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...

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?

Monday, June 10, 2019

CBI's Reimbursement and Access 2019

Reimbursement and Access 2019
August 13-14, 2019
DoubleTree by Hilton Center City | Philadelphia, PA
www.cbinet.com/Reimbursement

CBI’s Reimbursement and Access conference returns for the 7th year and takes place August 13-14, 2019 in Philadelphia, PA. This event arms attendees with real-time policy briefings, impactful managed market trends and strategies to ensure product access.

Drug Channels readers: use discount code QEF679 and save $500* off the standard rate when you register by July 19, 2019.

Below is a first look at the robust lineup of esteemed thought-leaders driving this year’s dialogue.
  • Christina Sandefur, Executive Vice President, Goldwater Institute
  • Jeff Henderson, Vice President, Head of Market Access and Government Affairs, Sobi, Inc.
  • J. Gabriel McGlamery, J.D., Senior HCR Policy Consultant, Florida Blue
  • Tami Carten, Executive Director, Market Access, Braeburn
  • Gregory Gierer, Senior Vice President, Policy, AHIP
  • Alex Keeton, Director, Policy Research and Analytics, BIO
  • Christina Simmons, Senior Corporate Counsel, Pfizer Inc
  • Ross Margulies, Associate, Foley Hoag LLP
  • Stacey Worthy, Counsel, Aimed Alliance
  • Kollet Koulianos, MBA, Senior Director, Payer Relations, National Hemophilia Foundation
  • William Daniels, Director, Business and Market Segment Development, Conduent
  • Douglas Neely, CMPE, Head, Global Market Access, Athenex Oncology
  • Rujul Desai, Of Counsel, Covington & Burling LLP
  • Colette Flack, Senior Director, Patient Support Services, Dermira
  • Jesse C. Dresser, Esq., Partner, Frier Levitt, LLC
  • Anthony Scicchitano, Assistant U.S. Attorney, U.S. Attorney’s Office for the Eastern District of Pennsylvania
  • Stuart Bell, Vice President Consulting, Medicines Access, Inceptua Ltd
  • Molly Burich, MS, Director, Public Policy – Biosimilars and Reimbursement, Boehringer Ingelheim
  • Everett Crosland, Vice President, Market Access, Reimbursement and Government Affairs, AppliedVR
  • Andy Molnar, Senior Director, Market Access, Cognoa
Request the full agenda and reserve your seat for this important meeting today.

Plus! Drug Channels readers are entitled to an exclusive $500 discount! Register using discount code QEF679 and save $500* off the standard rate when you sign up by July 19, 2019.

*Offer expires 7/19/19; 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 05, 2019

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

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, June 03, 2019

Medicaid Drug Rebate Program Summit 2019

Medicaid Drug Rebate Program Summit 2019
September 23-25, 2019
Renaissance Chicago Downtown | Downtown Chicago, IL

Join KNect365 for the 24th year of MDRP this September 23-25, 2019 at the Renaissance Chicago Downtown in Downtown Chicago, IL. This is your opportunity to benchmark best practices and gain solutions to overcome new operational challenges brought on by AMP Final Rule, 340B, Medicare Part B, Medicare Part D coverage gap, FSS, VA, OIG, and other critical government programs.


Register Now and use Priority Code P19MDRPDRUG to
SAVE an additional $200 off the current rates (a total of $800 in savings!)

Year after year, MDRP Chicago continues to be an important gathering for everything pricing, rebates, contracting, and collaboration. Ensure you have the most comprehensive educational experience over three days with access to government officials creating regulatory rules, the industry leaders interpreting them, and the pharmaceutical executives implementing them.

