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 26,000 subscribers. Learn more...

Tuesday, September 10, 2019

We Shouldn’t Give Up on Biosimilars—And Here Are the Data to Prove it

An interesting spat about biosimilars has emerged between two prominent policy-oriented physicians.

Dr. Peter Bach of Memorial Sloan Kettering and Mark Trusheim of MIT argues that we should “throw in the towel” on biosimilars and begin regulating drug prices.

On the other side, Dr. Scott Gottlieb, a former FDA commissioner, argues that we shouldn’t give up on biosimilars, but instead make structural and legislative changes that would increase competition.

To inform the debate, I share below the latest data on biosimilar adoption. As you will see, adoption rates for the most recently launched products—biosimilars of Neulasta and Epogen—are growing quickly, and prices are declining. These products are penetrating the market much faster than the biosimilars of Remicade did. Substitution rates for the upcoming wave of oncology biosimilars will likely penetrate even faster.

That’s why I concur with Dr. Gottlieb: Regulating prices at this stage of the market’s development is premature. This strategy may save some money in the short run, but it risks destroying a market that is finally beginning to fulfill its promise.

Sunday, September 08, 2019

CBI’s Federal Pricing and Reporting

CBI’s Federal Pricing and Reporting
October 22-23, 2019 | Philadelphia, PA
www.cbinet.com/fedpricing

With legislation and regulation changes on the horizon, CBI’s Federal Pricing and Reporting Summit is a must-attend for bio/pharma manufacturers! You'll learn about best practices and future opportunities directly from government officials, including keynotes from the VA, DoD and PHS, and industry experts on pricing models and processes for complying with complicated rules and regulations.

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 GDK898 and register prior to October 4th.

Take a deep dive into the latest innovations and challenges in federal reporting and contracting, especially as issues surrounding transparency and compliance evolve and offer opportunities for growth. The conference agenda covers the below and more:
  • Review Federal Supply Schedule (FSS) compliance rules post-Acetris Health case with updated knowledge on transparency expectations
  • Examine the possibilities around outcomes-based contracts and other strategies for better compliance and negotiations with the Big Four Federal Programs
  • Managing Refunds of 340B Overcharges and Mitigating Compliance Risk
  • Hear directly from the VA OIG regarding FSS contract compliance and audit expectations
  • Review leading strategies and best practices for coordination with the Department of Defense with new budgeting changes
  • Discuss the impact of drug shortages and limited distribution with an eye towards opportunities for growth and collaboration
Download the agenda here and prepare to return to the office armed with critical updates and valuable takeaways.

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 GDK898 and register prior to October 4th.

CBI will see you there!

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rates, clinic/hospital rates, non-profit rates other offers. 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, September 05, 2019

Preorder Now: Our 2019–20 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors

On October 8, 2019, Drug Channels Institute will release The 2019–20 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors.

This new tenth edition is the most comprehensive, fact-based tool for understanding and analyzing all aspects of the U.S. pharmaceutical distribution industry. It also contains detailed information about the largest companies: AmerisourceBergen, Cardinal Health, and McKesson.

For the 2019-20 edition, we have added 19 additional exhibits and interesting new material, such as a look at the factors that determine executive compensation at the public wholesalers. I’ll share more details when we release the full report.


We are providing you with the opportunity to preorder this thoroughly updated and revised 2019-20 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 before October 2.


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

Preorder and launch pricing discounts will be valid through October 18, 2019.

If you have any questions before purchasing a license to the report, please email me. As always, thank you for your support of our work.

P.S. The launch date has been updated from October 2,2019, to October 8, 2019.

Wednesday, September 04, 2019

The Shakeout Begins: The Fastest-Growing, Private Specialty Pharmacies of 2018

Time for our review of the Inc. 5000 list, the magazine’s annual ranking of the fastest-growing private companies in the United States. The list—based on revenue growth from 2015 to 2018—offers a valuable snapshot of the dynamic specialty pharmacy industry. Today’s article marks our eighth annual analysis of the list.

The specialty pharmacy industry slowdown meant that fewer specialty pharmacies than ever before were eligible for the Inc. 5000 list. We have identified eight specialty pharmacies in this year’s edition. Annual revenues range from $15.5 million to $726.1 million. For the four companies returning from last year’s list, 2018 sales-weighted average revenues grew by 48%.

This year’s Inc. roster signals that the shakeout is beginning. Fewer new specialty pharmacies are starting up, the bigger companies are getting acquired, and market share is concentrating further with the biggest players. Look for other dramatic changes in the coming year.

The specialty pharmacy industry outlook will be a hot topic at next week’s 2019 NASP Annual Meeting & Expo. I’ll be there, so please share your thoughts with me if you see me there.

Tuesday, September 03, 2019

CBI’s 4th Annual Outcomes-Based Agreements & Innovative Payer Contracting Summit

CBI’s 4th Annual Outcomes-Based Agreements & Innovative Payer Contracting Summit
October 2-3, 2019 | Sheraton University City | Philadelphia, PA
www.cbinet.com/OutcomesContracting

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

The shift from volume to value-based care presents an opportunity for payers and bio/pharma and device manufacturers to explore innovative contracting methods, while demonstrating a commitment to improving clinical outcomes and patient access.

CBI’s 4th Annual Outcomes-Based Agreements and Innovative Payer Contracting Summit, taking place October 2-3 in Philadelphia, is the ideal platform for cross-industry stakeholders to discuss critical strategies on how to navigate the continuous changing policy and regulatory landscape, structure value-based agreements and measure outcomes with real world data. Featured speaking faculty include those representing Titan Spine, Highmark Inc., Sanofi, Avalere Health, Pfizer, Pernix Therapeutics, Curant Health, Ferring Pharmaceuticals and more!

Forward-Thinking Topics of Discussion Include:
  • Evaluate how to target the best opportunities for an integrated delivery and financing system
  • Understand which therapeutic areas payers are looking into and at what level of investment
  • How do you define and derive value from real-world evidence?
  • Identify how Real-World Evidence and Health Economics Outcomes Research coalesce into actionable data generation platforms for internal and external collaboration
  • Examine how drug leasing models for curative cell and gene therapies [CAR-T] work
  • Explore the drug subscription model for direct contracting between employers and life sciences
PLUS! Join us for the pre-conference workshop Change Management for Value-Based Contracting with workshop leaders Nick Merryfield, CEO, Verpora and Omar Ali, Visiting Lecturer, Value-Based Pricing and Innovative Contracting of New Medicines, University of Portsmouth; Former Adviser, NICE.

Download the conference agenda for the complete speaker and session lineup, then register using promo code OUT400 to take advantage of $400 off* the standard rate!

*Discount expires 10/1/19; 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.

