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...

Friday, November 16, 2018

Commercializing Cell and Gene Therapies with High-Touch Services

Today’s guest post comes from Layne Martin, VP/GM, Specialty Distribution and Third-Party Logistics at McKesson Life Sciences.

Companies commercializing cell and gene therapies face many novel challenges, including: supply chain logistics, patient access, adherence, outcomes collection, and data analysis. Layne reviews the crucial issues and explains the services needed for success.

McKesson Life Sciences has developed a portfolio of patient-centric solutions to help cell and gene therapy companies. To learn more, download their new white paper: The Key to Commercializing Revolutionary Gene Therapies and Other Orphan Drugs.

Read on for Layne’s insights.

Wednesday, November 14, 2018

Express Scripts Launches a New Formulary for a World Without Rebates. Will Plan Sponsors and Drug Makers Play Along?

Express Scripts has just announced its National Preferred Flex Formulary, a new option that favors drugs with lower list prices over the high-list/high-rebate versions of these products. Click here to read the press release.

This new formulary signals that Express Scripts is trying to prepare its plan sponsor clients for a world without rebates. The formulary also provides a way for Express Scripts to prepare itself for such a world.

As I explain below, many plan sponsors embrace the warped incentives of 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. I outline two crucial payer and PBM factors that make it difficult for manufacturers to cut list prices and pop the gross-to-net bubble.

Express Scripts’ new formulary challenges plan sponsors that are addicted to rebate dollars. Let’s see how many plan sponsors will prefer a low list-price over a high-list/high-rebate product—and how many more manufacturers will respond with lower list prices.

Tuesday, November 13, 2018

13th Annual Health Care Supply Chain Summit

13th Annual Health Care Supply Chain Summit
January 28-29, 2019 | New Orleans, LA

Join senior supply chain executives from top hospitals as they share strategies to improve patient outcomes by optimizing and benchmarking supply chain operations.

Key Themes in World Congress’ 13th Annual Health Care Supply Chain Summit 2019 include:
  • Cost, quality and outcomes
  • Clinical integration and physician alignment
  • Supplier relationships
  • Sustainability and standardization
  • Strategic planning
  • Value analysis and strategic sourcing
  • Data, analytics, and technology
  • Talent acquisition, supply chain leaderships, and professional development
  • Logistics and distribution
Engage in strategic discussions regarding next frontier supply chain operations with leaders from: Ochsner Health System | Mayo Clinic | AHRMM | Stanford Health Care | UPS | Mount Sinai Health System | Boston Children’s Hospital | and more!

Download the 2019 brochure.

Ready to register? Use promo code DC200 and save $200 off of current rates.


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

Friday, November 09, 2018

Enhancing Care For and Management of Hepatitis C Patients

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

Lily discusses challenges treating Hepatitis C patients and explains how a specialty patient management platform can improve outcomes.

She introduces Therigy’s latest publication series: Specialty Pharmacy Standards of Care. Download the first volume in this series here: Specialty Pharmacy Standards of Care: Hepatitis C.

Read on for Lily’s insights.

Thursday, November 08, 2018

Drug Prices After the Midterms: Five Crucial Implications of Pharmacy Benefit Design

After Tuesday's election, House minority leader Nancy Pelosi pointed to "reducing the cost of prescription drugs" as a legislative priority. But addressing patient affordability issues will require more than decrying “high drug prices.”

Today, I highlight five implications of these benefit designs on patient affordability, out-of-pocket costs, and perceptions of prescriptions prices. My observations are based on Employer Pharmacy Benefits in 2018: More Tiers, Greater Coinsurance, and Lots of High-Deductible Plans, in which I summarized companies’ 2018 prescription drug coverage for their employees.

As I explain below, many aspects of employers’ plans are unfriendly to patients with serious medical conditions and to those who face coinsurance and high-deductible plans. What’s more, most employees don’t understand their increasingly complex prescription insurance.

If politicians want to get serious about controlling how voters feel about their prescription costs, they should focus on understanding the structure of commercial and Medicare Part D benefit designs.