Collaborate with your peers and benchmark best industry practices:
  • Navigate Regulatory Hurdles with Comprehensive Coverage of Topics including:
    • State Drug Pricing Transparency
    • Case Study on Value-Based Contracting
    • Innovative Bundling
    • Calculations & Reporting Requirements: Challenges and Innovative Solutions
    • Principles of Reimbursement & Contracting Strategy
    • GTN: Finance, Accounting & Accruals
    • 340B Policy and Process
    • Analytics and Technology
    • Rebate Operations and Disputes
    • Generics and Biosimilars
  • MDRP’s top-notch speaking faculty includes industry leaders you need to hear from:
    • Krista Pedley, PharmD, MS, CAPT, USPHS, Director, Office of Pharmacy Affairs, Healthcare Systems Bureau, Health Resources & Services Administration (HRSA)
    • John D. Shakow, Partner, King & Spalding will provide insights into Medicaid and the changing landscape with the current Administration.
    • Alice Valder Curran, Global Regulatory Practice Group Leader, Hogan Lovells
    • Scott Atlas, MD, David and Joan Traitel Senior Felloe, Hoover Institution, Stanford University
    • External Counsel Roundtable: The State of MDRP - featuring Christopher H. Schott with Hogan Lovells, John D. Shakow with King & Spalding, and Jeff Handwerker with Arnold & Porter Kaye Scholer LLP.
MDRP offers attendees the opportunity for face-to-face meetings between states and manufacturers during our exclusive Dispute Resolution Meetings. These one-on-one meetings can help you realize millions in potential savings!

For 2019, MDRP have a record 21 confirmed states and counting: Alaska, Arizona, Arkansas, Colorado, Georgia, Idaho, Indiana, Kentucky, Maryland, Michigan, Nevada, New Hampshire, New York, North Carolina, Oregon, South Carolina, Tennessee, Texas, Utah, Virginia, Wisconsin.

Stay ahead of the curve by getting the best networking, education, and technology at MDRP Summit 2019

Click Here to Register Now and SAVE an additional $200 off the current rates. Be sure to use Priority Code: P19MDRPDRUG.


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

Thursday, May 30, 2019

Drug Channels News Roundup, May 2019: Express Scripts’ New GPO, More on Amazon/PillPack, a BS Update, and Vegas Video

Summer is unofficially here! Before you break out the grill, check out these officially noteworthy items:
  • Why did Express Scripts launch a GPO … in Switzerland?
  • Behind the scenes of Amazon’s deal for PillPack
  • More on BS in healthcare
Plus, a fun video recap from Asembia’s 2019 Specialty Pharmacy Summit—including some footage of your friendly neighborhood blogger!

P.S. Follow my daily musings and links to neat stuff at @DrugChannels on Twitter.

Wednesday, May 29, 2019

CVS, Express Scripts, and the Evolution of the PBM Business Model

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.

Tuesday, May 28, 2019

Partnering with IDNs BioPharma Strategy Summit East

Partnering with IDNs BioPharma Strategy Summit East
August 21-22, 2019 | Sonesta Rittenhouse Square | Philadelphia, PA
www.cbinet.com/IDN

Healthcare is undergoing unprecedented transformation driven by payer reform, consumer demands and scientific advancements. The shift from volume- to value-based payment and care delivery has driven healthcare providers to reshape their approach and many have answered the call for personalized, convenient and coordinated patient care by forming large organizations such as IDNs and ACOs. Understanding these complex health systems and how they interact with the industry’s stakeholders is crucial for manufacturers to better support and meet the needs of these growing networks.

REGISTER TODAY! Drug Channels readers will save $400 off the standard registration rate when they use discount code MGX763* by July 12, 2019.

To address the challenges and opportunities ahead, join a distinguished group of industry pioneers at CBI’s Partnering with IDNs BioPharma Strategy Summit East, for a highly collaborative meeting on refining care coordination, increasing patient engagement and adherence, and ultimately, improving patient outcomes.