Friday, August 30, 2019

340B Program Purchases Reach $24.3 Billion—7%+ of the Pharma Market—As Hospitals’ Charity Care Flatlines (rerun)

This week, I’m rerunning some popular posts while I work on the forthcoming 2019-20 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. Click here to see the original post and comments from May 2019.

This article was the first of my 2019 series exploring the hidden economic mysteries of the 340B Drug Pricing Program. You can read the full series here: https://drugch.nl/340B


The 340B Drug Pricing Program continues to expand at double-digit rates. According to our government contacts, discounted 340B purchases hit a record $24.3 billion in 2018. That figure is an astonishing 26% higher than its 2017 counterpart.

What’s more, we have found that since 2014, purchases under the program have grown at an average rate of 28% per year. By comparison, manufacturers’ net drug revenues have grown at an average rate of below 5% over the same period. Consequently, the 340B program has grown to account for at least 7% to 8% of the total U.S. drug market.

Nearly all of the billions in 340B discounts have accrued to hospitals. Yet hospitals' charity care has dropped amid the 340B program’s growth. The charts have the details.

So where did the money go? We have no idea, because hospitals and their lobbyists fight any call for them to disclose or account for how they use their 340B profits—while consistently misrepresenting the program's size and growth. Be skeptical when you read random stories about the generosity of a 340B covered entity. As always, the plural of anecdote is not data.

Read on for the latest details and ponder who really benefits from the 340B program's size—and how much longer this shocking growth can continue.

Thursday, August 29, 2019

CVS, Express Scripts, and the Evolution of the PBM Business Model (rerun)

This week, I’m rerunning some popular posts while I work on the forthcoming 2019-20 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. Click here to see the original post and comments from May 2019.

This article was written before the rebate rule was withdrawn. That's why the PBMs Reborn scenario described below remains relevant.


Over the next week, CVS Health and Cigna will hold their annual investor days. (Links below.) They will offer business and financial overviews of their diverse companies, including an update on the outlook for their pharmacy benefit managers (PBMs).

It’s a tough time to be a PBM. Compensation models are shifting, due to increased scrutiny by payers, regulators, and politicians. Plan sponsors are more sophisticated and seek greater pass-through of rebates, admin fees, and other manufacturer-provided revenues. Network spreads are under pressure, while specialty pharmacy dispensing accounts for a growing share of profits. Plus, the entire drug channel system could move toward a world without rebates.

Below, I update Drug Channels Institute’s look at PBM market share and reflect on four crucial areas in which PBMs’ compensation will be evolving. No PBM discloses detailed information about the sources and composition of its profits, so consider my observations as general guidelines for evaluating the upcoming investor day commentary from management.

Wednesday, August 28, 2019

The State of Specialty Pharmacy 2019: Industry Trends and Photos from #Asembia19 (rerun)

This week, I’m rerunning some popular posts while I work on the forthcoming 2019-20 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. Click here to see the original post and comments from May 2019.

Last week, Paula and I had the pleasure of attending Asembia’s 2019 Specialty Pharmacy Summit at the wonderful Wynn Las Vegas.

The Specialty Pharmacy Summit remains the most important forum for learning, networking, and conducting business throughout the entire specialty marketplace.

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

Below, I offer reflections on the meeting, share my experiences during the featured session, and highlight four crucial specialty industry trends. You’ll also find a link to the conference’s Featured Session slides and cool photos—including two of the many selfies for which I posed during the meeting. Enjoy!

Tuesday, August 27, 2019

Profits in the 2019 Fortune 500: Manufacturers vs. Managed Care vs. Pharmacies, PBMs, and Wholesalers (rerun)

This week, I’m rerunning some popular posts while I work on the forthcoming 2019-20 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. Click here to see the original post and comments from June 2019.

Time to dive into our 12th (!) 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.

Fortune’s 2019 list contains only six drug channel companies: AmerisourceBergen, Cardinal Health, CVS Health, McKesson, Rite Aid, and Walgreens Boots Alliance.

Consolidation and vertical integration have transformed the channel—and the Fortune rankings. Below you will see our list of the companies that disappeared from the roster. We therefore have added to our analysis the four managed care and insurance companies on the list that operate PBMs.

Using the Fortune data, I explore the profitability and shareholder returns of the largest drug channel and managed care companies. I compare these companies with the Fortune 500’s eleven pharmaceutical manufacturers and with a separate survey of independent pharmacies.

These data remind us that many multi-billion-dollar businesses profit as drugs move through the U.S. reimbursement and distribution system. Enjoy our swim through this crazy complexity.

Monday, August 26, 2019

Which PBM Best Managed Drug Spending in 2018: CVS Health, Express Scripts, MedImpact, or Prime Therapeutics? (rerun)

This week, I’m rerunning some popular posts while I work on the forthcoming 2019-20 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. Click here to see the original post and comments from May 2019.

It’s time for our annual Drug Channels’ examination of drug spending reports. For 2018, we again aim our magnifying glass at the annual trend reports from four large pharmacy benefit managers (PBMs): CVS Health, Express Scripts, MedImpact, and Prime Therapeutics. (See their report links below.) The other large PBMs—Humana and OptumRx (UnitedHealth)—provide no public transparency into their performance.

Using these data, which account for most of the commercial market, we detect the following key trends for 2018:
  • Once again, we find that drug spending is not skyrocketing—contrary to what you often hear from journalists and politicians. Spending grew by about 2% in 2018, continuing a multiyear decline in the growth rate. Total drug spending at some plan sponsors even declined.
  • Spending on traditional drugs dropped by mid-single digits, continuing a multi-year trend driven by generic drug deflation.
  • For specialty drugs, higher utilization—not drug costs—was the biggest factor driving specialty spending growth. This wasn’t true for all specialty categories, however.
Patients—in the aggregate—gain from the slower growth in drug spending. What’s missing from the PBM reports is a transparent accounting of how much patients pay out of pocket for highly rebated drugs that are sold to insurers and PBMs at deep discounts. The hidden subsidies of the gross-to-net bubble remain—for now.

Friday, August 23, 2019

Decreasing Prescription Abandonment with Price Transparency

Today’s guest post comes from Miranda Gill, Senior Director of Provider Network at CoverMyMeds.

Miranda discusses how high-deductible plans are making prescription drug patients behave more like consumers. As a result, patients want to know how much their prescriptions costs—before they pick it up.

CoverMyMeds offers RxBenefit Clarity, a real-time benefit check platform that is available in most electronic health records (EHR) platforms. Learn more in this new case study: Improving Prescription Decision Support with RxBenefit Clarity.

Read on for Miranda’s insights.

