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 22,000 subscribers. Learn more...

Tuesday, September 18, 2018

Copay Accumulator Update: Widespread Adoption As Manufacturers and Maximizers Limit Patient Impact

In January, I alerted you to an important new benefit design trend in Copay Accumulators: Costly Consequences of a New Cost-Shifting Pharmacy Benefit. It is by far the most widely read article ever published on Drug Channels.

New data from Zitter Health insights (ZHI) suggest that these programs are widely used. Nearly one-third of commercially-insured lives are enrolled in plans that have implemented copay accumulator adjustment or closely-related copay maximizers. (We explain the benefit design math behind maximizers below.)

ZHI also found that a surprising number of plans are already set up to use these programs, but have not done so yet. And many more are planning implementation for 2019 and beyond. Check out the full data below.

Manufacturers have stepped up with more financial support to shield patients from the worst aspects of these benefit designs. This support further inflates the gross-to-net bubble. Plan sponsors’ use of maximizers instead of accumulators has also blunted the impact on patients.

Accumulators, maximizers, and large copay support programs are inefficient solutions to flaws in the U.S. drug channel system. Alas, it looks like they are all now a common—but possibly not even fully utilized—feature of the benefit design landscape.

Monday, September 17, 2018

GTN 2018 - CBI’s Gross-to-Net Summit

GTN 2018 - CBI’s Gross-to-Net Summit
November 15-16, 2018 | Philadelphia, PA
www.cbinet.com/gtn

With the total value of off-invoice discounts and rebates increasing over the last few years, it is pivotal that pharmaceutical and biotech manufacturers stay on the forefront of gross-to-net management. CBI’s GTN Summit, now in the 8th year, is the first step toward positioning your organization for success in the years ahead. You can download the complete agenda here.

The meeting is coming up on November 15-16 at the Hilton Philadelphia at Penn’s Landing and features expert perspectives from companies such as Adamas, Amgen, Amneal/Impax, Astellas, BMS, Chiesi, Daiichi Sankyo, GSK, EMD Serono, Insmed, Medac Pharma, Merck, Sandoz, Spark Therapeutics, Sunovion, Takeda and more, all ready to share their insights into strategic forecasting, accounting estimates, analytics and finance reporting strategies, specifically for life science companies.

Hot Topics on the Agenda Include:
  • Benchmarking and survey data illustrating company best practices for GTN management
  • Advanced analytics, new technology and accurate data sets for efficiency and reduced revenue leakage
  • Real-time analysis of the President’s ‘Patients First’ plan and the state of play for coupons, co-pay programs, accumulators and rebates
  • Industry insights on Coverage Gap changes, drug pricing and transparency laws
  • Current and future trends in revenue management and value-based contracting
  • Strategies for new product launch forecasting and financial planning and financial
  • GTN models for product returns and pipeline accruals
  • Profitability strategies when negotiating contracts with payers
  • Emerging issues with government programs and Medicaid calculations
Visit www.cbinet.com/gtn for further details and to register. Drug Channels readers will save $400 off of the standard rate when they use discount code QZD886 and register prior to September 28th.*

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, September 14, 2018

Artificial Intelligence (AI): How Specialty Pharmacies Are Making Medication Package Management More Predictable, Scalable, and Efficient

Today’s guest post comes from Scott Knight, Founder and President at ParcelShield.

Scott explains how artificial intelligence is being used to improve medication package management in specialty pharmacy. It’s an intriguing look at the application of next-generation technologies that can benefit patients.

To learn more about AI in specialty pharmacy, download ParcelShield’s free white paper Man Vs. Machine: How Artificial Intelligence (AI) Makes Specialty Parcel Management More Predictable, Scalable, and Efficient.

Read on for Scott’s insights.

Wednesday, September 12, 2018

Updated Part B Data: Hospitals Are Displacing Physician Offices Even Faster Than We Thought

The Medicare Payment Advisory Commission (MedPAC), the independent agency that advises Congress on the Medicare program, recently released its latest annual report: June 2018 Data Book: Health Care Spending and the Medicare Program. It’s a charming, 216-page data romp through all aspects of Medicare. Chapter 10 focuses on prescription drugs.