Featured Speakers include:
  • Matthew Malachowski, PharmD, BCPS, Supervisor, Specialty Pharmacy Services, UAB Medicine
  • Gerard Taglianetti, Director, Biosimilars Contract Strategy, U.S. Payer & Channel Access, Pfizer Inc.
  • Rebekah Hanson Anguiano, Clinical Assistant Professor, Pharmacy Practice, Clinical Pharmacist, Ambulatory Pharmacy Services, University of Illinois – Chicago
  • Michelle Steinfest, National Accounts and Payer Relations Director, Xeris Pharmaceuticals, Inc.
  • Sarah Johnson Conway, MD, Assistant Professor of Medicine, Johns Hopkins School of Medicine; Medical Director, Accountable Care, Office of Johns Hopkins Physicians; Medical Director, Johns Hopkins Hospital/Infusion Center; Associate Medical Director, Johns Hopkins Medicine Alliance for Patients, LLC
  • Christopher Boone, Vice President, Global Medical Epidemiology & Big Data Analysis Lead, Pfizer Inc.
  • Shibani Sharma, Project Manager, Population Health Management – OCIO, Northwell Health
  • Nisha Shah, PharmD., Research Pharmacist, Health Outcomes and Research Program, Vanderbilt University Medical Center
  • And more!
Visit www.cbinet.com/IDN for more information. Drug Channels readers will save $400 off the standard registration rate when they use discount code MGX763* by July 12, 2019.

 *Offer expires 7/12/19, 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, May 22, 2019

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

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.

Monday, May 20, 2019

Reimbursement and Access 2019

Reimbursement and Access 2019
August 13-14, 2019 | DoubleTree by Hilton Center City | Philadelphia, PA
www.cbinet.com/Reimbursement

For all companies within the life sciences arena, staying on the pulse of emerging trends, ensuring favorable reimbursement and justifying product prices are core pillars of overall product success. Whether your organization is pre-commercial or managing multiple products,
CBI’s Reimbursement and Access conference convenes stakeholders from across the life sciences community to provide insight into real-time policy briefings, impactful managed markets trends and strategies to ensure product access.

Drug Channels readers can register using discount code QEF679 to receive $500 off* the standard rate when you register by July 19, 2019.*

Gain critical insights from a distinguished speaking faculty representing AHIP, AppliedVR, Athenex Oncology, BIO, Boehringer Ingelheim, Cognoa, CSI Specialty Group, Foley Hoag LLP, Inceptua, National Hemophilia Foundation, Sobi Inc and many more!

Transform Access Strategies with Expert Insight and Compelling Discussions:
  • The Current State of Safe Harbor Protection for Rebates – Where Are We Now?
  • Realign Access Strategies to Overcome Challenges of Copay Assistance and PBM Restrictions
  • Trends in Benefit Design and the Continued Shift to High Deductible Plans
  • Medicare and Marketplace Coverage Policies Impacting Access
  • Patient Assistance Compliance and Oversight
  • The Role and Growing Use of Digital Therapeutics by Payers, IDNs and Health Systems
  • New Product Commercialization and Launch Scenario Planning
Drug Channels readers can register using discount code QEF679 to receive $500 off* the standard rate when you register by July 19, 2019.*

*Offer expires 7/19/19; 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.

Friday, May 17, 2019

A New Starting Point for Patient Support: Technology-Driven Hub Services

Today’s guest post comes from Erica Conroy, VP of Specialty at CoverMyMeds and Bill Nolan, VP/GM of Access and Adherence at RxCrossroads by McKesson.

Erica and Bill discuss the challenges that specialty pharmacy patients encounter when accessing and utilizing hub services. They also present evidence showing that how hub services positively affect patient outcomes.

To learn more, download CoverMyMeds’ whitepaper: Revolutionizing Patient Access and Support for Specialty Therapies: Multiple Sclerosis.

Read on for their insights.

Thursday, May 16, 2019

340B Health Gets It Wrong … Again

This week, Drug Channels published our annual update on the growth of the 340B Drug Pricing Program. See 340B Program Purchases Reach $24.3 Billion—7%+ of the Pharma Market—As Hospitals’ Charity Care Flatlines.