Tuesday, November 06, 2018

Employer Pharmacy Benefits in 2018: More Tiers, Greater Coinsurance, and Lots of High-Deductible Plans

It’s time for a deep dive into the 2018 Kaiser Family Foundation Employer Health Benefits Survey, which you can read online for free. The survey provides valuable national benchmarking for employer-sponsored health coverage in 2018.

If you’d rather not to wade through the entire report, please enjoy my highlights on prescription coverage below. I summarize employers’ 2018 pharmacy benefits by examining (1) cost sharing tier structures, (2) prevalence of copayment vs. coinsurance, and (3) average copayments and coinsurance rates, by formulary tier. I breakdown the 2018 results for plans with and without high deductibles.

For 2018, employers continue to increase cost-shifting for specialty drugs. Most plans have four or more tiers. Economically debilitating coinsurance—in some cases with no limit on out-of-pocket expenses—remains distressingly common. Many people with employer-sponsored insurance are being exposed to prescription list prices, regardless of the actual net, post-rebate costs.

In a follow-up article, I’ll provide thoughts on what employers’ benefit designs mean for patient affordability, out-of-pocket costs, and perceptions of prescriptions prices. Spoiler: Patients won’t be looking like they are having fun.

Monday, November 05, 2018

CBI’s Specialty Therapies 2019

CBI’s Specialty Therapies 2019
January 24-25, 2019 | Las Vegas, NV
www.cbinet.com/specialtytherapies

Kick off 2019 in Las Vegas at Specialty Therapies 2019! Don’t miss the chance to come together with colleagues from across the industry to examine disruptions in specialty drug distribution and the impact on access, quality and cost. You can read all about it here.

Visit www.cbinet.com/specialtytherapies for further details and to register. Drug Channels readers will save $400 off the standard rate when they use promo code BQH229 and register prior to November 30th.*

With the advent of innovative service delivery models, alternative payment models and an emphasis on data sharing and data standardization, the quest to drive better outcomes, ensure access and manage costs is more vital than ever.

Experts from Ochsner Health System, Ardon Health, Moda Health, Vanderbilt University Medical Center, Atrium Health, Indiana University Health, Fairview Specialty Pharmacy, MedImpact Health Systems, Boesen & Snow Law, Diplomat, VIVIO Health, University of Arizona Cancer Center and Blue Cross Blue Shield North Carolina lead robust discussions on topics such as:
  • Investigate how distribution channels for specialty therapies are changing and the impact on cost, access and health outcomes
  • Understand how in-house specialty pharmacies can enable health systems to accelerate a patient’s speed-to-therapy and improve quality of care through integrated clinical coordination
  • Evaluate the potential impact of the removal of safe harbor for drug rebates
  • Consider how distribution channels that accommodate 340B hospital pharmacies, PBM owned pharmacies, limited distribution drugs, any willing provider legislation and closed specialty networks affect clinical outcomes and costs
  • Unravel the complexities within Copay Accumulator Programs and how they will affect specialty therapy utilization rates and long-term medical spend
Visit www.cbinet.com/specialtytherapies for further details and to register. Drug Channels readers will save $400 off the standard rate when they use promo code BQH229 and register prior to November 30th.*

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.

Thursday, November 01, 2018

Surprise Deal: Cardinal Health Sells Its Specialty Pharmacy (Again)

The evolving specialty market has just claimed another victim. Cardinal Health is selling its specialty pharmacy to BioMatrix Specialty Pharmacy LLC, a private-equity-backed company. There was no public announcement, so today's article counts as another Drug Channels exclusive. Below, I provide background about BioMatrix and the specialty pharmacies that wholesalers operate.

Cardinal’s capitulation highlights the challenges for smaller specialty pharmacies. Cardinal operates a small, sub-scale specialty pharmacy that has had difficulty attracting patients. What’s more, Cardinal’s overall size as a $137 billion business couldn’t help its pharmacy gain sufficient access to manufacturers’ and payers’ limited networks.

Each of the Big Three wholesalers—AmerisourceBergen, Cardinal Health, and McKesson—is encountering challenges to its diversification efforts. Will Cardinal’s move prompt a rethinking of wholesalers’ broad business portfolios over the next 12 to 18 months?

