrated High Performing Specialty Pharmacy Model

Today’s guest post comes from Joseph Morse, CEO of Therigy. Joe describes challenges faced by specialty pharmacy leaders and Therigy’s solution for achieving a high performing, integrated specialty pharmacy service model.

You can also download Therigy’s case study: Memorial Hermann Realizes Significant Care Enhancements and Cost Savings by Bringing Specialty Pharmacy Services In-House. This case study explores how the largest health system in southeast Texas developed internal specialty pharmacy services.

Read on for Joe’s insights.

Tuesday, May 29, 2018

Drug Channels News Roundup, May 2018: CVS Caremark, Albertsons/Rite Aid, Copay Accumulators, and A World Without PBM Rebates

It’s almost June—wedding season! Our invitation to the recent royal nuptials apparently got lost in the mail, but I invite you to our own monthly shower of noteworthy news:
  • More questions about CVS Caremark’s profits in Ohio’s managed Medicaid programs
  • Albertsons and Rite Aid reveal new details about their pharmacy plans
  • HIV service organizations warn of patient dangers from copay accumulators
Plus, we revisit the classic Drug Channels black swan article for hints to a future without PBM rebates.

P.S. @DrugChannels on Twitter is now approaching 6,000 followers. Throw some rice and enjoy my daily tweets of interesting news, stories, and the reports you need to read.

Friday, May 25, 2018

CBI’s 4th Annual Specialty Pharmacy Network Design Summit

CBI’s 4th Annual Specialty Pharmacy Network Design Summit
June 14-15, 2018 | Washington, DC

Prescription dispensing revenues from specialty drugs at retail, mail, long-term care, and specialty pharmacies reached $138 billion in 2017. That amount accounts for one-third of the 2017 pharmacy industry’s $413 billion in total dispensing revenues. By 2022, prescription dispensing revenues from specialty drugs will account for $271 billion, almost half of the pharmacy industry’s projected $576 billion in total dispensing revenues. (See The 2018 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers, exhibit 70.)

At CBI’s 4th Annual Specialty Pharmacy Network Design Summit, gain the latest insights from leading multi-stakeholder perspectives, designed to help you learn how your network design decisions can impact patient access and the quality of patient care.

Visit CBI’s site for further details. Register by June 1 and receive $400 off the standard rate with discount code SPN400.

Download the complete agenda for the Specialty Pharmacy Network Design Summit.

Benchmark your specialty pharmacy network design strategies with your peers and with our distinguished speaking faculty:

  • Mike Agostino, RPh, President, Amber Pharmacy & Hy-Vee Pharmacy Solutions
  • Vice President, Specialty Pharmacy, Hy-Vee President, 2018 National Association of Specialty Pharmacy
  • Cheryl Allen, RPh, BS Pharm, MBA, Vice President, Industry Relations, Diplomat
  • Sheila M. Arquette, RPh, Executive Director, National Association of Specialty Pharmacy
  • Jasmine Daniel, Director, U.S. Commercial Specialty Trade, Shire
  • John Klimek, RPh, Senior Vice President, Standard and Information Technology, NCPDP
  • Lynnae M. Mahaney, BSPharm, MBA, FASHP, Director, Pharmacy Accreditation, American Society of Health-System Pharmacists
  • Brandon Newman, PharmD, CSP, Program Director, Vanderbilt Specialty Pharmacy, Vanderbilt University Medical Center
  • Timothy Paine, Director, Industry Relations, Fairview Specialty Pharmacy
  • Brandi Rabon, MSW, Patient Advocate, Manager, Patient Support Services
  • One Patient Services, LLC
  • John C. Robicsek, Assistant Vice President, Strategy, Business and Program Development, Pharmacy Administration, Atrium Health
  • Tim Safley, Director, DMEPOS, Pharmacy & Sleep, Accreditation Commission for Healthcare
  • Luis Torres, MBA, Vice President, Managed Care, BioPlus Specialty Pharmacy
  • Julie Zatizabal, SVP, Trade Relations, Amber Pharmacy

Featured Topics Include:
  • Copay and affordability criteria – reimbursement considerations to ensure specialty pharmacy network design success
  • Examining the role of IDNs/ACOs in specialty pharmacy and the unique characteristics of successful integrated model partnerships
  • Measuring outcomes and the impact on specialty pharmacy network design
  • Opportunities and pitfalls of specialty pharmacy network design decisions
  • Understanding the specialty patient population’s perspective
  • Patient data aggregation – effective data collection and interpretation strategies
  • Trends in oral oncology specialty pharmacy distribution
Visit CBI’s site for further details. Register by June 1 and receive $400 off the standard rate with discount code SPN400.

*cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rate or non-profit rates. 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, May 23, 2018

Who Best Managed the Drug Spending Slowdown in 2017: CVS Health, Express Scripts, MedImpact, or Prime Therapeutics?

It’s time for Drug Channels’ annual analysis of drug spending. For 2017, we again turn to the annual trend reports from four large pharmacy benefit managers (PBMs)—CVS Health, Express Scripts, MedImpact, and Prime Therapeutics. (See their report links below.)

Below, I compare who’s better and who’s best among the PBMs and share additional observations about the 2017 trends. We offer four key conclusions:
  • Drug spending grew by only 1.5% in 2017, continuing a multiyear decline in the growth rate.
  • Total drug spending declined at more than 40% of plan sponsors.
  • Spending on traditional drugs dropped by mid-single digits.
  • For specialty drugs, higher utilization was a much bigger contributor to spending growth than was growth in unit costs.
The 2017 data figures show that PBMs’ negotiating abilities continue to put spending growth in a squeeze box. Unfortunately, the warped incentives of the gross-to-net bubble and plan sponsor cost-shifting mean that patients do not always get on the magic bus and benefit from the low trend figures.

Monday, May 21, 2018

CBI's Reimbursement and Access 2018

Reimbursement and Access 2018
August 15-16, 2018 | 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 highly-acclaimed Reimbursement and Access arms attendees with invaluable learning, practical strategies and tangible takeaways on the most impactful ways to reduce barriers to access.

Join CBI in Philadelphia this August 15-16 at Reimbursement and Access 2018 for unparalleled insights and practical expertise.

Register today! Drug Channels readers will save $500 off the standard registration rate when they use discount code JUR627*

High-Impact Topics Transforming Access Strategy Including:
  • Copay Accumulators and PBM Restrictions
  • Evolving Health Policy Landscape
  • Value-Based Contracting
  • Formulary Management
  • Biosimilar Strategy and Access
  • Payer Engagement
  • Cell and Gene Therapies
  • Temporary Supply and Quick Start Programs
Dynamic Dialogue Driven by a Multistakeholder Speaking Faculty Representing:
AbbVie • Adama’s Pharmaceuticals • America’s Health Insurance Plan (AHIP) • Avalere, an Inovalon Company • BIO • Boehringer Ingelheim • Braeburn • Covington & Burling • CSL Behring • Eisai, Inc. • Frier Levitt • Health Results Group • Heron Therapeutics • Ipsen Biopharmaceuticals • Johnson & Johnson Health Care Systems • Jupiter Life Sciences Consulting • Kaiser Permanente Institute for Health Policy • King and Spaulding • Kite, a Gilead Company • Pfizer • Regional Cancer Care Associates • Sobi • Spark Therapeutics • U.S. Attorney’s Office for the District of New Jersey • U.S. Attorney’s Office for the Eastern District of Pennsylvania • U.S. Attorney’s Office for the Western District of Oklahoma • Walgreens • Xcenda • And More!


Visit www.cbinet.com/reimbursement for more information. Drug Channels readers will save $500 off the standard registration rate when they use discount code JUR627*

*Discount expires 06/22/2018 and may not be combined with other offers, category rates, promotions, or applied towards an existing registration. Offer not valid on workshop only or academic/nonprofit 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.

Tuesday, May 15, 2018

The Trump Drug Pricing Plan: Short Term Reprieve, Long Term Disruption

Last Friday, the U.S. Department of Health & Human Services (HHS) released American Patients First, a report billed as “The Trump Administration Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs.” This administration’s blueprint offers a thoughtful diagnosis of U.S. drug pricing along with the unintended consequences and warped incentives of our drug channel system.