Right on cue, 340B Health, which lobbies for hospitals that participate in the 340B program, immediately issued its annual rebuttal of the Health Resources and Services Administration (HRSA) data that we used.

340B Health was particularly distressed that our analyses “focused on 340B sales instead of discounts.” Below, you will see that when the program is measured using 340B Health’s suggested approach, it accounted for 9% to 11% of the relevant market in 2018. That’s even higher than my computation, which showed that the 340B program constituted 7% to 8% of the total drug market that year.

We’re all entitled to our own opinions about the 340B program, but we’re not entitled to our own facts. It is indisputable that 340B contributes to a large and growing share of the market.

Tuesday, May 14, 2019

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

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.

Monday, May 13, 2019

CBI’s Strategic Medicare Contracting Forum for Bio/Pharmaceutical Manufacturers

CBI’s Strategic Medicare Contracting Forum for Bio/Pharmaceutical Manufacturers
June 19-20, 2019 | Alexandria, VA
www.cbinet.com/Medicare

CBI’s Strategic Medicare Contracting Forum for Bio/Pharma Manufacturers provides a real-time analysis of newly proposed regulations, including the proposal to eliminate rebates, the use of step therapy under Medicare Part B, changes to coverage gap, influence of the International Pricing Index and much more.

Exclusive Offer for Drug Channels Readers:
Register Now and SAVE $400* using promo code MED400.

Taking place June 19-20 in Alexandria, VA, we invite you to convene with fellow stakeholders to receive an in-depth look into legislative and regulatory changes to Medicare and how it will impact manufacturers. You and your team members will benefit from this opportunity by gaining insights from industry experts on the complex changes occurring within Medicare, walking away with critical perspectives and robust knowledge on key topics.

Hear from 20+ Key Experts on High-Impact Issues, including:
  • [Keynote Address] Washington Update on Medicare Policy — The White House
  • HHS Keynote Address — U.S. Department of Health and Human Services (invited)
  • International Pricing Index Model: Evaluate the Proposed Changes for Medicare Part B Drugs — American Action Forum and Pacific Research
  • Examine the Implementation Strategies for Step Therapy Under Medicare Part B — BIO and Bristol-Myers Squibb
  • [Panel Discussion] Discover Coverage and Payment Strategies for Novel and High Cost Therapies for Rare Diseases Under Medicare Parts A and B — Health Policy Strategies, Inc., King & Spalding and Gilead Sciences
  • Impact of Value Frameworks on Access to Medications — Pfizer Inc.
  • What’s Next for Medicare? — Perspective From Capitol Hill — U.S. House of Representatives
Visit www.cbinet.com/Medicare to view the complete speaker and in-depth session lineup, then register using promo code MED400 for this exclusive savings of $400 off!

*Discount expires 6/18/19; 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.

Tuesday, May 07, 2019

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

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!

Monday, May 06, 2019

Patient Support Services Congress


Patient Support Services Congress
June 19-20, 2019 | Sheraton University City | Philadelphia, PA
www.cbinet.com/PatientServices

Join your colleagues for CBI’s Patient Support Services Congress — an industry-driven meeting, where you can participate in a wide-ranging dialogue surrounding customized patient support, operational efficiencies and compliant program services.

Visit www.cbinet.com/PatientServices for more information. Drug Channels subscribers will save $250 off the standard registration rate when they use discount code DRC250* by March 1, 2019.