Tuesday, October 30, 2018

Drug Channels News Roundup, October 2018: Amgen, Walgreens, Rite Aid’s PBM, Drug Price Ads, and Buy-and-Bill Murray

Boo! Time for my Halloween bag of Drug Channels news stories. This issue’s tricks and treats:
  • Shocking! The gross-to-net bubble for Amgen’s PCSK9 product magically vanishes—and my $0.02 appears
  • Creepy! Stefano Pessina of Walgreens Boots Alliance shares startling thoughts about Amazon, ABC, and more
  • Scary! Shareholders vote today on whether Rite Aid should amputate its PBM
  • Spooky! The Wall Street Journal conjures up a frightfully funny editorial about the drug channel
Plus, the Centers for Medicare & Medicaid Services summons Buy-and-Bill Murray for its latest foray into Part B reform.

P.S. Join the zombie horde who shamble after me at @DrugChannels on Twitter. It’s a great way to haunt me between Drug Channels articles.

Monday, October 29, 2018

CBI’s 6th Annual Reimbursement & Contracting Conference

CBI’s 6th Annual Reimbursement & Contracting Conference
January 23-24, 2019 | Philadelphia, PA
cbinet.com/Contracting

CBI’s 6th Annual Reimbursement & Contracting Conference is the ideal platform for bio/pharma manufacturers to unravel complexities associated with reimbursement, pricing strategies and commercial contracting. Join industry thought-leaders and colleagues in Philadelphia on January 23-24 at this CPE accredited event, and discover the necessary insights to navigate the evolving landscapes to develop innovative and competitive pricing strategies.

Exclusive Offer for Drug Channels Readers:
Register Now to SAVE $400* using promo code MGS852

Featured Sessions from Our Distinguished Faculty Include:
  • Best Practices and Implications of Contracting with Digital Therapeutics – Pear Therapeutics
  • Unmet Medical Need – Can the Stakeholder Align? – Chiesi USA, Inc.
  • 340B Summit – Case Studies and Provider Perspective – Boone County Hospital and ProMedica
  • HEOR and RWE Around the World – Roles in Reimbursement and Contracting – BeiGene, Ltd.
  • And more!
  • Plus, Choose Between Two In-Conference Summits:
    1. Foundational Summit: Principles of Reimbursement and Contracting – The Robinson Research Group, Inc.
    2. Strategic Summit: Network Contracting Strategies — The Janssen Pharmaceutical Companies of Johnson & Johnson and Johnson & Johnson Health Care Services
Visit cbinet.com/contracting to view the complete agenda and speaker lineup, then register using the Drug Channels promo code MGS852 to save $400 off* the standard rate.

 *Expires 1/22/18; applies to standard rate only and may not 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.

Thursday, October 25, 2018

PBM Pricing Overhaul: Express Scripts Prepares for a World Without Rebates—But Employers May Not Change

This week, Express Scripts announced an innovative pharmacy benefit contracting model for members of the National Drug Purchasing Coalition (NDPC), a group of 18 large employers. Click here to read the fully-titled press release.

You should pay close attention to this b.i.g. news. It is structured so that Express Scripts will not profit from the flow of funds from a brand-name manufacturer to a plan sponsor. What’s more, the PBM’s compensation will be fully delinked from drug list prices. Instead, Express Scripts will earn only fixed management fees plus additional at-risk compensation tied to clinical outcomes.

I spoke to Express Scripts and the NDPC’s consultant to clarify how the new model will differ from more conventional structures. As I see it, this PBM compensation approach could be an important step in our industry’s journey toward a world without rebates.

For now, it only applies to a sliver of Express Scripts’ revenues. But if the new pricing model is widely adopted, Express Scripts (Cigna) will be able to escape drug channel disruption unscathed.

The biggest unknown is how employers will behave as they select pharmacy benefits. Will the funds flowing transparently through the PBM be put toward solving the reverse insurance issue the gross-to-net bubble? Will this lower out-of-pocket costs for patients? As they say: Mo money, mo problems.