This year’s report provides new and revised details about the locations where Part B buy-and-bill spending occurs. As you will see below, physician offices account for a smaller share of spending than what we previously reported. Hospital outpatient departments account for a higher share. What’s more, the new MedPAC data show that the shift to hospitals is happening even faster for oncology products.

For years, I have been buzzing about the growing role of hospital outpatient departments in the buy-and-bill market. I’m afraid that these data will sting those hoping for a physician office rebound.

Monday, September 10, 2018

The Medical Affairs Launch Strategy Summit

The Medical Affairs Launch Strategy Summit
October 22-23, 2018 | Alexandria, VA

The World Congress' Medical Affairs Launch Strategy Track is designed to bring multiple stakeholders together including medical affairs executives, payers, IDNs and advocacy to examine stakeholder engagement opportunities and overcome patient access challenges.

As the role of medical affairs becomes increasingly important in ensuring product launch success, it is imperative pharma and biotech executives examine pre-launch strategies, develop effective scientific, medical and commercial communications and build stakeholder partnerships.

Key Topics in 2018 include:
  • Define the role of “value” and determine an effective pre-launch strategy to ensure patient access
  • Navigate pre-launch channels and develop a unified and scientific message
  • Engage with key stakeholders including physicians, patients, and payers
  • Network with senior medical affairs leadership to collaborate on common challenges and establish best practices
  • Attend an expert-led, intensive workshop on the Development of a Product Launch Strategy
  • Hear how medical affairs can partner with RWE and HEOR teams for commercialization projects


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

Wednesday, September 05, 2018

How 2017’s Fastest-Growing, Private Specialty Pharmacies Highlight an Industry Slowdown

Time for our annual review of the Inc. 5000 list, the magazine’s annual ranking of the fastest-growing private companies in the United States. The list offers a valuable snapshot of the dynamic specialty pharmacy industry. This marks our sixth annual review of the list.

We have identified nine specialty pharmacies on the 2018 list, which is based upon revenue growth from 2014 to 2017. Annual revenues range from $61.3 million to $1.4 billion. The companies on the list are larger but growing more slowly than those in our previous analyses.

The pharmacies and key stats are listed below. For the eight companies returning from last year’s list, median revenues in 2017 grew by 14%. This marks the second year of slower growth.

This year’s list showcases the maturation of the specialty pharmacy industry. The go-go growth years are fading. It’s becoming harder to enter the industry and more challenging to scale a business. OptumRx is rumored to be acquiring Avella Specialty Pharmacy, the largest company on the list. Everyone has to grow up someday.

Tuesday, September 04, 2018

3rd Annual Life Sciences Value-Based Contracting

3rd Annual Life Sciences Value-Based Contracting
October 22-23, 2018 | Alexandria, VA

Join cross-industry stakeholders at the 3rd Annual Life Sciences Value-Based Contracting Track, part of the Value-Based Health Care Congress, and learn how to design successful value-based agreements between manufacturers and payers.

How will you benefit?
  • Explore key strategies and opportunities in value-based contracting with payers
  • Examine value-based contracting terms, conditions, and metrics necessary to implement a successful value-based strategy
  • Hear a case example of how Spark Therapeutics created an innovative contracting model and outcomes-based agreement for the first FDA-approved gene therapy
  • Gain a high-level overview from CMS of the future of pharmaceutical regulations
  • Uncover a shared vision amongst pharma, plans, PBMs, and providers for reducing and sharing risk
  • Understand how to partner with ACOs and IDNs to ensure the optimal use of treatment to support the performance of the drug and drive the best outcomes
  • Leverage technology and experience to implement successful and scalable innovative contracts
  • Discuss the implications of the AMP rule and Best Price concerns
  • Mitigate the risk of fraud, abuse, privacy, and anti-trust allegations
Key speakers include executives from:

Pfizer | Novartis | Aetna | Express Scripts | CMS | J&J | Horizon Blue Cross Blue Shield of New Jersey | Spark Therapeutics | GSK | and many more!


ACT NOW! Register with discount code DC200 and save $200 off current rates.