A DIALOGUE-DRIVEN MEETING FOR ENFORCEMENT TRENDS AND NEXT-GENERATION APPROACHES TO PATIENT SERVICES:
  • Examine the regulatory implications around copy cards and foundation relationships
  • Discuss challenges in providing compliant assistance to functionally uninsured patients under Medicare Part D
  • Assess the pros and cons of different support service models
  • Learn how hubs qualify patients based on reimbursement, insurance, and industry knowledge
  • Explore how manufacturers can tailor patient support services to individual facilities without losing the integrity of the program’s guidelines
  • Address in-house versus outsourced hub services and the role that compliance plays in those decisions
  • Review training and monitoring procedures for your field nurses to alleviate risk as operations scale up
ENHANCE YOUR LEARNING EXPERIENCE

Nurse Educator Programs takes place one day prior, on June 18th. Join your Compliance, Patient Access, and Medical Affairs counterparts to uncover leading strategies to ensure compliance throughout the design and management of Nurse Educator Programs.

Visit www.cbinet.com/PatientServices for more information. Drug Channels subscribers will save $250 off the standard registration rate when they use discount code DRC250* by March 1, 2019.


*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.

Friday, May 03, 2019

Specialty Pharmacy M&A: Our Look at 2018’s Deals (rerun)

This week, I’m rerunning some popular posts while I attend Asembia’s 2019 Specialty Pharmacy Summit.

Click here to see the original post and comments from January 2019.


Let’s kick off 2019 with a quick review of last year’s specialty pharmacy mergers and acquisitions (M&A). Our list (below) includes only deals that were publicly announced in 2018.

Pharmacy benefit managers (PBMs) were especially busy. CVS Health bought five specialty pharmacies. UnitedHealth’s OptumRx bought Avella Specialty Pharmacy, the largest independent specialty pharmacy.

Diplomat Pharmacy was uncharacteristically quiet during 2018, though it had been one of the most active acquirers in previous years.

The specialty pharmacy industry is rapidly maturing, so I expect many more exits in the coming years. Looking to pick up a fast-growing specialty pharmacy? Click here for your post-holiday shopping list.

Thursday, May 02, 2019

Independent Pharmacy Economics Keep Deteriorating (rerun)

This week, I’m rerunning some popular posts while I attend Asembia’s 2019 Specialty Pharmacy Summit.

Click here to see the original post and comments from January 2019.


Time for Drug Channels’annual look at independent pharmacy owners’ business economics, drawn from the recently released 2018 National Community Pharmacists Association (NCPA) Digest, Sponsored by Cardinal Health. Here's the press release: NCPA Releases 2017 Digest.

Below, I update our estimates on pharmacy economics and margins. Our analysis reveals that independent pharmacy owners have faced another year of deteriorating finances.

What's more, we estimate that in 2017, the average pharmacy owner’s salary fell to a level comparable to that of an employed pharmacist. Owning a pharmacy, with all of its hassles and additional obligations, now brings the same reward as being an employee. I wonder how many owners will conclude that it’s barely worth the risk and effort.

Read on for our look at pharmacy profits and some comments on the industry’s competitive dynamics, including the financial impact of direct and indirect remuneration (DIR) fees.

The pharmacy consolidation endgame is getting closer. The next time you see a pharmacy owner, offer your condolences.

Wednesday, May 01, 2019

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

This week, I’m rerunning some popular posts while I attend Asembia’s 2019 Specialty Pharmacy Summit.

This is an especially timely rerun. Believe it or not, Express Scripts' 2019 formulary prefers Eli Lilly's high-list/high-rebate Humalog insulin over the authorized generic version that is being sold at a 50% lower list price. The authorized generic will be preferred only on Express Scripts' Flex Formulary, which has very low adoption. 


Bottom line: Many plans still crave rebate dollars. Sorry, patients with deductibles and coinsurance. The gross-to-net bubble lives on! 

Click here to see the original post and comments from November 2018.


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, April 30, 2019

My Wall Street Journal Op-Ed: Don’t Blame Drug Prices on ‘Big Pharma’ (rerun)

This week, I’m rerunning some popular posts while I attend Asembia’s 2019 Specialty Pharmacy Summit.

Click here to see the original post and comments from February 2019.


Yesterday, The Wall Street Journal published my op-ed: Don’t Blame Drug Prices on ‘Big Pharma’. The article text is pasted below for those who don't subscribe.