Tuesday, October 23, 2018

The Law of Holes: Some Independents Skip 2019 Part D Preferred Pharmacy Networks

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

Today, I examine independent pharmacies’ participation via the pharmacy services administrative organizations (PSAOs) that represent these pharmacies in negotiations with plans.

This year’s results show a major divergence in strategies. Three of the four biggest PSAOs will participate in a comparable number of Part D networks, as the big chains do. AmerisourceBergen’s Elevate network, however, continues to go its own way and will skip preferred status in the major Part D networks. You will find its reasoning below.

Are we at a turning point for preferred pharmacy networks? Remember that Humana will trigger a small pullback by switching two of its plans from preferred to open networks for 2019. Have pharmacies decided to stop digging holes in their income statements?

Monday, October 22, 2018

CBI’s Specialty Product Data Strategies Summit

CBI’s Specialty Product Data Strategies Summit
December 12, 2018 | Philadelphia, PA
www.cbinet.com/specialtydata

Specialty Product Data Strategies 2018 is your next step towards leveraging internal and third-party data to drive product access, uptake, adherence and outcomes. This unique and cutting-edge forum provides you with breakthrough data discussions and key industry perspectives on how to strategically contract, analyze and utilize specialty data to measure outcomes and illustrate value. You can read all about it here.

Drug Channels readers will save $200 off the standard rate when they use
discount code HXF785 and register prior to November 2nd.*

Innovative Discussions and Compelling Case Studies:
  • Leverage Artificial Intelligence (AI) to Drive Specialty Channel Insights and Examine Emerging Pharmacy Models Driving New Data Sets for Specialty Drugs
  • Transform Specialty Product Data Sets into Cutting-Edge Dashboards to Gain Actionable Insights
  • Update on NCPDP’s New Specialty Pharmacy Work Group and Task Group Activities
  • Partnership Pavilion— Collaborating with the Right Complex Patient Data Providers to Drive Value
  • I Know What I Want, but How Do I Get There? Building an Effective, Innovative Commercial Operations Organization
  • Value-Based Therapy Management Driven by Data Collection throughout the Patient and Product Journey
  • Revamp and Restructure Contracting Agreements for Specialty Data to Create Operational Efficiencies
  • Strategies to Foster High Quality Data for Advanced Analytics
  • Opportunities for Data-Driven Patient Services
Visit www.cbinet.com/specialtydata for further details and to register. Drug Channels readers will save $200 off the standard rate when they use discount code HXF785 and register prior to November 2nd.*

CBI will see you there!

REMINDER: Upgrade your registration and come in a day early to attend CBI’s Trade and Channel Strategies meeting. To register for both events, please visit this site, sign up for the Trade and Channel event and chose the Specialty Data track.

*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, October 19, 2018

McKesson: Biopharma Companies Need an Integrated, Customized and High-Touch Approach to Solve Critical Commercialization Challenges

Today’s guest post comes from Shawn Seamans, President of McKesson Life Sciences.

Shawn discusses the channel and commercialization complexities associated with launching and managing specialty medications. He then outlines McKesson Life Sciences, a business that brings together McKesson's multiple solutions for connecting biopharma companies, providers, pharmacies and payers. These solutions also help patients access their therapies.

To learn more, visit McKesson Life Sciences or email LifeSciences@mckesson.com.

Read on for Shawn’s insights.

Thursday, October 18, 2018

Battle Royale: CVS and Kroger Gain, Walgreens Slips in 2019 Part D Preferred Pharmacy Networks

In Humana Triggers a Pullback for Preferred Pharmacy Networks in 2019 Medicare Part D , I highlighted how preferred pharmacy networks will dominate next year’s Medicare Part D prescription drug plans (PDP).

Today, I examine chain pharmacies’ participation in 24 major 2019 Part D preferred networks. Some highlights:
  • CVS, for the second year, has strengthened its position as a preferred pharmacy in many 2019 networks.
  • Walmart and Kroger have maintained the strong positions that they have established over the past few years. Walgreens, however, has slipped as the other chains grow.
  • Poor ol’ Rite Aid will again be a preferred pharmacy only in the single plan offered by its EnvisionRx subsidiary.
Below, we provide you with a handy table for scoring each chain’s participation and all changes from 2018 to 2019. Get ready to do The Floss!