This event is part of the Value-Based Health Care Congress, a 4-track event bringing together stakeholders from all walks of health care to break down silos, coordinate efforts, and bend the cost curve. Benefit from shared Keynotes and networking breaks with the entire Congress delegation.


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

Friday, August 31, 2018

The State of Specialty Pharmacy 2018: Reflections from #Asembia18 (rerun)

This week, I’m rerunning some popular posts before the Labor Day weekend. Click here to see the original post and comments from May 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.

Thursday, August 30, 2018

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

This week, I’m rerunning some popular posts before the Labor Day weekend. Click here to see the original post and comments from May 2018. Note that the data from this post were provided to me by the Health Resources and Services Administration (HRSA)!

ICYMI, be sure to read yesterday's New York Times article: A Little-Known Windfall for Some Hospitals, Now Facing Big Cuts


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.

Wednesday, August 29, 2018

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

This week, I’m rerunning some popular posts before the Labor Day weekend. Click here to see the original post and comments from May 2018.

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.

Tuesday, August 28, 2018

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

This week, I’m rerunning some popular posts before the Labor Day weekend. Click here to see the original post and comments from June 2018.

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, August 27, 2018

CBI’s 3rd Edition Drug Pricing Transparency Congress

CBI’s 3rd Edition Drug Pricing Transparency Congress
September 27, 2018 | Philadelphia, PA
www.cbinet.com/drugpricing

Have you been keeping up with the various state drug pricing regulations that have been introduced and passed across the nation? Over the past year, states including Oregon, California, Nevada, Maryland, New York, Massachusetts and Vermont – to name a few – have introduced and/or enacted different laws and enforcement initiatives mandating the disclosure of drug pricing increases, introducing restrictions limiting Medicaid drug spending, requiring disclosure of company metrics and expenses, and other related pricing ballot initiatives.

CBI’s 3rd Edition Drug Pricing Transparency Congress convenes key industry stakeholders to discuss how the future of state drug pricing transparency regulations will impact commercialization, reimbursement, pricing and compliance practices.

Register by Friday, September 21, 2018 and
receive $300* off the standard rate with discount code DCP300.

Featured Discussion Topics:
  • State Drug Pricing Reporting Requirements and Interpretations — What You Need to Know Now to Ensure Reporting Compliance
  • Implications of State Drug Pricing Transparency Laws on Policy
  • Operational Best Practices Focused on Governance and Planning for the Future
  • Oregon HB 4005 — Reporting Requirements Overview and Update
  • California SB-17 — Implementation and Enforcement Update
  • The Latest Developments for New York's Medicaid Drug Cap and the Impact of ICER on Drug Pricing
  • The Impact of Transparency and Disclosure Legislation on Legal and Compliance Practices
  • Federal Legislative Activity Update — Patients First Blueprint Review
Speaker Perspectives
  • Brian A. Bohnenkamp, Partner, FDA & Life Sciences Practice, King & Spalding LLP
  • Joanne Chan, Assistant General Counsel, Pharmaceutical Research and Manufacturers of America (PhRMA)
  • Sarah diFrancesca, Partner, Cooley LLP
  • Seth Lundy, Partner, King & Spalding LLP
  • Angela Marcucci, Director of Global Policy, Pfizer Inc.
  • Kendra Martello, Senior Director, Public Policy, Government Affairs & Public Policy, Mallinckrodt Pharmaceuticals
  • William A. Sarraille, Partner, Sidley Austin LLP
  • Vince Sampson, Partner, Cooley LLP
  • Debbie A. Walters, Vice President, Assistant General Counsel, Pfizer Inc.
  • Sabrina Yohai, Vice President, Policy, Access & Value, Corporate Legal, Vertex Pharmaceuticals
  • Andrew Parks, Director, KPMG
Don't be left out of the critical conversation. Register by Friday, September 21, 2018 and receive $300* off the standard rate with discount code DCP300.

*Offer expires September 21, 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.