I wrote this piece for a general business audience, though my arguments about rebates and patient out-of-pocket costs will be familiar to regular readers of Drug Channels. Alas, I had to omit such insider terms as gross-to-net bubble, direct and indirect remuneration, and SpongeBob SquarePants.

A personal note: I have been reading the WSJ daily since I was 18 years old. It’s a genuine thrill to see my byline on an op-ed in this newspaper. Another item off my bucket list!

Monday, April 29, 2019

Financial Strategies and Accounting for Bioscience Companies

Financial Strategies and Accounting for Bioscience Companies
June 11-12, 2019 | San Francisco, CA
www.cbinet.com/financialstrategies

Expectations have never been higher as more small and mid-sized life science companies prepare to launch new and innovative products in a competitive marketplace. Gross-to-Net remains a top risk, especially after a launch, and it is pivotal to achieve accuracy in GTN forecasts to avoid large adjustments.

Ensure success by gaining proven pre-revenue commercialization strategies, frameworks for managing gross-to-net estimates and mitigating risk, models to scale the business and grow a best-in-class finance function, hearing, timely updates on tax and legal matters, and industry expertise for communications and investor relations at CBI’s Financial Strategies and Accounting Summit for Bioscience Companies.

Visit www.cbinet.com/financialstrategies for further details and to register. Drug Channels readers will save $400 off the standard rate when they use discount code NHA949 and register prior to May 17th.*

Sign up for the agenda and speaker announcements here. Here’s a sneak peek into who you’ll be hearing from:
  • Alan Fuhrman, Chief Financial Officer, Amplyx Pharmaceuticals
  • Laurie Stelzer, Chief Financial Officer, Halozyme
  • Marc Belsky, Chief Financial Officer, Kezar Life Sciences
  • Robin Washington, Chief Financial Officer, Gilead Sciences
  • Mark Kaufmann, Chief Financial Officer, Ardelyx
  • Murray Kay, former Commercial Controller, Abbvie
  • Jennifer Sharpe, Executive Advisor, Life Sciences Revenue Analytics, IntegriChain
Visit www.cbinet.com/financialstrategies for further details and to register. Drug Channels readers will save $400 off the standard rate when they use discount code NHA949 and register prior to May 17th.*

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.

Friday, April 26, 2019

Help for the Patient Journey–Electronic Modernization of Medication Access

Today’s guest post comes from Ben Stormer, VP of Product Development and Strategy for Specialty at CoverMyMeds.

Ben discusses how automatic, streamlined electronic enrollment in patient hub services will improve patients' adherence to specialty medication.

To learn more, connect with CoverMyMeds at the Asembia Specialty Pharmacy Summit next week in Las Vegas.

Read on for Ben’s insights.

Thursday, April 25, 2019

Drug Channels News Roundup, April 2019: Cigna’s Insulin Program, Amazon's PillPack Moves, Magellan’s Biosimilar Success, Prime’s Formulary Exclusions, and a World Without Rebates

April is over, and now, come what May, it’s time for our monthly roundup of news stories highlighting key trends for U.S. drug channels. In this issue:
  • My $0.02 on the Cigna/Express Scripts’ $25 insulin program
  • Amazon starts marketing PillPack to Prime customers
  • Surprise! Magellan drives major biosimilar adoption.
  • Prime Therapeutics shows the power of formulary exclusion
Plus, read media coverage of our recent webinar: Preparing for a World Without Rebates.

P.S. Join the more than 7,400 people who follow my daily updates and links to neat stuff at @DrugChannels on Twitter.

Tuesday, April 23, 2019

The Specialty Pharmacy Boom: Our Exclusive Update on the U.S. Market

It’s time for Drug Channels Institute’s annual update of the number of U.S. specialty pharmacies.

As always, I had outstanding research assistance. (See photo at right.) But even we can’t count the total number of pharmacies dispensing specialty drugs, since any pharmacy can designate itself a specialty pharmacy.