The report also proposes a very long list of more than 50 regulatory and legislative fixes. It therefore doesn’t translate to quick action or simple sound bites. Many people are discounting the plan as no big deal and therefore underestimating how radically the system could change.

Below, I review some of its more radical notions—and highlight why the document's ideas pose substantial long-term risks for drug channel companies and their profit models. I also examine proposed changes for modernizing the Medicare Part D program and discuss two popular but ineffective ideas that were omitted from the document. While I don’t cover it in this article, I suspect changes to the Medicare Part B program may arrive soon.

The blueprint avoids facile diagnoses and simplistic solutions. It therefore looked on Friday like a weak political move. However, I expect last Friday’s announcement will mark the start of many coming changes.

Monday, May 14, 2018

Partnering with IDNs BioPharma Strategy Summit

Partnering with IDNs BioPharma Strategy Summit
August 15-16, 2018 | Philadelphia, PA
www.cbinet.com/IDNStrategy

In this complex healthcare market, integrated delivery networks have different decision-making processes, the size to leverage price discussions and access to real-world data in order to assess a therapy’s value. It is up to manufacturers to understand what IDNs require to meet their goals and adapt their sales teams to support and communicate effectively with these customers.

CBI’s 3rd annual Partnering with IDNs BioPharma Strategy Summit convenes manufacturers and integrated delivery networks to discuss how to create a mutually beneficial partnership for data-driven product advancement, greater patient engagement and adherence, and optimal care coordination.

Drug Channels readers will save $400 off the standard registration rate when they use discount code FGD662.* REGISTER TODAY!

Diverse Perspectives from Industry Pioneers:
  • Scott Canfield, Specialty Pharmacy Clinical Programs Manager, John Hopkins Home Care Group
  • Mark Fisher, Director – Key Account Lead, Sanofi Joint Health
  • Scott Garrett, Respiratory Institutional Regional Business Manager, Sunovion Pharmaceuticals
  • Brandon Newman, PharmD, MMHC, CSP, Program Director, Specialty Pharmacy, Vanderbilt University Medical Center
  • Elliot Jones, Regional Account Executive, IDNs-Northeast, Bayer
  • John Robicsek, Assistant Vice President, Strategy, Business and Program Development, Pharmacy Administration, Atrium Health
  • Michelle Templin, Vice President, Government Affairs and Business Development, MHA ACO Network
  • Ameet Wattamwar, Pharm.D., Pharmacy Manager, Transition of Care, NYU Langone Medical Center
Take Your Health System Strategy to the Next Level with Dynamic Sessions:
  • Engage with industry pioneers at this highly collaborative event and benefit from 5+ hours of dedicated networking opportunities
  • Learn new sales models for engaging large hospital systems and IDNs
  • Hear case studies around system care coordination and population health management
  • Analyze the impact of an outcomes-driven marketplace for payers and providers
  • Take away contracting strategies that provide the most value to organized customers
  • Initiate and nurture network-based relationships
  • Overcome the challenges of specialty data management
  • And more!

Visit www.cbinet.com/IDNStrategy for more information. Drug Channels readers will save $400 off the standard registration rate when they use discount code FGD662*

*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.

Thursday, May 10, 2018

Reflections from #Asembia18: The State of Specialty Pharmacy 2018

Last week, Paula and I had the pleasure of attending Asembia’s 2018 Specialty Pharmacy Summit.

The Specialty Pharmacy Summit remains the most important forum in the specialty marketplace. This year, a record 6,500 people learned, networked, and connected in Las Vegas. It was another year of record attendance. (Here’s the official press release.) Drug Channels again salutes Larry and Robert Irene for sustaining and growing an annual event that unites the entire industry.

Today marks the eighth year that I will violate Vegas code and tell you what happened there.

Below, I offer reflections on the meeting and highlight key specialty industry trends. You’ll also find a link to the conference’s Featured Session slides and a few cool photos. Feel free to add your own observations and photos in the comments section below.