Tuesday, August 21, 2018

Drug Channels News Roundup, August 2018: PBM Spread Profits, Part D Rebates, 340B Questions, Amazon and Dentists, and PBS on PBMs

We’re wrapping up one of newsiest summers in recent memory. As you send the kids back to school, savor this curated collection of curiosities, combed from the now-empty Drug Channels beach:

In this issue:
  • An Ohio audit provides unprecedented data about pharmacy benefit manager (PBM) profits
  • New revelations about rebates in Medicare Part D. (Bonus: AHIP discovers that rebates actually exist!)
  • Congress has tough questions for 340B contract pharmacies
  • How Amazon Business is drilling into the dental supplies market
Plus, an unexpectedly straightforward PBM news story that is clear enough to watch with your kids.

P.S. Join the more than 6,200 people who follow my daily musings and neat links at @DrugChannels on Twitter.

Monday, August 20, 2018

CBI’s 13th Annual Value-Based Oncology Management Summit

CBI’s 13th Annual Value-Based Oncology Management Summit
October 10-11, 2018 | Scottsdale, AZ
www.cbinet.com/VBO

As cancer care costs continue to soar, innovations in oncology care management and payer-provider payment reform remain a critical imperative for key stakeholders. Now in its 13th year, CBI’s Value-Based Oncology Management Summit convenes payers, providers, PBMs, manufacturers and specialty pharmacies to examine current trends/challenges and share best practices to control costs, reduce variation in care and improve patient outcomes.

Drug Channels readers will save $400 off the standard registration rate when they use discount code FZK768*
.
In-Depth Sessions and Discussions Include:
  • Demystify current trends in value-based oncology payment and reimbursement models
  • Examine the future of (CAR)-T cell therapy and cost effectiveness
  • Explore the use of biosimilars in cancer treatment – Consider how biosimilars contribute to treatment options, efficiencies and expanded access to cancer therapies
  • Assess the impact of oncology value partnerships with managed care plans
  • Leverage real-world data and observational insights to understand and assess value-based care performance
  • Advance palliative care models – Empower patients to make informed treatment decisions

Visit www.cbinet.com/VBO for more information, or download the full agenda today. Drug Channels readers will save $400 off the standard registration rate when they use discount code FZK768*.

*Discount expires October 10, 2018; 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, August 16, 2018

2019 Express Scripts Formulary Exclusions: Hepatitis C Changes Show Why the Drug Channel Must Change, Too

Last week, Express Scripts released the 2019 updates to its formulary exclusion lists. They are available below for your downloading pleasure. Unfortunately, CVS Health won’t release its list until October.

For 2019, Express Scripts was more aggressive than ever, expanding its list to more than 240 excluded products. For the first time, it excluded products in two specialty categories: HIV antiretrovirals and Factor VIII recombinant products. It also added a new exclusion in multiple sclerosis.

Oddly, Express Scripts has made a patient unfriendly change to the hepatitis C category. It has excluded AbbVie’s Mavyret, the market share leader with a low list price. Instead, it added Merck’s Zepatier, whose list price was recently cut but can’t treat all types of hepatitis C. Consequently, the 2019 preferred formulary will force at least one in four patients to use the products with high list prices and high rebates. Many patients will end up incurring much higher out-of-pocket costs. Incredibly, Express Scripts advocates copay cards as a fix!

To me, the hepatitis C formulary change are further evidence of the warped incentives of our gross-to-net bubble. Payers benefit from a low net price, and PBMs gain from high list prices with high rebates (though less than we once thought). Meanwhile, patients get stuck making out-of-pocket payments based on the higher list price. Is this any way to run a drug channel?

Tuesday, August 14, 2018

New Disclosures Show CVS and Express Scripts Can Survive in a World Without Rebates. Are Plan Sponsors Now the Real Barrier to Disruption?

Last week, the two largest pharmacy benefit managers (PBMs)—CVS Health and Express Scripts—both stated that rebates now account for a small part of their profits. The companies therefore strongly implied that they could survive in a world in which PBMs did not participate in the flow of funds from a brand-name manufacturer to a plan sponsor. Below, I unpack the new disclosures, which move us materially closer to a new model.

Hmm. The two biggest PBMs and at least one major manufacturer (Pfizer) have now implied a willingness to change. So what’s to stop massive drug channel disruption?