We therefore counted every pharmacy location that had achieved accreditation by an independent organization.

Our exclusive findings:
  • As of the end of 2018, more than 900 unique pharmacy locations had achieved specialty pharmacy accreditation from one or more of three major independent accreditation organizations. The 2018 figure marks a 25% increase over the 729 locations in 2017 and is more than double the 2015 figure.
  • Pharmacy locations owned by healthcare providers—hospitals, health systems, physician practices, and providers’ group purchasing organizations—now account for more than one-quarter of all accredited specialty pharmacy locations.
Enjoy more of our arithmomania below. It will help explain why you’ll count more people than ever at next week’s Specialty Pharmacy Summit 2019. Drug Channels Institute will be there, so please say hello, e.g. “Greetings, it is I, a Drug Channels reader.”

Monday, April 22, 2019

CBI’s 15th Annual Commercial Contract & Chargeback Excellence

CBI’s 15th Annual Commercial Contract & Chargeback Excellence
June 25-26, 2019 | Philadelphia, PA
www.cbinet.com/chargebacks

Heading into Year 15, CBI’s Commercial Contract & Chargeback Excellence conference has become a must-attend for pricing and contracting professionals, offering interactive dialogue and best practices to guide you through a rapidly changing market.

Visit www.cbinet.com/chargebacks for further details and to register. Drug Channels readers will save $400 off the standard rate when they use discount code ZKE535 and register prior to May 10th.*

Our esteemed speaking faculty, made up of companies such as Pacira Pharmaceuticals, Premier, Celgene, McKesson, Chiesi USA, Zydus Pharmaceuticals and more, will collaborate and offer perspectives on chargeback efficiency, class-of-trade, GPO membership management, contract administration, and everything in between.

Download the agenda here and see in-depth coverage on critical topics, such as:
  • Key trends and drivers of change impacting the commercial contracting landscape and market access
  • New strategies for risk-share agreements and value-based contracting
  • Optimize data exchange between trading partners from the wholesaler perspective
  • GPO Best practices for streamlined membership management and accountability
  • Valuable strategies for payer cost control approaches in the contracting space
  • Impact of HHS Proposed Rule to eliminate prescription drug rebates on contracting stakeholders
Plus! New for 2019!
  • In-Conference Workshops on the following topics: Class-of-Trade Membership Management, Value-Based Contracting Agreements, Pricing, Contracting and GTN Considerations at Launch, EDI Data Exchange, and 340B Pricing and Chargeback Reconciliation
  • Tracked programming diving into the strategies and best practices for both complex contracts management and GPO and chargeback administration
Visit www.cbinet.com/chargebacks for further details and to register. Drug Channels readers will save $400 off the standard rate when they use discount code ZKE535 and register prior to May 10th.*

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, April 18, 2019

TrialCard: The Role of Hub Services in an Era of Drug Price Transparency, Value-Based Care, and Consumerism

Today’s guest post comes from Scott Dulitz, Chief Strategy Officer at TrialCard.

Scott discusses the evolution of pharmaceutical manufacturer hub programs. As he explains, crucial industry trends are changing how patients and healthcare providers interact with and evaluate support services.

To learn more about TrialCard’s patient management solution, view TrialCard's recent video: Emerging Market Trends Shape Hub/Market Access Services, or email Scott at scott.dulitz@trialcard.com.

Read on for Scott’s insights.

Tuesday, April 16, 2019

The Road to 2020: Understanding the Regulatory Timeline for Part D Rebate Reform

The Department of Health & Human Services (HHS) keeps signaling that it wants to move us toward a world without rebates. Right now, it is evaluating comments on its proposal to remove rebates from federal programs. HHS wants to implement this rule in time for the January 1 start of the 2020 Medicare Part D plan year.

I would like, if I may, to take you on a journey through the 2019 regulatory timeline for both Part D and the proposed rule. As you will see, there is still a viable—but narrow—window for regulatory reform of rebates.

