Drug Channels delivers timely analysis and provocative opinions from Adam J. Fein, Ph.D., the country's foremost expert on pharmaceutical economics and the drug distribution system. Drug Channels reaches an engaged, loyal and growing audience of more than 30,000 subscribers. Learn more...

Thursday, February 13, 2020

Pharmacy DIR Fees Hit a Record $9 Billion in 2019—That’s 18% of Total Medicare Part D Rebates

Pharmacy-related price concessions in Medicare Part D—known as pharmacy DIR fees--have grown faster than most people realize.

We estimate that these payments reached $9.1 billion in 2019. This figure indicates that about 18% of total Medicare Part D rebates are now paid by pharmacies, not manufacturers. Details below.

To address concerns about how these fees are computed, the Centers for Medicare & Medicaid Services (CMS) has proposed some minimal transparency requirements for monitoring the metrics behind DIR fees. I suspect that the proposal will have no near-term impact on slowing the growth trends.

Our long time readers know that I’ve been skeptical about pharmacy owners’ claims regarding the impact of DIR fees. But it does now appear that these payments have become a significant economic burden. When the facts change, I change my mind. What do you do?

Tuesday, February 11, 2020

Preorder Now: The 2020 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers

On March 10, 2020, Drug Channels Institute will release The 2020 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. This report—our eleventh edition—remains the most comprehensive, fact-based tool for understanding the entire U.S. drug pricing, reimbursement, and dispensing system.

We are providing you with the opportunity to preorder this thoroughly updated and revised 2020 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 March 10.


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.

Special preorder and launch pricing discounts will be valid through March 22, 2020.

Monday, February 10, 2020

Informa Connect - CBI’s 6th Edition Drug Pricing Transparency Congress

Informa Connect - CBI’s 6th Edition Drug Pricing Transparency Congress
March 30-31, 2020 | Philadelphia, PA
www.cbinet.com/drugpricing

Are you and your team on the pulse? Hundreds of leaders in Drug Pricing have benefited from Informa Connect - CBI’s 6th Edition Drug Pricing Transparency Congress conference series. Join key stakeholders at this timely meeting as they address the current and future drug pricing transparency regulations, assess how companies are planning internally for these changes and gain a preview of what’s to come in 2020 and beyond.

As regulations and legislation continue to evolve, it is imperative for companies to stay ahead of these anticipated changes for strategic long-term planning. We encourage you to prepare for 2020 now. Drug Channels readers will save $400 off the standard rate when they use code DPT400 and register prior to February 28th*. Sign up to see the agenda here.

Experts from Boehringer Ingelheim, Sidley Austin LLP, Covington & Burling LLP, Porzio Life Sciences, LLC, Ingenus Pharmaceuticals, Chiesi USA, Inc., Sandoz, Amneal Pharmaceuticals, Novo Nordisk, ClassOne Insights, BIO, PhRMA, and more will lead robust discussions on topics such as:
  • Review State Transparency Requirements
  • Examine how the future of pricing transparency requirements will impact commercialization, reimbursement and drug pricing models
  • Keep a Pulse on New Legislation and Current Industry Efforts
  • Assess evolving drug pricing transparency legislation and litigation
  • Comprehend legal interpretations of drug pricing transparency and reporting laws currently on the books and the policy outlook for 2020 and beyond
  • Explore federal initiatives for pricing transparency
  • Benchmark with industry peers on managing transparency requirements and reporting for compliance
  • Safeguard your most sensitive information — Intersection of transparency legislation and trade secret law
New for 2020!
  • Enhanced State Transparency Reporting Requirements Showcase
  • Ask the Experts Round Up
  • 2-day programming and extended networking opportunities

Visit www.cbinet.com/drugpricing for further details and to register. Drug Channels readers will save $400 off the standard rate when they use code DPT400 and register prior to February 28th*.

Informa Connect - CBI will see you there!

*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. 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, February 04, 2020

New Part D Enrollment Data for 2020 Preferred Pharmacy Networks: CVS Holds Steady, Walmart Rebounds, and Walgreens Tanks

The Centers for Medicare & Medicaid Services (CMS) has just released its first 2020 data on enrollment in Medicare Part D prescription drug plans (PDPs).

Our exclusive analysis of these numbers finds that for 2020, 92% of seniors are enrolled in PDPs with preferred pharmacy networks. That’s an increase from last year’s figure (88%).

Below, we use the new enrollment data to examine the major pharmacy chains’ position within the 25 major Part D plans that have preferred networks.

As you will see, in 2020 Walmart seems poised to capture market share from Walgreens, while CVS has maintained its position. Rite Aid’s position looks better than it has in previous years.

A pharmacy’s per-prescription profits are lower in preferred plans. However, I expect that pharmacies will continue to accept low reimbursements and suffer with direct and indirect remuneration (DIR)  payments in exchange for increasing or maintaining store traffic.

I'll have an update on pharmacy DIR soon. In the meantime, the pharmacy industry shoudl consider what John Maynard Keynes once observed: Markets can remain irrational longer than you can remain solvent.