CVS Health perhaps inadvertently identified the real barrier to a system without rebates: employers and health plans. As you will see below, CVS Health disclosed for the first time the massive gross-to-net bubble within its commercial book of business. The new information confirms that plan sponsors are hoarding rebates rather than sharing the savings with the employees whose prescriptions generated the rebate funds.

If we really do migrate to a system without rebates, PBMs’ reportedly minimal profits from rebates mean they could escape drug channel disruption unscathed. The focus will now turn to the plan sponsors that are absorbing rebate dollars. Whether plan sponsors realize it or not, they are the next target.

Monday, August 13, 2018

CBI’s Life Sciences Outcomes-Based Contracting Summit

CBI’s Life Sciences Outcomes-Based Contracting Summit
October 3-4, 2018 | Philadelphia, PA
www.cbinet.com/OutcomesContracting

Exclusive Offer for Drug Channels Readers:
Register Now to SAVE $400* using discount code OUT400

CBI’s 3rd Annual Life Sciences Outcomes-Based Contracting Summit is the ideal platform to discuss best practices for value optimization and price alignment with health outcomes data and provides critical strategies into the process of outlining, structuring and negotiating risk-sharing agreements between bio/pharma manufacturers and payers.

This timely event will address the continuous challenges the industry faces to lower drug costs and increase patient access, all while demonstrating the value of their drugs to insurers by providing best practices and key insights from thought-leaders regarding the nuances surrounding outcomes-based contracting.

Gain critical insights from distinguished speaking faculty, including those representing AstraZeneca, Novartis Pharmaceutical Corporation, Aetna, University of Portsmouth, Center of Medicine in the Public Interest, BeiGene, Ltd., University of Washington Medicine Health System, Bristol-Meyers Squibb and more.

Join CBI for Solutions-Oriented Sessions, Powerful Payer Insights and Illuminating Case Studies:
  • Overview of over 60 published outcomes-based innovative contracts
  • Pinpoint how AstraZeneca and Aetna have succeeded in creating outcomes-based contracts
  • Explore new conditional reimbursement models with real-world versus real-time performance data
  • Implement contracts to define, measure, report and create payment mechanisms for value-based arrangements
  • Hear how payers perceive value-based agreements that involve rebates versus those with refunds
  • And more!
  • Plus, join us for the Pre-Conference Workshop: Playbook for the Construction & Deployment of Outcomes-Based Innovative Contracting
Download the complete agenda, then register using promo code OUT400 to receive $400 off* the standard rate.

 *Expires 10/2/18; applies to standard rate only and cannot be combined with other offers or applied to 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, August 10, 2018

Redefining Digital Health: How a Different Approach Can Get Manufacturers Closer to Patients

Today’s guest post comes from Mary Roberts, Vice President of Business Development at EnvoyHealth, a subsidiary of Diplomat.

Mary describes the next generation of patient services and explains how manufacturers can use new digital health tools to get closer to patients.

Visit envoyhealth.diplomat.is/innovative to learn more about using technology to enhance patient services and differentiate brands.

Read on for Mary’s insights.

Wednesday, August 08, 2018

Still Possible: Hospitals Overcharge Health Plans for Specialty Drugs

Over the years on Drug Channels, I have explained the two primary reasons a drug’s list price doesn’t reflect what a third-party payer actually spends for that drug: (1) channel intermediaries and providers add markups that account for the costs, profits, and value of the services, and (2) manufacturers provide rebates and discounts to third-party payers.

Two recently-released reports confirm the often-overlooked magnitude of provider markups.

As you will see below, commercial payers use reimbursement approaches that permit hospitals to inflate specialty drug costs by thousands of dollars per claim when compared with physician offices. This is not about differences in patient care. It’s about hospitals adding big markups to drug costs.

Meanwhile, commercial insurers complain about “drug prices,” going so far as to publish misleading data about drug spending. Yet insurers conveniently forget to mention their own role in allowing powerful providers inflate drug spending. As evidenced by the proposed outpatient prospective payment system (OPPS) rule, the Secretary (of Health and Human Services) does not disavow any knowledge of site-neutral payments.

