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 24,000 subscribers. Learn more...

Wednesday, March 20, 2019

A World Without Rebates: Predictions for How the Channel Will Evolve and Why Drug Prices Will Go Down

Two years ago on Drug Channels, I wrote about a shift from rebates to discounts as a black swan event—a massively important yet unexpected break from current practice.

Given recent developments, I believe that we are moving ever closer to a world without rebates. Yet there are many unanswered questions were such a radical shift to occur.

As I see it, a world without rebates would force manufacturers to use net price as a competitive weapon. If PBMs and payers behave logically, then drug prices would drop as manufacturers are forced to compete more aggressively for prescriptions.

These conclusions are based on the predictions about market changes that I describe below. Other key implications include:
  • Winner-take-all auctions and narrow formularies for categories with therapeutically comparable products
  • Broader formularies to encourage indication-based price competition for other therapeutic categories
  • Faster patient access to new drugs with superior efficacy for certain subgroups of patients
  • Fewer pharmacy benefit benefit tiers and a greater ability for physicians and patients to make cost/value tradeoffs
  • The popping of the gross-to-net bubble and declines in brand-name list prices
  • Slower growth in drug prices
This is a longer-than-average post, but I still only scratch the surface in speculating how our world could change. If the black swan continues to spread its wings, I’ll expand in future posts on implications for drug makers, pharmacy benefit managers (PBMs), wholesalers, pharmacies, health plans, and patients. As always, I encourage you to leave your comments and ideas below.

SAVE THE DATE: Drug Channels Institute will hold a special live, interactive webinar titled Competing in a World Without Rebates on April 12, 2019, at 12 PM ET. Details and registration information will be announced in the first week of April.

Monday, March 18, 2019

CBI’s Real-Time Benefit Check & ePrior Authorization Summit

CBI’s Real-Time Benefit Check & ePrior Authorization Summit
May 14-15, 2019 | Philadelphia, PA

CBI’s Real-Time Benefit Check & ePrior Authorization Summit is your chance to stay on the pulse of groundbreaking advancements and innovations in real-time benefit verification and prior authorizations in this evolving and complex healthcare environment. Convene with industry stakeholders from bio/pharma, PBMs, payers, health systems, prescribers and system solution providers to discuss the latest in standards, adoption and best practices to enable streamlined healthcare team workflow and quicker access to therapy to improve patient outcomes.

Visit www.cbinet.com/eprior for further details and to register. Drug Channels readers will save $300 off the standard rate when they use promo code ANS268 and register prior to April 5th. *

Download the agenda here and see in-depth coverage on critical issues, such as:
  • Real-Time Prescription Benefit and ePrior Authorization
  • New Regulations from CMS on Medicare Part D and RTBT
  • Implementing Medical Specialty Drug ePA
  • eBV and ePA Frameworks for the Future of the Medical Benefit
  • Reducing Friction in the Prescribing Process
  • Fixing ePrior from a Prescriber Perspective
  • Collaborating to Improve Patient Outcomes
  • Low Utilization of RTBC and ePA Among Stakeholders
  • Turnaround Time for Accelerated Patient Access to Therapy
  • Real-Time Benefit Data at the Point of Prescription
  • HL7 Da Vinci Project for Value-Based Care Interactions between Payers and Providers
Featured Sessions:
  • Trailblazer Talk- Hear Updates on Industry Scorecard
    • Melissa Paige, Oncology/Infusion Patient Access Principal Coordinator, University of Virginia
    • Eric Weidmann, M.D., Chief Medical Officer, eMDs
    • Evan Grossman, Vice President, Integration Services, athenahealth
  • Working Group for Specialty Pharmacy Advancements and Standard Updates in Real-Time Prescription Benefit and ePrior Authorization
    • John Klimek, R.Ph., Senior Vice President, Standards and Industry Information Technology, NCPDP
Visit www.cbinet.com/eprior for further details and to register. Drug Channels readers will save $300 off the standard rate when they use code ANS268 and register prior to April 5th. *

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.

Tuesday, March 12, 2019

Employers Are Absorbing Even More Manufacturer Rebates from Their PBMs

The likelihood of a radical restructuring of the U.S. drug channel has never been greater. A serious effort exists to remove or decrease the role of rebates.

Today, we shed light on one crucial aspect of the current rebate system: how employer-sponsored health plans access the billions of dollars in manufacturer rebates that are negotiated by their pharmacy benefit managers (PBMs). For this analysis, we rely on the Pharmacy Benefit Management Institute’s (PBMI) excellent new reports.

As you will see, employers are receiving an increasing share of the rebate money collected by pharmacy benefit managers. However, employers’ rebate agreements with PBMs vary widely. Important differences also exist in rebate arrangements for traditional vs. specialty drugs.