Tuesday, October 16, 2018

EXCLUSIVE: Humana Triggers a Small Pullback for Preferred Pharmacy Networks in 2019 Medicare Part D (Plus: Top Sponsors and CVS Health’s POS Plan)

The Centers for Medicare & Medicaid Services (CMS) has recently released the initial raw data on the 2019 Medicare Part D plans.

Our exclusive analysis of these data reveals that preferred cost sharing pharmacy networks will be slightly less popular next year. For 2019, 92% of Medicare Part D regional prescription drug plans (PDP) will have a preferred network. This figure compares with 99% of plans in 2018. The decline will occur primarily because two Humana plans will switch from preferred to open networks for 2019.

Below, I provide historical context on preferred networks’ growth and then discuss the top nine companies behind the 2019 plans. As you will see, narrow pharmacy networks are now an essential and established component of Part D benefit design.

Especially notable will be CVS Health’s SilverScript Allure, the first Part D plan with point-of-sale (POS) rebates for brand drugs. Is Allure the next generation of Part D plan design, or an unattractive offer that helps CVS stop a mandated policy shift that it opposes?

Monday, October 15, 2018

Join me at CBI’s 14th Life Sciences Trade and Channel Strategies

CBI’s 14th Life Sciences Trade and Channel Strategies
December 11-12, 2018 | Philadelphia, PA
www.cbinet.com/trade

Are you ready for some channel strategy? Then join me at CBI’s 14th Life Sciences Trade and Channel Strategies Conference, being held this December in Philadelphia. CBI’s annual event has become our industry’s premier event focused on bio/pharma trade management.

I’ll kick things off with an interactive keynote address titled Drug Channels Update – Things to Watch in 2019. I'll highlight the key trends for the year ahead.

I'll also be moderating a panel with Wall Street experts. We'll delve further into industry trends and such other hot topics as stock market valuations, M&A, Amazon (of course), and more.

Drug Channels readers will save $300 off the standard rate
when you register with promo code HNB269 by October 26th.*

I hope you’ll join me in Philadelphia this December.

Regards,
Adam

A MESSAGE FROM CBI

Don’t miss the life science industry’s favorite event where the experts will share how to expand the playbook on product-specific network design, contracting and specialty distribution strategy.

Gain critical insights on industry trends, political impact, market dynamics and product-specific channel strategies. Key stakeholders come together to navigate the complex distribution and contracting landscape and discuss ways to optimize channel strategies in order to reach patients in need and provide the necessary services based on product type, site of care and reimbursement.

You can read all about it here.

The hottest topics addressed by the experts:
  • Drug Channels Update – Things to Watch in 2019
  • Adam J. Fein, Ph.D., CEO, Drug Channels Institute
  • Fragmentation and Customization Comes to Pharmaceutical Channels
  • William Roth, Founding Partner, Blue Fin Group
  • Market Economics and Emerging E-Commerce Players
  • Lance Wilkes, Senior Equity Analyst, Healthcare Services, Sanford C. Bernstein
  • Utilization Management and Copay Accumulator Impact
  • Jeff Henderson, Vice President, Head of Market Access and Government Affairs, US, Sobi, Inc.
  • Seamless Distribution Models for Orphan Therapies
  • Dave MacLeod, Senior Director, Patient Services and Channel Operations, Intercept Pharmaceuticals
  • Inaugural Specialty Pharmacy Working Group and Data Standard
  • John Klimek, R.Ph., Senior Vice President, Standards and Information Technology, NCPDP
  • Specialty Pharmacy and Distribution Trends Reshaping the Industry
  • Erika Chiles, Director, Pricing, Contracting and Trade, Neurocrine Biosciences, Inc.
  • Navigate the Biosimiliars Landscape for Market Access
  • Joseph P. Fur, Jr., Professor Emeritus of Economics, Widener University
PLUS! Customize your experience through a master class series:
  • Integrating Pharmacy and Medical Benefits for Better Health and Cost Reduction
  • Specialty Pharmacy Strategy Design for Biosimiliars and On-Market Brands
  • Navigate Limited and Closed Pharmacy Network Models
  • Accelerate Access through Patient Support Programs and Hub Services in an Increasingly Competitive Therapy Class
  • Advanced SP Contracting Course - Industry Best Practices During an Evolving and Consolidating Era
  • Managed Markets Compliance - Pharmaceutical Manufacturer Relationships with Specialty Pharmacies, Wholesalers, Distributors and GPOs
Visit www.cbinet.com/trade for further details and to register. Drug Channels readers will save $300 off the standard rate when they use code HNB269 and register prior to October 26th.*