Tuesday, August 20, 2019

Drug Channels News Roundup, August 2019: Amazon Insanity, Diplomat’s Final Days, Express Scripts DIR Fees Exposed, and a Rebate Cartoon

Another news-laden summer is coming to an end. Time to pack away your bathing suit, send the kids back to school, and savor these curated curiosities that have washed up on our Drug Channels shore:
  • Amazon, PillPack, and collective insanity
  • For Diplomat Pharmacy, the end is nigh
  • Fresh info on Express Scripts’ DIR fees
Plus, a cartoon about … rebates?

P.S. @DrugChannels on Twitter is approaching 8,000 followers. Recent tweets have explored generic drug prices, importation, the retail pharmacy shakeout, hospital economics, ICER, Yoda, and more. Follow me for daily insights and cool links.

Monday, August 19, 2019

CBI's 14th Annual Value-Based Oncology Management Summit

14th Annual Value-Based Oncology Management Summit
October 3-4, 2019 | Saguaro Scottsdale | Scottsdale, AZ
www.cbinet.com/VBO

With the rapid influx of new oncology drugs and innovative treatments entering the market, there is a greater urgency to examine the impact of payer-provider payment reform on overall oncology costs and patient outcomes. Now in its 14th year, 14th Annual Value-Based Oncology Management Summit convenes payers, providers, PBMs, manufacturers and specialty pharmacies to discuss current trends, challenges and best practices to bend the oncology cost curve, enhance the quality of care and improve patient outcomes.

Visit www.cbinet.com/VBO for more information. Drug Channels readers will save $300 off the standard registration rate when they use promo code NMT596*.

JOIN VALUE-BASED ONCOLOGY LEADERS TO:
  • Assess the current success of alternative oncology payment models
  • Understand key components of provider readiness to accept risk in value-based contracts
  • Evaluate how shifting payment models, payer initiatives to promote palliative care and advanced care directives impact patient outcomes and total cost of care
  • Examine the role of treatment innovation, biosimilars and care-delivery improvement in managing oncology costs
  • Explore critical factors, both clinical and financial, affecting the adoption of biosimilars
  • Consider the potential impact of the increase in risk-based models on patient access, outcomes and costs
  • Discuss the evolving role of specialty pharmacy in filling gaps in the patient cancer care continuum
  • Prepare for a mandatory alternative payment model for radiation oncology — Explore the impact of the mandatory model on practices and patient outcomes
  • Address how to manage the business of oncology as risk-based reimbursement models increase
  • Review the current state of data interoperability within cancer care and consider the benefits of greater access for regulators, health systems, health plans and patients
DISTINGUISHED FACULTY:
  • Arif H. Kamal, M.D., MBA, MHS, FASCO, Associate Professor of Medicine and Business Administration, Duke University
  • Terrill Jordan, President, CEO and Board Member, Regional Care Cancer Associates, LLC
  • Jonathan Harding, M.D., Senior Medical Director, Senior Products Division, Tufts Health Plan
  • Steven Peskin, Executive Medical Director, Population Health, Horizon Blue Cross Blue Shield of New Jersey
  • Anne Hubbard, MBA, Director of Health Policy, The American Society for Radiation Oncology
  • Anthony V. Coletta, M.D., MBA, CEO and Chairman of the Board, Tandigm Health a wholly owned subsidiary of Independence Blue
  • Scott Soefje, PharmD, MBA, BCOP, FCCP, FHOPA, Director, Pharmacy Cancer Care, Assistant Professor of Pharmacy, Mayo Clinic
  • Nick Calla, Vice President, Pharma Relations, BioMatrix Specialty Pharmacy
  • And more!


Visit www.cbinet.com/VBO for more information. Drug Channels readers will save $300 off the standard registration rate when they use code NMT596*.

*Offer 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 15, 2019

CBI’s 5th Edition Drug Pricing Transparency Congress

CBI’s 5th Edition Drug Pricing Transparency Congress
September 18-19, 2019 | Sheraton University City | Philadelphia, PA
www.cbinet.com/DrugPricing

With the recent regulatory activity surrounding drug pricing transparency, bio/pharma manufacturers must continuously be ahead of the ever-evolving changes. Stay on the pulse of Federal and State reporting requirements, policy initiatives and strategic best practices for implementation at the 5th Edition Drug Pricing Transparency Congress taking place September 18-19 in Philadelphia.

Exclusive Offer for Drug Channels Readers:
Register Now to SAVE $300* using promo code DRG300

This meeting’s agenda provides timely and mission-critical updates on how drug pricing transparency regulations will impact commercialization, reimbursement, pricing and compliance practices, with an expert speaking faculty including those representing PhRMA, Sanofi, King & Spalding, Celgene, BIO, Boehringer Ingelheim, Sidley Austin, Pfizer, Mallinckrodt and more!

High Impact Topics Transforming Pricing Dynamics Include:
  • Anticipate New State Legislations to Watch in 2020 — A Practical Analysis
  • State Drug Pricing Transparency Level-Set — Reporting and Requirements Landscape
  • Status Update on Federal Initiatives for Transparency
  • State-by-State Analysis Showcase
  • Industry Talk — Set up an Internal Team to Respond to Drug Pricing Transparency Laws
  • PLUS! Choose Between Two Pre-Conference Workshops
    • A. Drug Pricing Transparency Bootcamp — Key Considerations and Learnings For Reporting
    • B. Strategize for 2020 — Breaking Down Transparency Headlines for Industry
Visit cbinet.com/DrugPricing to view the complete speaker and in-depth session lineup, then register using promo code DRG300 for this exclusive savings of $300 off!*

*Discount expires 9/17/19; 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.

Wednesday, August 14, 2019

As Hospitals Pursue Specialty Pharmacy (and Walgreens Bets More on 340B), PBMs Become Their Best Frenemies

The American Society of Hospital Pharmacists (ASHP) has just released its latest national survey of pharmacy practice in hospital settings. Download it here. (Available for purchase.) I always enjoy this annual treasure trove of insights.

This year’s survey updates our understanding of hospitals’ and health systems’ all-out pursuit of specialty pharmacy dispensing revenues. In 2018, more than 75% of the largest hospitals operated a specialty pharmacy. Check out the data below.

The 340B Drug Pricing Program has—and will continue to—encourage even more specialty pharmacy growth at hospitals. It is also providing a new way for Walgreens Boots Alliance to profit from 340B.

Amidst this growth, hospital-owned specialty pharmacies find themselves competing for prescriptions against pharmacy benefit managers (PBMs). These PBMs have built benefit networks that shift prescriptions away from hospitals in favor of the PBMs’ own specialty pharmacies.

Hospitals can fight PBMs for network access—or they can befriend a PBM-owned 340B contract pharmacy and still earn super-size profits. As you’ll see below, the odd combination of narrow networks and 340B is creating unexpected frenemies in the drug channel.