Tuesday, May 08, 2018

Integrate 2018: Three Co-Located Summits

Integrate 2018: Three Co-Located Summits
July 23-25, 2018 | Philadelphia, PA
www.worldcongress.com/events/Integrate/

This July 23-25, Philadelphia will become home to Integrate 2018 featuring three one-day Pre-Summits and three Full Summits.
Choose one of three Pre-Summits:
  • The 2018 Copay Summit
  • Specialty Data & Access Strategies Master Class
  • AI & Blockchain Strategies Summit
Main Day Summits include:
  • 2nd Annual Patient Services Compliance Summit
  • 5th Annual Patient Support Services & Hub Design Summit
  • 5th Annual Specialty Network Design & Channel Optimization Summit
Truly customize your experience by selecting one-, two-, or three-day options and the specific tracks of your choice. One ticket price allows you access to any session from any of the three main day Summits.

Register with discount code DC200 and save $200 off of current registration rates!

Attendees will have the opportunity to break down silos and engage in forward-thinking discussions with cross-functional colleagues in order to develop best practices for improving support and access from manufacturer to patient, provider and networks.

Shared Keynotes include:
  • Examine Specialty Trends, Advancements, Emerging Partnerships, and Opportunities to Impact the Patient Journey and Improve Channel Strategies
  • MULTI-STAKEHOLDER PERSPECTIVES: Advance Stakeholder Collaborations to Navigate the Evolving Specialty Pharma Marketplace, Improve Channel Strategies and Align Stakeholders Across the Patient Journey
  • POLITICAL KEYNOTE: Insight into the Present Healthcare Landscape and its Implications on Patient Services, Specialty Pharmacy and Hub Design
  • PATIENT INSIGHTS: Understand the Patient Journey to Enhance Channel Strategies, Ensure Affordable Patient Services, Improve Specialty Distribution Operations, and Impact the Patient Experience
Confirmed speakers include executives representing:
Otsuka Pharmaceuticals | Walgreens | UPMC Health Plan | Pfizer | LuckFupus | Patient Advocate Foundation | CVS Specialty Pharmacy | Asembia | Accredo Express Scripts | Teva | Chiesi USA | Eisai | Sandoz Novartis | and many more!

Don’t miss out on this opportunity to experience unprecedented value, networking and education. Register with discount code DC200 and save $200 off of current registration rates!


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

Monday, May 07, 2018

EXCLUSIVE: The 340B Program Reached $19.3 Billion in 2017—As Hospitals’ Charity Care Has Dropped

The 340B Drug Pricing Program continues to expand at double-digit rates. Our research reveals that these discounted sales hit a record $19.3 billion in 2017.

What’s more, we found that since 2014, purchases under the program have grown at an average rate of 29% per year. By comparison, manufacturers’ net drug sales grew at an average rate of less than 5% over the same period.

Consequently, the 340B program has grown to account for at least 6% of the total U.S. drug market.

Here’s another uncomfortable fact: Nearly all of the billions in 340B discounts have accrued to hospitals. Yet hospitals' charity care has dropped by almost $8 billion amid the 340B program’s astounding growth.

Read on for the latest details and ponder who really benefits from the 340B program's growth.

Friday, May 04, 2018

Employers Are Getting More Rebates Than Ever—But Sharing Little With Their Employees (rerun)

This week, I’m rerunning some popular posts while I attend Asembia’s 2018 Specialty Pharmacy Summit. Click here to see the original post and comments from January 2018.

Yesterday, I examined new data showing that employers are receiving an increasing share of the rebate money collected by pharmacy benefit managers. See Employers Are Extracting More of Their Rebate Dollars from PBMs.

The data, from a Pharmacy Benefit Management Institute (PBMI) survey, also documented a troubling reality. Employers acknowledged that they are hoarding rebates rather than sharing the savings with the employees whose prescriptions generated the rebate funds. It’s the first time that I’ve seen such an admission from plan sponsors.

Consider the data below as confirmation of the warped incentives caused by the gross-to-net bubble—the growing spread between a manufacturer’s list price for a drug and the net price. Consider the diabetes example below. Fixing this situation will be more challenging than walking to Mordor. Point-of-sale (POS) rebates may be a good place to start, but employers seem unwilling to part with their precious.

Thursday, May 03, 2018

A Lesson from McKesson: How Specialty Pharmacy Growth Is Hurting Wholesalers (rerun)

This week, I’m rerunning some popular posts while I attend Asembia’s 2018 Specialty Pharmacy Summit. Click here to see the original post and comments from February 2018.