Despite our assessment, you should know that in the Medicare program, there are many implementation and logistical challenges in shifting rapidly toward a world without rebates. I outlined some of these issues in last Friday’s webinar: Preparing for a World Without Rebates. Don’t worry if you missed the live event. You can watch a replay and download the complete slide deck. CLICK HERE TO WATCH THE REPLAY.

In the meantime, read on for our look at the rest of 2019. I can see you shiver with antici...pation.

Monday, April 15, 2019

Rare Disease Innovation and Partnering Summit

Rare Disease Innovation and Partnering Summit
June 13-14, 2019 | Boston, MA
www.raredisease-summit.com

As genomics and advanced diagnostics expand our understanding of rare diseases, so too does the scope of impact expand. More than 30 million Americans live with a rare disease. While the industry has seen growth and heightened focus around the pursuit of orphan products and rare therapies, we’ve only scratched the surface.

CBI and EBD Group, along with support from the Alliance for Regenerative Medicine, Global Genes and MassBio, are pleased to announce the Rare Disease Innovation and Partnering Summit, a platform designed to increase chances of therapeutic success for drug developers, patient groups and investors within the rare disease marketplace. Business brings breakthroughs. Breakthroughs can transform lives.

Visit www.raredisease-summit.com for further details and to register. Drug Channels readers will save $300 off the standard rate when they use discount code SFK676 and register prior to May 10th.*

Take a deep dive into the critical and evolving topics impacting you today and hear from industry thought leaders and patient advocates who have designed and led innovative approaches to complex challenges in driving curative progress.

You can download the complete agenda here. Take a look inside:

Real Life Case Examples:
  • Develop New Models for Patient-Centric Registries – Parent Project Muscular Dystrophy
  • Leverage Novel Collaborations in Orphan Drug Commercialization – Notable Labs and Cures Within Reach
  • Mapping the Patient and Caregiver Journey – An Insights-Driven Approach to Building the Foundation of Patient Identification and Services – Rhythm Pharmaceuticals
PLUS! FDA Perspectives:
  • Regulatory and Policy Update – Legislative Updates and New Initiatives within the FDA’s Orphan Drug Program
    Featuring: Janet Maynard, MD, MHS, Director, Office of Orphan Products Development, FDA, Samir Shaikh, Deputy Director of Patient Affairs Staff, Office of Medical Products and Tobacco, FDA, Martine Zimmerman, Global Head, Regulatory Affairs, Alexion and John Hallinan, Chief Business Officer, Massachusetts Biotechnology Council
And! Benefit from Four Impactful Tracks:
  • Patient-Driven Progress
  • Reimbursement & Access
  • New Launch & Commercialization
  • Partnering & Investment
Additional perspectives and insight from 50+ leaders at companies such as Aegerion Pharmaceuticals, Alliance for Regenerative Medicine, Asklepios BioPharmaceuticals, Athersys, Bexion Pharmaceuticals, BioMarin, bluebird bio, Blueprint Medicines, Boston Children’s Hospital, Cotinga Pharmaceuticals, Cure CMT4J, Cydan II Inc., EveryLife Foundation for Rare Diseases, Geisinger, Global Genes, Horizon Pharma, Intercept Pharmaceuticals, Jackson Lab, Massachusetts General Hospital, MDA, Pfizer, Rare Access Action Project, Recordati Rare Diseases, Recursion Pharmaceutical, Sobi, Syros Pharmaceuticals, Tufts University School of Medicine, Xontogeny and more. Mark this as a must-attend event in 2019. Don’t miss it!

Visit www.raredisease-summit.com for further details and to register. Drug Channels readers will save $300 off the standard rate when they use discount code SFK676 and register prior to May 10th.*

CBI and EBD Group will see you there!

Produced by: CBI and EBD Group
Supported by: Alliance for Regenerative Medicine, Global Genes and MassBio

*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.