Monday, August 12, 2019

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

West Coast Real-Time Benefit Check & ePrior Authorization Summit
October 16-17, 2019 | Hyatt Centric Fisherman’s Wharf | San Francisco, CA
www.cbinet.com/eBenefit

CBI’s 12th Real-Time Benefit Check & ePrior Authorization Summit provides attendees with an understanding of key issues and developments in electronic patient services, including electronic benefit verification, real-time benefit verification, prior authorizations health records and prescribing services.

Visit www.cbinet.com/eBenefit for more information. Drug Channels readers will save $400 off the standard registration rate when they use promo code TTZ273*.

TOP FIVE REASONS TO JOIN US IN SAN FRANCISCO THIS YEAR:
  1. Advanced Case Studies — Learn from industry experts who have successfully implemented real-time benefit verification in their organizations
  2. Multi-stakeholder Panel Discussions — Hear from diverse perspectives on the advantages and challenges of integrating electronic patient services
  3. Regulatory Updates — Hear insights into the recent regulations released from CMS on Medicare Part D and real-time benefit tools
  4. Tech Talk — Deep dive into the future of real-time benefit verification technologies and its impact on healthcare
  5. Benchmarking and Networking — Take part in pre-conference surveys, interactive roundtables, coffee breaks and cocktail reception to make the most of your two-day experience and take away strategic insights you can only get at this meeting!
GAIN CRITICAL INSIGHTS AND STRATEGIES TO IMPROVE PATIENT ACCESS:
  • Examine how to configure interoperability in a local/regional health setting and recent efforts within the FHIR/HL7 standards
  • Hear how to streamline electronic benefit verifications and prior authorization solutions into a hub model
  • Discuss clinical and operational factors to consider when implementing portal PA solutions with medical specialty drugs
  • Understand the implementation steps needed to achieve real-time benefit verification
  • Address considerations for enrollment standards in hubs and specialty pharmacies
  • Facilitate efficient information exchange between key stakeholders, including manufacturers, health plans, health systems, PBMs and physicians
Featured Speakers include:
  • Nancee March, Director of Pharmacy Authorizations, Blue Shield of California
  • Brent Schwartz, Executive Director of Marketing and Access, Medical Dermatology, Allergan
  • Amanda Robinson, Access Services Manager, Fairview Specialty Pharmacy
  • Tyler Scheid, JD, Senior Policy Analyst, American Medical Association
  • Michele V. Davidson, Senior Manager, Pharmacy Technical Standards, Development and Policy, Government Relations, Walgreens Co
  • Michael B. Marchant, Director – System Integration & Health Information Exchange, UC Davis Health
  • Hannah Fine, CPhT, Pharmacy Medication Authorization Technician, UVA Specialty Pharmacy Services
  • And more!

Visit www.cbinet.com/eBenefit for more information. Drug Channels readers will save $400 off the standard registration rate when they use promo code TTZ273*.

*Offer 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.

Wednesday, August 07, 2019

Here’s How PBMs and Specialty Pharmacies Snag Super-Size Profits from the 340B Program

Last week, I documented how the biggest independent and PBM-owned specialty pharmacies participate as contract pharmacies within the 340B program. These specialty pharmacies are owned by CVS Health, Cigna (Express Scripts), OptumRx (UnitedHealth Group), Walgreens Boots Alliance/Prime Therapeutics, and Diplomat Pharmacy.

Today, let’s follow the prescription dollar to expose how specialty pharmacies and covered entities profit from 340B prescriptions. We rely on confidential disclosures made to the U.S. Government Accountability Office (GAO).

You’ll see the indisputable prescription math that permits large specialty pharmacies to share in the 340B discounts that covered entities earn. These pharmacies’ profits can be $1,000 per prescription—far exceeding their typical profits from dispensing a third-party-paid prescription.

No wonder PBMs and specialty pharmacies are racing to become 340B contract pharmacies!

For years, hospitals and their lobbyists have been claiming that discounts from the 340B program support care for low-income and uninsured patients. What they don’t say: These discounts are also supporting some of the largest public companies in the U.S.

Monday, August 05, 2019

CBI’s 7th Annual Coupon and Copay Forum

CBI’s 7th Annual Coupon and Copay Forum
October 2-4, 2019 | Sonesta Rittenhouse Square | Philadelphia, PA
www.cbinet.com/coupon

Exclusive Offer – Register by 8/23/2019 and
save $500* (mention promo code COUPDC)

These continue to be turbulent times for life sciences manufacturers, as the drug pricing debate shows no signs of wavering, state legislation to ban copay accumulator programs intensifies, and rebate reform gets replaced by Trump’s push for ‘most favored nation” drug pricing policy. Staying on the pulse of the patient affordability landscape and overcoming patient access barriers by leveraging strategic copay programs is more paramount than ever.

CBI's flagship Coupon and Copay Conference, taking place October 2-4 in Philadelphia, is an important event devoted exclusively to designing (and re-designing) copay programs aimed at driving patient access and affordability to offset high-cost therapies and deductibles.

By popular demand, the 2019 agenda includes an all-new programming feature with one day of content devoted to the pressing topic of copay accumulators. Don’t miss three full days of jam-packed content on coupons, copays and accumulators covering:
  • State and federal progress regulating copay accumulator programs
  • Alternative copay strategies to respond to the rise of copay accumulator and maximizer programs
  • Shifts in benefit plan design today and over the next 2-5 years
  • Drug pricing legislation and potential impact on patient access
  • Innovative copay program designs
  • Impact of copay assistance programs on overall healthcare costs
  • Potential effect of the price transparency debate and consumerism on patient adherence rates
  • Performance metrics to justify the cost of copay programs
  • And so much more!
Register today and save $500 or learn more at www.cbinet.com/coupon.

*Discount offer valid through 8/23/2019; applies to standard rates only and may not be combined with other offers, categories, 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.

Thursday, August 01, 2019

Specialty Pharmacies and PBMs Hop On the 340B Money Train

I recently documented the astounding growth in the number of pharmacies participating in the 340B Drug Pricing Program.

Below, we turn our attention to specialty pharmacies and PBMs in the 340B program. We have updated our exclusive analysis of how the biggest independent and PBM-owned specialty pharmacies participate as contract pharmacies within the 340B program.

The five largest specialty pharmacies are owned by CVS Health, Express Scripts, OptumRx, Walgreens Boots Alliance/Prime Therapeutics, and Diplomat Pharmacy. As you will see below, these specialty pharmacies account for more than 20% of total contract pharmacy relationships with 340B hospitals and other covered entities. Yet they represent only 1% of 340B contract pharmacy locations.

We also review 340B participation by other large independent pharmacies.

Large, multi-billion-dollar, for-profit companies don’t participate in government programs unless there is money to be made. So next week, we’ll follow the prescription dollar to explore how specialty pharmacies and covered entities profit from 340B prescriptions.