Last week, McKesson released its quarterly earnings for the fourth calendar quarter of 2017. See the links below.

The profit outlook for its distribution business was lower than Wall Street’s expectations, due partly to what management termed “customer and product mix.” Below, I offer my take on the three interrelated mix changes that challenge wholesalers' profits from the growth of specialty pharmacy drugs.

Wholesalers have been trying to alter their conventional pricing and contracting approaches to address these pressures, though it’s not clear how successful these efforts have been. The specialty boom may prove to be a mixed blessing for wholesalers.

Wednesday, May 02, 2018

Cigna-Express Scripts: Vertical Integration and PBMs’ Medical-Pharmacy Future (rerun)

This week, I’m rerunning some popular posts while I attend Asembia’s 2018 Specialty Pharmacy Summit. Click here to see the original post and comments from March 2018.

Wow. Yesterday, Cigna announced that it would acquire Express Scripts. See the links below.

Though Cigna was an unexpected acquirer, the deal confirms the importance of pharmacy and medical benefit integration. It also reinforces the role that pharmacy benefit management (PBM) plays in the drug channel. PBMs are now linked closely to the expensive specialty drugs that treat smaller patient populations, not to the primary care blockbusters of yesteryear.

The strategic logic, however, is much more compelling for Express Scripts than it is for Cigna. Perhaps that’s why the stocks reacted so differently yesterday. Express Scripts’ stock closed up 9%, while Cigna’s stock closed down 12%. Better to sell a PBM than buy one?

Below, I provide data about the PBM market, highlight vertical integration between PBMs and insurers, and discuss other industry implications.

Please feel free to leave your own $0.02 below. If you’re shy, you can comment anonymously.

Tuesday, May 01, 2018

Copay Accumulators: Costly Consequences of a New Cost-Shifting Pharmacy Benefit (rerun)

This week, I’m rerunning some popular posts while I attend Asembia’s 2018 Specialty Pharmacy Summit. Click here to see the original post and comments from January 2018.

Let’s kick off 2018 with a Last Jedi-themed look at copay accumulator programs—a benefit design option that I expect to become highly controversial this year.

Accumulator programs target specialty drugs for which a manufacturer provides copayment assistance. Unlike conventional benefit designs, the manufacturer’s payments no longer count toward a patient’s deductible or out-of-pocket maximum.

As you will see below, plan sponsors—employers and health plans—will save big money because accumulators shift a majority of drug costs to patients and manufacturers. Accumulator programs will further lower a plan’s drug spending by discouraging the appropriate utilization of specialty therapies and reducing adherence. What’s worse, many patients won’t understand their new “benefit.”

Given the direct human healthcare impact of copay accumulator programs, I don’t see how they can be considered value-based designs. Is it any wonder that people think their employers and insurance companies are from the dark side?

Monday, April 30, 2018

The Top 15 Specialty Pharmacies of 2017: PBMs and Payers Still Dominate (rerun)

This week, I’m rerunning some popular posts while I attend Asembia’s 2018 Specialty Pharmacy Summit. Click here to see the original post and comments from March 2018.

Below is our exclusive Drug Channels Institute list of the 15 largest pharmacies, ranked by estimated 2017 revenues from dispensing specialty pharmaceuticals.

The battle for control of the specialty market accelerated in 2017, though pharmacies owned by pharmacy benefit managers (PBMs) continued to capture most of the market share. The top four specialty pharmacies are all owned or co-owned by a PBM. They accounted for about two-thirds of prescription revenues from pharmacy-dispensed specialty drugs.

Vertical integration M&A has been in the news. But as our data shows, the integration of PBMs and specialty pharmacies has already happened.

Thursday, April 26, 2018

Drug Channels News Roundup, April 2018: Copay Accumulators, Express Scripts, Pharmacy Pricing, Amazon, and Almost-Pharmacist Jack Nicklaus

Baseball season is finally here! Oil up your glove, lace up your cleats, and let's run the bases around this month's news stories. Remember: Sometimes you win, sometimes you lose, and sometimes it rains.