Monday, February 03, 2020

The World Congress 8th Annual Patient Congress

The World Congress 8th Annual Patient Congress

The 2020 World Congress Patient Congress takes place April 6 -7 at the Doubletree Hotel in Center City, Philadelphia. Now in its 8th year this is an outstanding educational and networking event that explores innovative and collaborative ways to improve access and health outcomes for patients.

Drug Channels readers save $100 off the standard rate when you use promo code DCAD and register by March 31, 2020.* To register your team, contact World Congress at 800-767-9499; or email WCReg@worldcongress.com.

The agenda features C-level keynote discussions and thought leader presentations across three streams of content:
  • The Patient Advocacy Track provides an opportunity for pharmaceutical manufacturers to join together with patient groups, patient leaders, and policy makers to examine ways to tackle the complexities of patient advocacy and the health care market
  • The Copay Summit convenes manufacturers, payers, states, government officials, advocacy and foundational groups, to examine regulations on the use of Copay and Coupon programs, and Copay Accumulator and Maximizers
The distinguished speaking faculty includes executives from Leo Pharma, Enzyvant, and UnitedHealth Care. Here’s a sample of the thought-provoking sessions:
  • Harvey Littman, Senior Vice President, Chief Financial Officer, Capital BCBS on the payer’s perspective on value-based payment systems
  • Andrea Furia-Helms, Director, Patient Affairs, FDA, on how to drive patient engagement
  • David Kalowsky, Director, Patient Access, Eyepoint Pharmaceuticals, on key strategies to designing effective copay programs
The Congress is honored to host the WEGOHealth Patient-Choice Awards, where patients will share their stories and organizations that truly put patients first will be recognized.

More than 150+ industry leaders representing life sciences companies, pharmacies, health plans, provider organizations, patient groups, and patient leaders will be in attendance. Join the conversation around innovative and collaborative ways we can improve access and health outcomes for patients. Develop your organization's patient-centric strategy from drug development through commercialization, break down internal silos, and improve patients' lives across the entire continuum of care.

Benefit from the opportunity to connect, learn, and share best practices in an elite networking forum resulting in an exchange of valuable patient-centric strategies.

Drug Channels readers save $100 off the standard rate when you use promo code DCAD and register by March 31, 2020.* To register your team, contact World Congress at 800-767-9499; or email WCReg@worldcongress.com.

*Cannot be combined with other offers or prior registrations.


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

Tuesday, January 28, 2020

Drug Channels News Roundup, January 2020: ESI/Walgreens Breakup, Amazon Pharmacy, Humira’s G2N, Generic Prices, ABC's CEO, and Miss America

Super Bowl LIV is here. Time for some blow-out beer commercials, occasionally interrupted by the 49ers and Chiefs.

But who needs a Super Bowl-party when you can tackle this month’s selection of notable news stories, intercepted for you from the Drug Channels gridiron:
  • Fumble: Express Scripts will stop buying generic drugs with Walgreens
  • Trick play: Amazon signals global pharmacy ambitions
  • Pass interference: The gross-to-net bubble for Humira
  • Touchdown! ABC’s CEO pens a good letter to the editor
  • Defensive line: Competition still lowers prices, says the FDA
Plus, the new Miss America is … a PharmD student?

P.S. Join the nearly 8,800 followers of my daily musings and links to neat stuff at @DrugChannels on Twitter. My recent tweets have highlighted best practices for biosimilar adoption, white bagging, hospital profits, 340B program oversight, insulin economics, the innovation ecosystem, California’s bonkers idea for generic drugs, Baby Yoda, and much more.

Monday, January 27, 2020

sPCMA Business Forum 2020

sPCMA Business Forum
March 16 & 17, 2020
Hilton Bonnet Creek | Orlando, FL

The sPCMA Business Forum brings together senior executives and decision makers from PBMs, health plans, and specialty pharmacy to collaborate with biopharmaceutical manufacturers and other key business partners.

Conference sessions will cover pressing business issues such as the pharmacy value transformation, total cost of care, the evolution of retail healthcare, 2020 Medicare Part D changes, and more.


Contact PCMA
Please contact Kayla Firriolo (kfirriolo@pcmanet.org) with questions or to request further information.


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

Wednesday, January 22, 2020

Why Part D Plans Prefer High List Price Drugs That Raise Costs for Seniors

Our high-list-price/high-rebate system remains a fundamental source of warped incentives and cascading problems within the Medicare Part D program.

For proof, check out the previously unpublished data below on market share for products that treat hepatitis C. Despite manufacturers offering products with lower list prices, Medicare Part D plans have rejected the therapeutically identical but lower-priced versions of these drugs.

List prices significantly affect seniors’ out of-pocket costs, so Part D plans are needlessly costing many of them thousands of dollars. The federal government's Medicare spending is also unnecessarily higher.

Anyone concerned about drug prices should pay close attention to this situation. Part D plans and seniors who don’t need specialty medications are benefiting, while seniors who need treatment with specialty medications are ripped off. Just another day inside the gross-to-net bubble!