Tuesday, July 30, 2019

Drug Channels News Roundup, July 2019: Amazon/PillPack, Novo Nordisk on the G2N Bubble, Copay Accumulators, and Adam's Favorite Chart

Let’s cut through the steamy summer haze with our refreshing selection of articles and insights. In this issue:
  • New details about Amazon’s PillPack deal
  • Novo Nordisk’s CEO on the gross-to-net bubble
  • Fresh data on adherence problems with copay accumulators
  • My all-time favorite chart!
Plus, I am dazed and confused by a Specialty Pharmacy Times article.

P.S. Stay current with my daily links to cool stuff at @DrugChannels on Twitter.


ON SALE! We are offering our 2018–19 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors at discounts up to 30% off. Sales prices valid thru 9/3/19. The updated 2019-20 edition will be available in early October 2019.

Monday, July 29, 2019

CBI’s 5th Annual Life Sciences Compliance Congress for Specialty Products

CBI’s 5th Annual Life Sciences Compliance Congress for Specialty Products
September 12-13, 2019 | Hyatt Regency | Cambridge, MA
www.cbinet.com/SpecialtyCompliance

CBI’s 5th Annual Life Sciences Compliance Congress for Specialty Products conference, taking place September 12-13 in Cambridge, MA, is tailored to the distinctive business needs and compliance challenges of specialty biotech and pharmaceutical manufacturers.

Exclusive Offer for Drug Channels Readers: Register Now to SAVE $400* using promo code TXF846

This CCB, CPE, CLE accredited conference provides numerous interactive sessions, panel discussions and networking events, optimizing face-to-face engagement with fellow compliance and legal industry professionals, including:
  • Create your own tailored conference experience with 4 comprehensive breakout sessions
  • Gain insights into the government perspective with a keynote panel featuring U.S. Attorneys from the District of Massachusetts, District of New Jersey and Southern District of New York
  • Deep dive into patient support and assistance with 3 focused afternoon sessions highlighting compliant patient interactions, nurse educator programs and copay assistance
  • Hear about the successes and letdowns of building compliance programs from the ground-up during the closing fireside chat with senior thought leaders
  • PLUS! This year will include the inaugural, invitation-only Legal & Compliance Leadership Summit, designed to encourage an open exchange of ideas and strategies surrounding some of the most critical issues facing compliance leaders across the industry
Hear valuable content on high-impact issues for breakthrough therapies from 40+ industry leaders including Acceleron Pharma, Sobi, Vertex Pharmaceuticals, EMD Serono, Radius Health, Sanofi Genzyme, Sarepta Therapeutics, Sunovion, Strongbridge BioPharma, TherapeuticsMD, Avanir Pharmaceuticals, TESARO, Servier Pharmaceuticals, Alexion, Akebia Therapeutics, Takeda, Sage Therapeutics, Boehringer Ingelheim, Boston Biomedical, Blueprint Medicines and more!

Visit www.cbinet.com/SpecialtyCompliance to view the complete speaker and in-depth session lineup, then register using promo code TXF846 for this exclusive savings of $400 off!*

*Discount expires 9/11/19; 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.

Friday, July 26, 2019

Improving Medication Access Through Network Connections to Impact More Patients

Today’s guest post comes from David Holladay, President of CoverMyMeds.

David discusses the obstacles and frustrations patients experience as they navigate the patient journey. He describes CoverMyMeds’ technology solutions that have helped solve medication access and adherence challenges for patients.

To learn more about technology-enabled patient support, download this new case study: Comprehensive Prior Authorization Support to Help Impact More Patients.

Read on for David’s insights.

Tuesday, July 23, 2019

Our STAT Op-Ed: Drug Importation Can’t Coexist with U.S. Track-and-Trace Law

STAT recently published our op-ed: State drug importation laws undermine the process that keeps our supply chain safe.

I co-authored this op-ed with Dirk Rodgers, an independent consultant and author of the excellent RxTrace blog.

As we see it, there is no legal or operational way of transforming a drug packaged for a foreign market into a drug that meets the U.S. requirements of our in-progress track-and-trace system. What’s more, there is no way to alter the law to enable importation without undermining the law’s purpose and value.

States can't wish away the requirements of a significant federal law. Either we have a secure drug supply chain or we don’t.

Note that our op-ed was published before Canada announced that it would resist drug exportation.

Full text below. Read on and let us know what you think.

Monday, July 22, 2019

CBI’s 13th Hub and SPP Model Optimization

CBI’s 13th Hub and SPP Model Optimization
September 26-27, 2019 | San Diego, CA
www.cbinet.com/hubswest

With mounting cost pressures and increased demands for affordable, value-based treatment options, our industry faces an increasingly competitive market, for both specialty and non-specialty products. Increasingly, companies must strategize to manage the most critical challenges associated with product and patient services. CBI’s 13th Hub and SPP Model Optimization provides executives with strategies for developing and integrating hub programs and other patient-centric services to ensure product access and maximize reimbursement.

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 YZN462 and register prior to August 9th.*

Just a few highlights from the program include:
  • Current litigation/court rulings that impact Hub and SP Models
  • Integration of medical and pharmacy benefits
  • AI across patient access programs to improve conversion and adherence
  • Key learnings on aligning patient services and market access for rare disease launch success
  • Examining EHR data to generate claims data and understand care episodes to see the effectiveness of a therapy
  • Evaluating key patient and therapeutic traits that influence hub model design
  • Best practices for combining data sources to provide a complete picture of the patient journey
  • Tips to prepare for the hubs of the future and designing patient-centric hub models
Download the agenda here and prepare to return to the office armed with critical updates and valuable takeaways.

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 YZN462 and register prior to August 9th.*

CBI will see you there!

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rates, clinic/hospital rates, non-profit rates or other offers. 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 19, 2019

Expanding Patient Engagement in Commercial Healthcare

Today’s guest post comes from Pritesh Patel, Commercial Segment Director of Clinical Effectiveness at Wolters Kluwer, Health.

Pritesh presents a case study of how technology improved patient engagement, which translated into better patient health outcomes. To learn more, download their complete ebook: Patient Engagement in Commercial Health.

Read on for Pritesh’s insights.

Thursday, July 18, 2019

Walgreens, CVS, and Walmart Lead the 25,000 Pharmacies Now Profiting From the 340B Program

It’s time for our annual look at the booming pharmacy component of the 340B Drug Pricing Program. Our latest, exclusive analysis finds that:
  • About 25,000 pharmacy locations now act as contract pharmacies for the hospitals and other healthcare providers that participate in the 340B program. Contract pharmacies now account for almost 40% of all pharmacy locations in the United States. Wow.
  • The total number of pharmacy locations has grown by 14% over the past 12 months and has almost doubled since 2013.
  • Six large retail chains—Walgreens, CVS, Walmart, Rite Aid, Kroger, and Albertsons—account for two-thirds of 340B contract pharmacy locations. CVS added 1,200 locations—as many as the other five chains combined.
Clearly, multi-billion-dollar, for-profit, publicly traded pharmacy chains are benefiting from the 340B discounts intended for covered entities. Below, I offer some policy suggestions so that we can better understand what's going on here.