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, October 12, 2018

DIR Fees: A Prescription While You Wait

Today’s guest post is sponsored by Elsevier and written by Todd Grover, Co-Founder, Glass Box Analytics and President, PharmacyFocus.

Todd discusses some of the challenges associated with Direct and Indirect Remuneration (DIR) fees. He explains how Elsevier’s Predictive Acquisition Cost (PAC) pricing tool helps pharmacies better manage DIR fees and challenge insufficient reimbursements.

Learn more by downloading Elsevier’s infographic: Managing the Impact of DIR Fees.

Read on for Todd’s insights.

Tuesday, October 09, 2018

NEW: The 2018–19 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors

I am pleased to announce our new 2018–19 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors, available for purchase and immediate download.
We’re offering special discounted pricing if you order before October 26, 2018.

The 2018–19 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors—our ninth edition—remains the most comprehensive tool for analyzing the economic and business realities of U.S. pharmaceutical distribution. This year's edition has been thoroughly updated, revised, and expanded. It contains the most current market and industry and data. The report is the only resource of its kind available anywhere.

See below for more info. Enjoy!

P.S. If you would like to pay by corporate purchase order or check, please email Tamra Feldman. If you preordered the report, you should have already received an email with download instructions. Please contact us if you did not receive the email.

Monday, October 08, 2018

CBI’s Copay Accumulator Summit

CBI’s Copay Accumulator Summit
December 13, 2018 | Philadelphia, PA
www.cbinet.com/accumulators

Exclusive Offer for Drug Channels Readers:
Register Now to SAVE $300* using discount code PBQ239.

As the adoption of copay accumulators and maximizers becomes widespread, so does the need for pharmaceutical manufacturers to ensure a comprehensive understanding of the impact to the commercially insured patient population.

CBI’s Copay Accumulator Summit convenes stakeholders from across the life sciences community to discuss the growing trend of cost-shifting pharmacy benefits and strategies to enhance financial support.

Gain critical insights from a distinguished speaking faculty representing Amgen, Allergan, EMD Serono, Jazz Pharmaceuticals, ConnectiveRx, NASP, Pacific Pharmacy Group, Multiple Sclerosis Association of America, CSRO, FirstView, BIO, TrialCard and more!

Elevate Access Strategies with Expert Insights and Compelling Discussions:
  • Evaluate cost-shifting trends in drug plan benefit design and cost management
  • Measure the impact of copay accumulator programs on patients and manufacturers
  • Hear stakeholder insights on managing patient access and adherence challenges
  • Promote patient education and informed discussion to encourage adherence
  • Discuss payment technologies to manage the impact of copay accumulator programs
  • Forecast and anticipate what is to come with PBM restrictions, payer access and copay reform
Register using discount code PBQ239 to receive $300 off* the standard rate.

*Expires 12/12/18; 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.

Wednesday, October 03, 2018

Does Rite Aid Have the Grit to Succeed With Its EnvisionRx PBM Business?

Let’s check in with poor ol’ Rite Aid, the little drugstore that couldn’t.

Over the past year and half, Rite Aid has sold off 2,000 stores to Walgreens Boots Alliance, scuttled a proposed merger with Albertsons, and watched its stock price drop from nearly $9 to about $1. Yikes.