In this issue:
  • Green Monster: The drug manufacturers that are most vulnerable to copay accumulators
  • Pop Fly: Express Scripts wants to pop the gross-to-net bubble?
  • Foul! Fresh evidence that uninsured consumers pay rip-off cash prices at retail pharmacies
  • Strikeout: My $0.02 on Amazon’s decision not to sell drugs to hospitals
Plus, from the diamond to the green: the secret pharmacy history of golf legend Jack Nicklaus.

P.S. For my daily pitches on the industry’s hits and misses, follow @DrugChannels on Twitter. My recent tweets have covered copay accumulators, the oncology market, drug costs, biosimilars, PBMs, and more.

Tuesday, April 24, 2018

The Gross-to-Net Bubble Topped $150 Billion in 2017

In 2017, the gross-to-net bubble—the ever-growing pile of money between a manufacturer’s list price for a drug and the net price after rebates and other reductions—hit a new high.

Based on new data from IQVIA, manufacturers of brand-name drugs in 2017 reduced list price revenues by an astonishing $153 billion. Those reductions came primarily from rebates, discounts, and other payments to the drug channel. That figure has grown by 10% from the 2016 figure, even though net prices for brand-name drugs grew by only 1.9%.

We can no longer ignore the warped incentives created by our bubble buddy. As regular readers know, I think plan sponsors and insurers should be more transparent about what they do with the billions collected via pharmacy benefit managers (PBMs) from manufacturers—or even be forced to pass through these rebates to point of sale. Read on and let me know what you think.

Monday, April 23, 2018

CBI’s 14th Annual Commercial Contract & Chargeback Excellence

CBI’s 14th Annual Commercial Contract & Chargeback Excellence
June 20-21, 2018 | Philadelphia, PA

CBI’s Commercial Contract & Chargeback Excellence Summit, take a deep dive into ways to improve chargeback efficiency, navigate class of trade assignments, streamline membership management and optimize contract administration and operations. Through illustrating software solutions, case studies and perspectives from leading distribution partners, this conference is a comprehensive forum for pharmaceutical professionals to learn best practices and gain strategies to improve contract operations and retain revenue.

Download the agenda here.

2018 Program Highlights:
  • Partnership Pavilion – Collaborate with Distribution Partners, Manufacturers and Legal counterparts
  • Manufacturer Panel – Overcome Key Challenges of Contract Operations and Administration
  • Advanced Discussions on the hottest Topics Impacting Commercial Contracting:
    • Manage Tier Commitments and Compliance in Complex Contracting
    • Explore Key Benefits and Challenges of Outsourcing Chargebacks and Membership Functions
    • Apply Data Analytics to Sales and Chargebacks to Enhance Business Decision-Making
Visit www.cbinet.com/chargebacks for further details and to register. Drug Channels readers will save $400 off the standard rate when they use discount code XYC552 and register prior to May 18th.

CBI will see you there!

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rate or non-profit rates. 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.

Friday, April 20, 2018

Improving Patient Prescription Access and Adherence Journeys

Today’s guest post comes from Bill Nolan, VP/GM of McKesson Specialty Health.

Bill discusses ExpressCoverage™, a solution from McKesson and CoverMyMeds®. It offers new ways for McKesson’s Patient Support Services to electronically access and efficiently communicate with a vast network of physicians, payers, and pharmacies. Bill highlights how this tool improves the specialty patient’s access and adherence to therapy.

To learn more, download the free document ExpressCoverage™: Revolutionizing Patient Drug Access For Pharmaceutical Companies.

Read on for Bill’s insights.

Thursday, April 19, 2018

Why Retail Pharmacies Still Overcharge Uninsured Patients—And What That Means for Amazon

Consumer Reports recently published a fascinating survey of pharmacies’ cash prices for five common generic drug prescriptions.

The results were startling. Prescription prices ranged from $66 to $1,351—a nearly 2,000% difference. The big three retail drugstore chains—CVS, Walgreens, and Rite Aid—consistently had higher average prices compared with those of other pharmacies. Independent pharmacies had some of the lowest prices, but also some of the highest prices.