In upcoming articles, I’ll examine pharmacy benefit manager (PBM) and specialty pharmacy participation in 340B and explain the oversize profits that pharmacies can earn from the program.

For now, you should ponder how and why the 340B program continues its unbridled takeover of the pharmacy industry...and beyond.

Tuesday, July 16, 2019

JAMA: Withdraw This Flawed and Inaccurate Article About the 340B Program and Drug Prices

The Journal of the American Medical Association (JAMA) recently published Estimated Changes in Manufacturer and Health Care Organization Revenue Following List Price Reductions for Hepatitis C Treatments by Sean Dickson and Ian Reynolds. The paper purports to show that manufacturers’ net revenues increased following a decrease in three drugs’ list prices.

However, the paper contains a significant computational error: The authors do not properly calculate the 340B ceiling price. Consequently, the authors’ calculations are inaccurate and their conclusions are erroneous. As we might expect, a manufacturer’s revenue per-patient doesn’t increase when list prices decline and net prices remain constant.

Below, I explain how to compute a drug’s ceiling price under the 340B Drug Pricing Program. I then illustrate the crucial mathematical error in the JAMA paper. I also briefly highlight a few other errors and omissions in the paper.

The paper’s serious and irredeemable flaws imply that readers will be significantly misinformed about drug prices and the 340B program. You may or may not agree with me about the 340B program. But I hope you will concur that respected academic journals should publish truthful and accurate information.

Monday, July 15, 2019

CBI’s 3rd Annual Finance & Account for Bioscience Companies

CBI’s 3rd Annual Finance & Account for Bioscience Companies
September 24-25, 2019 | Boston Marriott | Cambridge, MA
www.cbinet.com/BioFinance

Exclusive Offer for Drug Channels Readers:
Register Now to SAVE $400* using promo code ACC400

CBI’s Finance & Accounting for Bioscience Companies conference, taking place September 24-25 in Cambridge, MA, is tailored to the distinctive business needs and technical accounting challenges of small-middle market biotech, pharmaceutical and device companies.

During this CPE, CLE accredited conference, Finance and Accounting executives gain commercialization and product launch strategies, frameworks for managing gross-to-net estimates and mitigating risk, models to scale and grow a best-in-class finance function, timely updates on tax and legal matters, systems implementation case studies and industry expertise for communications and investor relations.

Hear valuable content on high-impact issues from CFOs, chief accountants, corporate controllers and more from a broad range of life sciences companies, including those representing Neon Therapeutics, Alnylam, Akcea Therapeutics, Karyopharm, Ironwood Pharmaceuticals, RSM US LLP, Spring Bank Pharmaceuticals, Shire, Karuna Therapeutics, Novapeutics, Sunovion Pharmaceuticals, Bluerock Therapeutics, Merck and more! Plus, attendees choose from two tracks of sessions, one tailored for Clinical-Stage Companies and one tailored for Commercial-Stage Companies.

Visit cbinet.com/BioFinance to view the complete speaker and in-depth session lineup, then register using promo code ACC400 for this exclusive savings of $400 off!

*Discount expires 9/23/19; 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.

Friday, July 12, 2019

Six Reasons Why the Rebate Rule Failed—And What’s Next

Yesterday, we all awoke to the unexpected news that the Department of Health & Human Services (HHS) withdrew its plans to reform rebates in federal programs. The world without rebates has been delayed—perhaps indefinitely.

Below, I highlight six key policy and political factors behind this decision. I also discuss winners and losers among drug channel participants.

The underlying problems of the the gross-to-net bubble remain. As H.L. Mencken observed: “There is always a well-known solution to every human problem—neat, plausible, and wrong.” Get ready for a slew of drug pricing policy proposals that perfectly fit these criteria.

Thursday, July 11, 2019

The Gross-to-Net Bubble Reached a Record $166 Billion in 2018 (rerun)

This morning, the White House withdrew its proposed rule to reform the rebate system in federal programs. I am surprised by the timing, which likely has more to do with politics than policy. Tomorrow, I'll post some reflections on this unexpected news. 

In the meantime, today's rerun is a reminder of what's still at stake in reforming rebates within the U.S. drug channel

Click here to see the original post and comments from April 2019. You can also reach this post at www.GrossToNetBubble.com. ;)

The gross-to-net bubble—the ever-growing pile of money that sits between a manufacturer’s list price for a drug and the net price after rebates and other reductions—reached another high last year.

Drug Channels Institute developed the term gross-to-net bubble to describe the speed and size of growth in the total value of manufacturers’ gross-to-net reductions.

We estimate that in 2018, the total value of gross-to-net reductions for brand-name drugs was $166 billion. As you will see below, that figure doubled over the preceding six years. Below, I also highlight the various elements that fill the bubble. About two-thirds of total gross-to-net reductions come from rebates paid to third-party payers.

The gross-to-net bubble reflects—and drives—many of the problems with U.S. drug pricing. However, recent movement toward a world without rebates suggests that we may soon hear this bubble pop.

Wednesday, July 10, 2019

How Health Plans Profit—and Patients Lose—From Highly-Rebated Brand-Name Drugs (rerun)

This week, I’m rerunning some popular posts during the holiday week. Click here to see the original post and comments from February 2019.

My Wall Street Journal op-ed (Don’t Blame Drug Prices on ‘Big Pharma’) has received a lot of attention.

Especially notable was a letter to the editor from American Health Insurance Plans (AHIP). It claims that “the savings that insurance providers negotiate are returned directly to consumers through lower premiums and out-of-pocket costs."

Don’t believe this misleading half-truth. It distorts the primary argument of my WSJ op-ed: Patients often pay full price for drugs that are sold to insurers at deep discounts.

Below, to show you why, I follow the dollar for an expensive, highly rebated brand-name drug used by a consumer with a high-deductible health plan. As you will see, the consumer pays more than twice the true discounted price of the drug. Meanwhile, the health plan pockets a large rebate.

That's the uncomfortable reality of the gross-to-net bubble that AHIP wants to hide. Insurers may not use rebates to lower the out-of-pocket costs for the patient whose prescription generated the rebate. And at the same time, AHIP indignantly blames "the prices drugmakers set." We all deserve better.

Tuesday, July 09, 2019

The Big Three Generic Drug Mega-Buyers Drove Double-Digit Deflation in 2018. Stability ahead? (rerun)

This week, I’m rerunning some popular posts. Click here to see the original post and comments from January 2019—complete with now-dated Bird Box references!