Rite Aid’s EnvisionRx business, which includes two small PBMs and some related pharmacy services businesses, still has some value. But as you will see below, there appear to be few synergies between Rite Aid’s pharmacy business and the Envision PBMs. Investors are grumbling that Rite Aid should sell EnvisionRx before things get any worse.

Rite Aid is again trying to prove that hope will triumph over experience. I suspect that the industry’s dynamics will hip check the company onto the ice.

Monday, October 01, 2018

Therigy’s Free Webinar: Systems Interoperability and Its Impact on Coordinated Specialty Therapy Management

Therigy’s Free Webinar: Systems Interoperability and Its Impact on Coordinated Specialty Therapy Management
Tuesday, October 16, 2018, 2:00 to 3:00 pm ET
Register Here

One of the nation’s leading specialty pharmacy technology companies, Therigy is hosting a free webinar on Tuesday, October 16, 2:00 to 3:00 pm ET.

This webinar will explore current trends of interoperability within the industry.  It will provide actionable insights to help pharmacy leaders exchange and share data between their pharmacy operation/care management systems and their EMR.

Speakers will dive into analytics and tools that tap every aspect of the clinical experience. They will explore how to deploy insightful, immediate diagnostic suggestions to physicians on robust, multi-function care delivery systems, creating an exceptional patient experience.

Featured team of expert speakers from Therigy include:
  • Russel Allinson, RPh, MS, Executive Chairman, Therigy
  • Jon Hamrick, MBA, President and Chief Operating Officer, Therigy
  • Kate Fontenau, Director, Product and Technology, Therigy
When it comes to the healthcare industry, interoperability has to do with the capability of disparate computer and software systems to exchange and share data from a range of vital sources, including laboratories, clinics, pharmacies, hospitals, and medical practices.

All attempts at interoperability must inherently begin by recognizing the starting point of what makes everything so tricky: EHRs consist of a series of disparate systems built in silos that are suddenly being asked to work together for the good of the patient. (Click here for background information.)

It’s only now, in an era of value-based care where every aspect of an organization is being scrutinized like never before, that administrators are starting to rethink whether the systems they have in place act as a hindrance to overall care.

Webinar topics to be discussed:
  • Why specialty patient outcomes can be enhanced through coordination and integration of care and therapy management activities
  • Current role and uses of various systems (dispensing systems, electronic medical records, electronic pharmacy records/care management systems), existing limitations, and the need for system interoperability
  • Dispensing system/care management system interoperability case study
  • Pathway to a meaningful pharmacy system integration with Health System EMRs and the benefits for specialty pharmacy management
Visit Therigy’s registration page for additional information and to register.


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

Thursday, September 27, 2018

Drug Channels News Roundup, September 2018: Gilead’s Price Cuts, Out-of-Pocket Costs, Hospital-Physician Vertical Integration, and WXPN + Me

Autumn is here, and we’ve squirrelled away some great acorns that have fallen from the mighty Drug Channels oak trees:
  • Gilead’s new pricing starts to pop the gross-to-net bubble
  • New fact-based insights on patient out-of-pocket costs and prescription abandonment
  • Cool new stats on hospital-physician vertical integration by specialty
  • The U.S. healthcare crisis will probably never end (Sorry.)
Plus, your friendly neighborhood blogger joins the board of 88.5 WXPN, the country’s leading non-commercial Triple A (adult, album, alternative) radio station.

P.S. Follow my daily stream of links to neat stuff at @DrugChannels on Twitter.Recent tweets have highlighted rebates, step therapy, PSAOs, white bagging, PBM network spreads, lab-based microbreweries, and more.

Tuesday, September 25, 2018

The Cigna-Express Scripts Deal's Intriguing Connections With—And Implications For—AmerisourceBergen and Walgreens

Almost there! Last week, the U.S. Department of Justice (DOJ) Antitrust Division closed its investigation of Cigna’s proposed acquisition of Express Scripts. Click here to read the DOJ’s closing statement.

As with everything in the U.S. drug channel, there’s more to this transaction than meets the eye.

Below, I explain how the transaction will benefit AmerisourceBergen (ABC), which supplies the mail and specialty pharmacies of Express Scripts. But as you’ll see, Express Scripts has been relying less on ABC as a source of supply for its mail and specialty pharmacies.