Monday, August 06, 2018

CBI's West Coast Real-Time Benefit Check & ePrior Authorization Summit

West Coast Real-Time Benefit Check & ePrior Authorization Summit
October 17-18, 2018 | San Francisco, CA
www.cbinet.com/eBenefit

CBI’s West Coast Real-Time Benefit Check & ePrior Authorization Summit convenes stakeholders, including manufacturers, specialty pharmacies, PBMs, health plans, solution providers and prescribers to discuss and share best practices regarding electronic patient service technology and speed to therapy. With constant innovations in electronic patient services (ePA, FHIR, HL7, RTPBI), the integration and implementation of this technology is imperative to drive patient access to therapy.

Join the conversation and participate in open discussions with your peers to discuss workflow improvements, firsthand experiences with system integration and the latest advancements in ePA and RTBC. Drug Channels readers will save $400 off the standard registration rate when they use discount code SGK838.*

Critical Topics for Peer-To-Peer Benchmarking:
  • Discuss clinical and operational factors to consider when implementing portal PA solutions with medical specialty drugs
  • Hear how to streamline electronic benefit verifications and prior authorization solutions into a hub model
  • Examine how to configure interoperability in a local/regional health setting and recent efforts within the FHIR/HL7 standards
  • Understand how to work more efficiently between specialty pharmacies, providers and payers to manage patient therapy
  • Discuss alert fatigue, additional clicks, and how to avoid prescriber burnout
  • Address considerations for enrollment standards in hubs and specialty pharmacies

Visit www.cbinet.com/eBenefit for more information, or download the full agenda today. Drug Channels readers will save $400 off the standard registration rate when they use discount code SGK838*

*Discount expires October 17, 2018; 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, August 02, 2018

A System Without Rebates: The Drug Channels Negotiated Discounts Model

Are you ready for a world without rebates?

In June, Alex Azar, Secretary of the U.S. Department of Health & Human Services (HHS), summarized his long-range vision for a new drug channel system:
“[W]e may need to move toward a system without rebates, where PBMs and drug companies just negotiate fixed-price contracts. Such a system’s incentives, detached from artificial list prices, would likely serve patients far better.” (emphasis added)
No one has yet explained what a system without rebates would look like.

To facilitate the discussion, I have sketched out a possible new drug channel system that would:
  • Respond to the HHS vision for a “system without rebates”
  • Remove/decrease the reliance on list price as a component of intermediary compensation
  • Use negotiated discounts as an alternative to the current system of retrospective rebates
  • Require manufacturers to negotiate for desirable market access
You can download The Drug Channels Negotiated Discounts Model below.

Please note that I am not advocating for this approach. I am merely exploring one way that a system without rebates could be implemented. I hope you find it helpful for your strategic planning.

As always, I welcome feedback on how to improve and refine this model. Either leave comments below or email me. Enjoy!

Tuesday, July 31, 2018

Drug Channels News Roundup, July 2018: Amazon’s med-surg business, Naughty 340B hospitals, GoodRx pricing data, and CVS’s musical controversy

The lazy days of summer are here. Take some time off from the gross-to-net bubble and enjoy my curated collection of timely articles. This month:
  • A must-read Q&A on Amazon’s healthcare products distribution business
  • A new GAO study discovers that more than one in five 340B hospitals provides minimal charity and uncompensated care
  • Fresh data from GoodRx about the crazy variability in pharmacies’ prescription prices
Plus, The Wall Street Journal publishes some hard-hitting journalism about the controversial hold music played at CVS pharmacies.

P.S. Join the more than 6,000 people who follow my daily musings and neat links at @DrugChannels on Twitter. Recent tweets have tackled biosimilars, specialty pharmacy, copay accumulators, drug pricing, health policy news, and much more.

Monday, July 30, 2018

CBI’s PAP Legal Update Forum

CBI’s PAP Legal Update Forum
September 25-26, 2018 | Arlington, VA
www.cbinet.com/papupdate

Join CBI this fall at the PAP Legal Update Forum to delve into the nuances of compliance for patient assistance programs, address new copay card legislation, analyze critical areas of risk within the Anti-Kickback Statute, and explore strategies for effective risk management and compliance monitoring to optimize and ensure patient access.