Oral generic drugs keep getting cheaper. The Food & Drug Administration (FDA) has intensified the generic industry’s competitive pressures with record drug approvals. The FDA’s actions, combined with the negotiating leverage of the large generic purchasing organizations, led to 2018’s persistent double-digit deflation in manufacturers’ selling prices for oral generic drugs.

Below, we update our analysis of these generic drug mega-buyers.

We estimate that for 2018, the three largest buyers  accounted for more than 90% of total U.S. generic drug purchases from manufacturers. In 2019, acquisitions and contract switches will shift market share among these groups, but not diminish their impact. It's no surprise that manufacturers lose their minds when seeing these monster firms.

There are now fewer therapeutic areas with excess inflation, so future price reductions will be smaller. What’s more, some generic manufacturers have signaled their intention to exit highly competitive generic drug categories in which prices have dropped. Look for oral generic prices to stabilize—and possibly rise—over the next 12 to 18 months. Perhaps the blindfolds will come off?

P.S. Portions of this post have been adapted from our forthcoming 2019 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. We'll be taking this updated and expanded edition out of our bird box on March 5!

Monday, July 08, 2019

PBMI’s 2019 Specialty Rx Forum

PBMI’s 2019 Specialty Rx Forum
September 10, 2019 | JW Marriott Minneapolis Mall of America | Minneapolis, MN
www.pbmi.com/srx19

In 2021 specialty pharmacy is expected to grow to $500 billion. Specialty drug spend is also expected to reach upwards to 60% of total drug spend. Healthcare stakeholders are not only challenged by the costs and increased utilization of specialty medications, but also by the uncertainty and complexity of specialty pharmacy.

Join PBMI and other healthcare stakeholders for a dynamic and interactive one-day event at PBMI’s 2019 Specialty Rx Forum on September 10, 2019.

The agenda covers a wide variety of topics such as:
  • New drugs in the specialty pipeline
  • Managing hemophilia
  • Cost savings through specialty generics and biosimilars
  • Lower net-cost drugs
  • Enhancing the patient experience through technology and data devices
  • Getting the most out of specialty contracts
  • And more.
Check out the full program here.

Early bird rates for this event end July 12, 2019.

Exclusive Offer for Drug Channels readers:

Drug Channels readers can use discount code SRX19 to extend the early bird rate through August 23, 2019! Do you have colleagues who would also like to attend? Feel free to extend this offer to them too.

Click here to register. If you register after July 12th, use discount code SRX19 at checkout to get the early bird rate.

Do you have questions, or are you interested in sponsoring this event? Contact Linda DeChant at ldechant@pbmi.com.


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

Monday, July 01, 2019

National Association of Specialty Pharmacy 7th Annual Meeting and Expo

National Association of Specialty Pharmacy 7th Annual Meeting and Expo
September 9-12, 2019 | Washington, D.C.
www.naspmeeting.com

Join the National Association of Specialty Pharmacy (NASP) at its 7th Annual Meeting and Expo September 9-12 at the Marriott Wardman Park in Washington, D.C.

The Annual Meeting and Expo hosts over 1,200 specialty pharmacy stakeholders including senior executives, pharmacy directors, staff pharmacists, consultants and other management-level personnel from specialty pharmacy providers, infusion pharmacies, pharma/biotech manufacturers, institutional pharmacies, managed care organizations, data management and analytic organizations, group purchasing organizations, distributors and suppliers to the industry.

Benefits of Attending:
  • Network with industry stakeholders and exhibitors
  • Earn continuing education credits
  • Share best practices in specialty pharmacy
  • Participate in wellness initiatives and fundraisers
  • Interact with thought leaders and industry experts
  • Extend clinical and practical pharmacy knowledge
  • Attend the Women in Specialty Pharmacy Luncheon
  • Present original or encore research
In addition to the activities listed above, the following workshops will be offered on September 12:
  • The 4th annual Specialty Pharmacy Law Conference delivers valuable insight into the current legal and regulatory requirements, and complexities associated with operating today’s specialty pharmacy. Attendees can receive continuing legal education credits as well as pharmacist continuing education (CE) credits.
  • The 3rd annual Certification in Specialty Pharmacy Exam Preparatory Course covers all essential topics to prepare pharmacists interested in taking the CSP exam. CE credit is available for completing the course.
  • NASP hosts the 2nd annual Home Infusion Workshop, in partnership with National Home Infusion Association, to provide attendees with a unique opportunity to learn more about the regulatory, legal, operational and clinical complexities of the home infusion industry.
The NASP Education Committee welcomes submission of original or encore research relevant to specialty pharmacy, outcomes related to specialty pharmacy products or services provided by specialty pharmacies. Accepted abstracts will be presented at the NASP Annual Meeting and Expo and published online in the PubMed-indexed Journal of Drug Assessment. Submit your research today.

Secure your spot at the NASP 2019 Annual Meeting and Expo by registering today!


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

Thursday, June 27, 2019

Drug Channels News Roundup, June 2019: PBM Spread Pricing, Rebate Walls, Reforming Part D, and Not-So-Smart Bulbs

Happy 243rd birthday, America! Before you launch your July 4 festivities, Drug Channels offers some fireworks of its own:
  • Surprising PBM spread pricing profits in Massachusetts plans
  • Eli Lilly explains rebate walls for specialty drugs
  • MedPAC suggests Part D changes—and endorses a well-known Drug Channels term!
Plus, the funniest video that I have ever seen.

P.S. @DrugChannels on Twitter now has more than 7,700 followers. See why by following my daily musings and cool links.

Tuesday, June 25, 2019

A CVS Lawsuit Uncovers Three Surprising Revelations about Amazon’s PillPack Strategy

Last week, a judge in Rhode Island issued a decision in CVS Pharmacy, Inc. v. John Lavin. Briefly: CVS had sued Lavin, who had been a senior vice president responsible for CVS Caremark's retail network contracting. Lavin had left CVS to work for Amazon’s PillPack business. CVS successfully argued that Lavin had violated the terms of his non-compete agreement

Below, you’ll find links for the public documents in the case.

I also highlight three surprising disclosures that arose in the decision. These shed light on PillPack’s contracting strategy with payers, its not-quite-disruptive plans for pharmacy benefit management, and its alleged attempts to get retail pharmacy reimbursement rates.

We’re all expecting Jeff Bezos to pull a rabbit out of his hat, but Amazon’s disruption may be different—and take longer—than many people expect.

Monday, June 24, 2019

CBI’s 5th Annual 340B Manufacturer Summit

CBI’s 5th Annual 340B Manufacturer Summit
August 20-21, 2019 | Alexandria, VA
www.cbinet.com/340BManufacturer

Given the increasing industry uncertainty and complex market dynamics, ensuring 340B program integrity has never been more paramount. Later this summer, CBI’s 340B Manufacturer Summit will bring you solutions to the most pressing challenges.