Meanwhile, the new organization transaction will have few degrees of separation from Walgreens Boots Alliance (WBA). To add to the intrigue: WBA is both ABC’s largest customer and its largest shareholder. Below, I map how Cigna, Express Scripts, AmerisourceBergen, and Walgreens Boots Alliance connect with one another.

Drug channels are organizing and aligning themselves into multifaceted entities that cross traditional functional boundaries. Are you ready to compete, collaborate, and coexist with a complex arrangement that crosses many traditional boundaries?

Monday, September 24, 2018

CBI’s 10th Federal Pricing and Reporting – VA, DoD, PHS

CBI’s 10th Federal Pricing and Reporting – VA, DoD, PHS
November 7-8, 2018 | Baltimore, MD
www.cbinet.com/fedpricing

At CBI’s 10th Federal Pricing and Reporting Summit, elevate the conversation and take a deep dive into the complexity of contracting with the “Big 4” federal programs. In an era of political transformation and industry uncertainty, this highly acclaimed meeting is a must-attend, offering bio/pharma manufacturers best practices and timely updates from government officials and industry counterparts on pricing models and processes for complying with complicated rules and regulations.

With perspectives from Marci Anderson of the VA, Vincent Valinotti of the DoD, Captain Robert W. Hayes of PHS, and Captain Mike Crockett of the BoP, along with a Spotlight Session from J'Aime Conrod and Eric Escobar of UCB, this is a meeting you can't afford to miss!

Visit www.cbinet.com/fedpricing for further details and to register. Drug Channels readers will save $300 off the standard rate when they use discount code ATT954 and register prior to October 12th.*

You can read all about the Summit here.

Featured Sessions Include:
  • Uncover leading strategies and best practices for coordination with the DoD
  • Receive answers to critical questions related to TAA Non-Compliant Covered Drugs Policy and its specific role in the Acetris Health LLC v. United States court cases
  • Navigate the recent and impending changes to 340B legislation and guidance and their impact on federal contracting and reporting
  • Discuss the financial implications of government contracting strategies in the context of GTN
  • Analyze and build your understanding of non-FAMP and Federal Ceiling Price with regard to the calculations and data from which they are derived
  • Gain insight on key challenges surrounding the Federal Supply Schedule (FSS)
  • Hear directly from the VA OIG regarding FSS contract compliance and audit expectations
Visit www.cbinet.com/fedpricing for further details and to register. Drug Channels readers will save $300 off the standard rate when they use code ATT954 and register prior to October 12th.*

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 21, 2018

It’s Time to Rethink Channel Strategy for Oral Oncolytics

Today’s guest post comes from Akin Odutola, Senior Vice President, Specialty and Branded Product Access, Strategic Global Sourcing, at AmerisourceBergen.

Akin discusses the challenges facing patients treated with oral oncology drugs in community practices and health systems. He then describes AmerisourceBergen’s solution for coordinating patient care and providing aggregated specialty pharmacy data from healthcare providers.

To learn more, download Rethink: Channel Strategy for Oral Oncolytics.

Read on for Akin’s insights.

Thursday, September 20, 2018

Preorder Now: Our 2018–19 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors

On October 9, 2018, Drug Channels Institute will release The 2018–19 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors.

It’s the ninth edition of our annual evaluation of the economic and business realities driving U.S. drug distribution. This definitive, nonpartisan resource remains the most comprehensive tool for analyzing the industry. The 2018-19 edition has been thoroughly updated and revised with the latest information.

This year, we are providing you with the opportunity to preorder the 2018-19 edition at special discounted prices. This means that you can be among the first to access our new report. Those who preorder will receive a download link on or before October 9.

You can pay online with all major credit cards or via PayPal. Email admin@drugchannels.net if you would like to pay by corporate purchase order or check. Preorder and launch pricing discounts will be valid through October 26, 2018.

I’ll share more details when we release the full report in a few weeks. In the meantime, click here to download a free pre-publication draft overview.

If you have any questions before purchasing a license to the report, please email me.

All the best,
Adam

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.