You can read all about it here.

Participate in compelling discussions led by expert speakers:
  • Examine the Impact of Legal Actions and Developments Related to Patient Assistance Programs
  • Analyze PAP Critical Risk Areas within the Anti-Kickback Statute (AKS), False Claims Act (FCA) and Other Key Laws
  • Redefine Relationships between Manufacturers and 501(c)3 Foundations
  • Dissect Evolving State Copay Card Legislation in California, Massachusetts and Rhode Island
  • Tackle Critical Challenges in Providing Assistance for Rare Disease and Specialty Therapeutics Patients
  • Build Effective Strategies to Balance Patient Centricity and Compliance in Patient Access
  • Implement Robust Compliance Monitoring Programs for PAPs
Visit www.cbinet.com/papupdate for further details and to register. Drug Channels readers will save $300 off the standard rate when they use discount code YHX639 and register prior to August 24th.*

CBI looks forward to seeing 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.

Tuesday, July 24, 2018

Building a New Drug Wholesaler Compensation Model: What Happens as Brand Inflation Slows?

Today, drug wholesalers make money from distribution in a straightforward manner: Buy low, sell high, collect early, and pay late. They also profit as brand-name list prices increase. Like other drug channel intermediaries, wholesalers have warped incentives to prefer ever-higher list prices.

But what happens to their business model if list prices don’t rise—or even if they decrease?

This question is no longer theoretical. Many drug makers—Pfizer, Roche, Novartis, Novo Nordisk, Sanofi, and others—have announced an intention not to raise list prices for 2018 or have rescinded planned increases. Merck has gone further and become the first major manufacturer to reduce the list price of a brand-name, patent protected product, albeit for a product with minimal sales. And for the first time, there is a serious attempt to pop the gross-to-net bubble and build a system without rebates.

Below, I analyze what this could mean for the Big Three drug wholesalers—AmerisourceBergen, Cardinal Health, and McKesson. I explain some of the problems that arise when wholesalers are compensated based on a brand-name drug’s list price. I then suggest an alternative approach that would reshape wholesalers’ economics. It appears that even the wholesalers’ trade association supports some sort of new model.

Given what’s happening, it’s clearly time for some ch-ch-ch-ch-changes.

Monday, July 23, 2018

CBI’s 11th Hub and SPP Model Optimization

CBI’s 11th Hub and SPP Model Optimization
September 12-13, 2018 | San Diego, CA
www.cbinet.com/hubswest

In order to keep up with the escalating challenges associated with rebooting or maintaining your hub model, your organization requires novel and innovative strategies for customizing your products and services. CBI has once again gathered the pioneers in the industry to share practical strategies for advancing patient services, enhancing program effectiveness and driving speed to therapy.

Join CBI in San Diego, CA for the 11th installment of the Hub and SPP Model Optimization Summit on September 12-13. You can read all about it here.

Visit www.cbinet.com/hubswest for further details and to register. Drug Channels readers will save $300 off the standard rate when they use discount code TJC549 and register prior to August 17th.*

Conference Highlights Include:
  • Discover how to best streamline the information generated by the hub back to the manufacturer
  • Review the overall end-to-end experience from the physician and patient perspective in e-prescribing, prior authorization and dispensing workflows
  • Discuss the impact of DIR Fees on practice-based pharmacies
  • Examine best practices on the development and administration of a third-party monitoring and oversight program
  • Understand the consequences of narrow channel medication distribution on patient adherence in post-acute care
  • Gain an understanding for how to consolidate specialty distribution data
  • Use EHR technologies to determine formulary, launch electronic prior authorizations and streamline fills at retail pharmacies and through mail-away hubs

PLUS! Don't miss the heart-wrenching Keynote Address from former NFL great Rolf Benirschke, current CEO of Legacy Health Strategies.

Visit www.cbinet.com/hubswest for further details and to register. Drug Channels readers will save $300 off the standard rate when they use discount code TJC549 and register prior to August 17th.*

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.

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.