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 EYA692 and register prior to July 19th.*

Benefit from Interactive Discussions and Benchmarking with Multi-Stakeholder Perspectives Addressing:
  • 340B program developments and anticipated future rulings
  • 340B Drug Pricing Program Ceiling Price and Manufacturer Civil Monetary Penalties (CMP) regulation
  • Impact of HHS proposed reform and significance of the final rule
  • Best practices for preventing revenue leakage
  • Covered entity and contract pharmacy challenges and strategies for collaboration
  • Relevant case studies showcasing manufacturer successes and lessons learned
Can’t Miss Spotlight Session: Critical Updates on Government Initiatives within 340B
  • Delivered by Jeff Lucas, Health Policy Advisor, United States Senate
Plus, Choose Between Two In-Conference Workshops:
  • 340B Boot Camp — A 101 Primer on Program Intricacies and Regulatory Guidance
  • Senior-Level Think Tank— Best Practices to Improve Compliance and Prevent Revenue Leakage
Download the agenda here and prepare to return to the office armed with critical updates and valuable takeaways.

2019 is a year for change for the 340B program. It is essential now more than ever that manufacturers are ensuring compliance amid the integrity of the program being called into question. Join CBI to ensure that you are equipped with best practices for what the future holds.

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 EYA692 and register prior to July 19th.*

CBI will see you there!

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rates, clinic/hospital rates, non-profit rates other offers. 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 20, 2019

New 340B Health Reports Confirms the Program’s Size—But Double-Dips on Hospitals’ Community Benefit Obligations

340B Health, which lobbies for hospitals that participate in the 340B Drug Pricing Program, recently issued an eye-opening member survey. It found that 340B Health’s member hospitals reported total 340B discounts of $15.3 billion. (Details below.)

Hmm. That’s pretty darn close to our estimate of $14.9 billion, shown in 340B Program Purchases Reach $24.3 Billion—7%+ of the Pharma Market—As Hospitals’ Charity Care Flatlines. It looks like 340B Health has perhaps inadvertently validated our computations of the program’s size.

The 340B Health report also claims to show evidence that hospitals are properly using 340B funds.

In reality, the report merely affirms that hospitals are spending money to meet their fundamental legal and statutory community benefit obligations. Any money from 340B discounts shouldn’t be double-counted to meet hospitals’ fundamental spending requirements.

This latest report therefore again highlights the need for transparency and accountability to ensure that billions in 340B discounts are shared with the patients whose prescriptions generated those funds.

Tuesday, June 18, 2019

Meet the Top Ten Drugs of 2024 (Maybe)

The professional prognosticator EvaluatePharma recently released its World Preview 2019, Outlook to 2024 report, which projects prescription drug sales and R&D activity in the U.S. and abroad. (The report is free with site registration.)

You’ll find predictions for the ten best-selling U.S. drug products on page 24. Below is my handy summary chart comparing the 2024 list along with each product’s 2018 sales. For fun, I have also compared the 2018 actual sales with EvaluatePharma’s projections from 2013.

The figures should make us all humble about our ability to project the future. For many products, the EvaluatePharma figures sharply underestimated actual growth rates from 2013 to 2018. The projections to 2024 show that growth will accelerate, which to me suggests an overestimation of future growth. Notably, EvaluatePharma predicts that Humira will retain its sales lead, despite forthcoming biosimilar competition.

These projections, while useful, remind us of another valuable lesson: Good forecasters may not be smarter than everyone else—they merely have their ignorance better organized.

Monday, June 17, 2019

PBM Contracting 2019

PBM Contracting 2019
August 21-22, 2019 | Hilton Magnificent Mile Suites | Chicago, IL
www.cbinet.com/PBMContracting

Now in its 5th year, CBI’s PBM Contracting provides you a great opportunity to gather the most timely information, best practices, and innovations relating to pharmacy benefit management contracts. Unravel the many complexities surrounding the rapidly evolving PBM contracting landscape. You won’t want to miss powerful co-presentations, panel discussions, facilitated networking opportunities, and diverse perspectives on the changing industry dynamics impacting PBM contracting.

Drug Channels readers save $400 off the standard rate when you register and use discount code RXK565.

Hear the latest insights and innovations from industry thought-leaders:
  • Arlene Edlin, General Manager, Sales, Navitus Health Solutions
  • Garrett Brown, Assistant General Counsel, Employers Health Coalition
  • Natasha Davis, Senior Pharmacy Benefits Manager, North Carolina State Health Plan
  • Ben Daniels, Special Counsel, Foley and Lardner, LLP
  • Brandy Millen, Consulting Actuary, Milliman
  • Molly Breimhorst, Vice President, Financial and Analytical Services, PSG
  • And more!
Navigate the changing landscape and collaborate with peers on cutting-edge strategies:
  • Keep pace with regulatory requirements for PBM contracting
  • Benefit from a birds-eye view on the current regulatory status of drug manufacturer rebates
  • Gain tips on thinking outside-of-the-box for development of your prescription benefits plan design and contracts
  • Discover trends in what PBMs are offering in contracts
  • Review the structure of a PBM agreement and assess plans for oversight and monitoring
  • Discuss prescription drug plan pricing and PBM fees
  • Analyze how rebates are defined, potential trends and future of point of sale rebates
  • Provide actionable strategies for plan sponsors to optimize return on drug spending
Request the full agenda and reserve your seat for this important meeting today.

Plus! Drug Channels readers are entitled to an exclusive $400 discount! Just register using discount code RXK565 to receive $400 off* the standard rate when you sign up.

*Offer 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 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.

Wednesday, June 12, 2019

CVS Health: Will This Giant's Scale and Scope Confound Its Vision for Healthcare?

Last week, CVS Health held its annual investor day. (Links below.) In the aftermath of the Aetna transaction, CVS Health has become a uniquely diverse organization with revenues exceeding $250 billion.

As expected, CVS Health management explained the cost-cutting synergies that it expects from having united CVS Health and Aetna. It also laid out a long-range vision for generating value—and operating income—from making the disparate pieces of its empire work together in new ways. CVS Health called these new products and services “transformational initiatives.”

Below, I summarize investor day high points concerning CVS Health’s overall strategy, offer thoughts on the challenges facing the HealthHUB store concept, and highlight the headwinds and tailwinds affecting the company’s major business segments.

I commend CVS Health’s management for their willingness to take giant steps toward a bold vision. But I wonder if its transformation will scale with the speed and efficiency needed to generate superior returns for CVS Health and its investors. And along the way, how much margin will the company sacrifice to preserve its novel business combination?