Despite these data, we still don’t know how much of these rebates offset out-of-pocket costs for the patients whose prescriptions generated the rebate funds. As I warned last August: The focus of rebate reform will turn from PBMs to the plan sponsors that are absorbing rebate dollars.

Monday, March 11, 2019

3rd Annual Manufacturers’ 340B Summit

3rd Annual Manufacturers’ 340B Summit
May 16-17, 2019 | Philadelphia, PA

Join pharmaceutical manufacturers, legal experts, thought leaders, and leading regulatory strategists at World Congress’ 3rd Annual Manufacturers’ 340B Summit, May 16-17, in Philadelphia. This event is your first opportunity of 2019 to ensure you have the internal strategies in place to effectively execute 340B processes.

Register with promo code DC200 and save an additional $200 on current early bird rates.

How will you benefit from attending?
  • Review the scope of the 340B Program and possible changes to the program
  • Utilize data to identify duplicate discounts and other inconsistencies
  • Explore challenges of contract pharmacies and solutions that work for all stakeholders
  • Evaluate the implications of penny pricing, limited, distribution networks, ceiling price calculation, and civil monetary penalties
  • Survey best practices for working with the states and covered entities
Shouldn’t you be there?

Register with promo code DC200 and save an additional $200 on current early bird rates.
Can’t leave the office? Live stream this event from the convenience of your office.

This event, co-located with the 4th Annual Covered Entities’ 340B Summit, provides comprehensive coverage of the 340B program.

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

Friday, March 08, 2019

Delivering an Enhanced Patient and Prescriber Experience for Personalized Therapies

Today’s guest post comes from Rob Brown, VP/GM of Pharmacy Solutions at McKesson Life Sciences.

Rob provides insights on designing patient-centric channel strategies. He also reviews the role of centralized hub services with an integrated specialty pharmacy.

Click here to download McKesson’s case study. It describes how an emerging biotech company streamlined access for patients with an acute complex condition.

Read on for Rob’s insights.

Tuesday, March 05, 2019

NEW: The 2019 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers

I am pleased to announce our new 2019 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers, available for purchase and immediate download.
We’re offering special discounted pricing if you order before March 22, 2019!

The 2019 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers is the only resource of its kind available anywhere. With 180 proprietary charts, exhibits, and data tables, the report provides the most comprehensive, fact-based tool for understanding the entire U.S. drug pricing, reimbursement, and dispensing system.

The 2019 edition has been significantly restructured since last year’s edition. Many sections and chapters have been expanded or reorganized to better cover the latest industry developments. Throughout the report, we have added new industry data sources, deepened our coverage of many topics, added more trending information.

Below, you can read more info and some behind-the-scenes tidbits. See page viii of the free report overview for a summary of the many significant changes and updates in this 2019 edition. Happy reading!

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

Monday, March 04, 2019

Join Me for Asembia’s Specialty Pharmacy Summit 2019

Asembia’s Specialty Pharmacy Summit 2019
April 29 to May 2, 2019 | Las Vegas

Please join me at Asembia's Specialty Pharmacy Summit 2019 which will take place from April 29 to May 2, 2019 in Las Vegas.

This is a must-attend event for anyone connected to specialty pharmacy. You'll meet an impressive diversity of people from pharmacies, manufacturers, health plans, wholesalers, hospital systems, pharmacy benefit managers, patient advocacy groups, and more. Click here to view the agenda.

This year, I will again lead the Featured Session, titled Specialty Pharmacy Industry Outlook: What's Next? I'll be joined by Doug Long from IQVIA and Lisa Gill from J.P. Morgan Securities. And of course, I'm looking forward to another epic selfie!

Here's my review of last year's Summit: Reflections from #Asembia18: The State of Specialty Pharmacy 2018.

Read on for more details about this great specialty pharmacy event and register now. See you in Vegas!


As the nation’s largest annual healthcare conference for specialty pharmacy, Asembia’s 2019 Specialty Pharmacy Summit will welcome 6,500+ attendees from over 1,200 pharmacy providers, health systems, pharma/biotech manufacturers, payers, drug wholesalers and many other specialty pharmacy stakeholders.

Don’t miss this unique opportunity to gain in-depth understanding of specialty pharmacy from industry experts who share current information and insightful commentary on the many facets of the $150+ billion specialty pharmacy channel.

The value-packed 2019 agenda includes interactive business seminars, continuing education sessions, business workshops, extraordinary networking events and engaging exhibits.

Register and learn more at www.asembiasummit.com.

Watch the 2018 Video Highlights.

Asembia's 2018 Specialty Pharmacy Summit - Event Highlights from Asembia on Vimeo.

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