Our analysis of prescription profits highlights the pharmacy industry’s unfortunate pricing strategy for cash-pay prescriptions. Average profit margins ranged from $8 to $264 per prescription for the five drugs. We can only hope that consumers didn’t pay the pharmacies’ sky-high cash prices.

The results expose the insane soak-the-poor mentality baked into the U.S. pharmacy industry’s historical pricing models. The data also highlight the potential pharmacy opportunity for Amazon.

P.S. Before other states follow Maryland and pass laws against price gouging by generic manufacturers, perhaps they should take a closer look at the behavior of their own states’ pharmacies.

Tuesday, April 17, 2018

McKesson Leads Another Round of PSAO Consolidation

Last week, McKesson announced the formation of Health Mart Atlas (HMA), a joint venture between McKesson’s Access Health business and American Pharmacy Network Solutions (APNS). Click here to read the press release.

The combination extends McKesson’s position as the largest pharmacy services administrative organization (PSAO). PSAOs are the awkwardly named intermediaries that operate between smaller pharmacies and pharmacy benefit managers (PBMs), per our U.S. Distribution and Reimbursement System flowchart.

When the Arete Pharmacy Network was formed, in 2016, I predicted that the fragmented PSAO sector would begin a long-overdue consolidation. Given the PBM titans now sitting atop Mt. Olympus, the remaining PSAOs can’t shrug off Health Mart Atlas.

Monday, April 16, 2018

CBI’s 4th GPO Membership Eligibility & Class of Trade Maintenance

4th GPO Membership Eligibility & Class of Trade Maintenance
June 19-20, 2018 | Philadelphia, PA
www.cbinet.com/gpo

Assembling over 100 industry professionals representing manufacturers, GPOs, wholesalers, distributors, and solution providers, CBI’s 4th GPO Membership Eligibility & Class of Trade Maintenance conference provides a rare, interactive forum on membership data management, class of trade, and workflow efficiency. Join your colleagues this June to learn strategies and insights from peers and industry stakeholders, and acquire the ability to overcome significant operational challenges related to proper management of GPO membership data. For additional information on session topics and speaking faculty, download the agenda here.

Visit www.cbinet.com/gpo for further details and to register. Drug Channels readers will save $400 off the standard rate when they use discount code NHY548 and register prior to April 20th.*

Compelling Sessions and Actionable Takeaways on Topics, Including:
  • Spotlight Panel Session: Ensure Seamless Membership Management and Accountability Across the GPO Supply Chain
  • Understand Best Practices for Efficient Membership Maintenance in a World on HCP Service Evolution
  • Kickback Risks of Arrangements with GPOs – Case Studies on Fraud and Abuse
  • Audit COT Designations to Find Inaccuracies
  • Develop Strategies to Streamline Communication With Your Distribution Network
  • Distinguished Speaking Faculty Includes: Kendrion Biopharma, Anada Inc., Sanofi, UCB, Zydus Pharmaceuticals, Amneal Pharmaceuticals, Prometric Biotheraputics, Lilly USA, Chiesi USA Inc., and more.
Visit www.cbinet.com/gpo for further details and to register. Drug Channels readers will save $400 off the standard rate when they use discount code NHY548 and register prior to April 20th.*

CBI will see you there!

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rate or non-profit rates. 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.

Friday, April 13, 2018

Copay Accumulator Programs: TrialCard Measures the Impact on Patients and Pharmaceutical Manufacturers

Today’s guest post comes from Mark Bouck, President and CEO of TrialCard.

Mark reviews copay accumulator adjustment programs and shares some of TrialCard’s unique data about these programs. He also discusses TrialCard’s proprietary methodology for identifying patients affected by this benefit design. This topic is crucial for 2018 (per my own article from January), so I encourage you to review his commentary.

To learn more about TrialCard’s approach to copay accumulator programs, download the free e-book The Rise of Co-Pay Accumulator Programs: Are Your Brand’s Patients at Risk?

To learn more about TrialCard’s solutions for accumulators, email Mark Droke, TrialCard's Senior Vice President, Patient Affordability & Virtual Engagement Business Units, at mark.droke@trialcard.com. You can visit Trialcard in booth 610 at Asembia’s upcoming 2018 Specialty Pharmacy Summit.