Tuesday, January 21, 2020

PAP 2020 - 21st Annual Patient Assistance & Access Programs

PAP 2020 - 21st Annual Patient Assistance & Access Programs
March 23-25, 2020 | Baltimore, MD
www.cbinet.com/pap

PAP 2020, the industry’s highly anticipated annual program, convenes over 450 passionate leaders to discuss how to break through barriers to accelerate prescription access and affordability, manage compliance risk and gain operational efficiencies. 2020 features powerful programming and compelling content and brings you the opportunity to exchange techniques for successful partnering, gain key industry trends in PAPs and connect personal and professional goals to accelerate success.

Visit www.cbinet.com/pap for further details and to register. Drug Channels readers from life science manufacturers will save $200 off the standard rate when they use code RAR664 and register prior to February 7th.*
The 2020 agenda features coverage on topics that matter most to you in the year ahead. Conference features include:
  • Featured Keynote Kick-off SpeakerEzekiel J. Emanuel, Vice Provost for Global Initiatives, the Diane v.S. Levy and Robert M. Levy University Professor, and Chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania, addresses how pending health policy changes may impact patient access and affordability
  • Three Tailored Strategy Streams —Technology to Automate PAPs * Compliance Risk Management * Collaborations to Expedite Access
  • Patient Spotlight Sessions — Patient Q&A sessions highlight current challenges and successes along the patient journey
  • OIG Compliance Review on PAPs and Copay Programs — Hear key insights on where the OIG focus may extend to next from former special agent and senior counsel with the OIG
  • Benchmarking Survey Results — Gain insight into exclusive intelligence around the state of patient assistance
Download the complete agenda and speaker list to get the full picture of what to expect in March.

Visit www.cbinet.com/pap for further details and to register. Drug Channels readers from life science manufacturers will save $200 off the standard rate when they use code RAR664 and register prior to February 7th.*

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, January 14, 2020

Express Scripts vs. CVS Health: Five Lessons From the 2020 Formulary Exclusions and Some Thoughts on Patient Impact

For 2020, the two largest pharmacy benefit managers (PBMs)—Express Scripts and the Caremark business of CVS Health—have again increased the number of drugs they have excluded from their standard formularies. The 2020 formulary exclusion lists are available below for your downloading pleasure.

Below, I highlight my key takeaways from the 2020 lists:
  • The number of exclusions
  • Management of specialty drugs
  • Indication-based formularies
  • The slow adoption of biosimilars
  • The PBMs’ patient-unfriendly exclusions in the hepatitis C category
Formulary exclusions have emerged as a powerful tool for PBMs to gain additional negotiating leverage against manufacturers. The prospect of exclusion leads manufacturers to offer deeper rebates to avoid being cut from the formulary. Exclusions are therefore a key factor behind falling brand-name net drug prices.

Read on for a look at this year’s exclusions along with some closing thoughts on what exclusions mean for patients.

Monday, January 13, 2020

PBMI’s 25th Annual National Conference

PBMI’s 25th Annual National Conference
March 2-4, 2020 | Rosen Shingle Creek Hotel | Orlando, Florida
www.pbmi.com/AC20

You’re invited to join PBMI for their 25th Annual National Conference. This conference is considered one of the most insightful conferences addressing the challenges of managing drug benefits – and the robust agenda offers education to help employers, health plans, PBMs and other industry stakeholders effectively manage drug benefits for the year ahead.

Drug Channels readers can enter discount code PEM20
to receive $200 off conference registration rates. Register today!

The keynote for this year is Mr. Barry Meier, author and former Pulitzer-winning reporter for The New York Times and two-time winner of the prestigious George Polk Award for Investigative Reporting. He has authored several books, including Pain Killer, which chronicles the rise of the multi-billion-dollar pain management industry and lays bare its excesses and abuses. Mr. Meier’s keynote will dive into the opioid crisis in America today.

Here are some highlights of the event:
  • Earn CE credit for sessions identified with a CE icon*
  • Get the latest, state-of-the-industry news and trends directly from providers, industry organizations, analysts, and consultants
  • Learn about new technologies shaping the industry
  • Hear what some of the nation’s leading PBMs, health plans, and pharmacies are doing to manage drug costs
  • Network with peers facing the same challenges as you
*CE credit available for pharmacists.

You can learn more about the program here. For more information about the conference click here.

Drug Channels readers can enter discount code PEM20 to receive $200 off conference registration rates. Register today!


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

Thursday, January 09, 2020

Surprise! Brand-Name Drug Prices Fell in 2019

Manufacturers recently announced list price increases for many brand-name drugs. The typical increase was about 5%. Judging by recent history, these moderately higher list prices will translate into another year of falling brand-name drug prices in 2020.

This surprising conclusion comes from our analysis of SSR Health data on prices for more than 1,000 drugs. Details below.

SSR Health data reveal that list prices for brand-name drugs rose by about 5% in 2019. However, net prices (after rebates and discounts) decreased by -3.1%. Drug makers discounted their brand-name drug list prices by an average of 45%.

Too many journalists and politicians remain committed to the false narrative of “skyrocketing drug prices.” In 2020, Congress may again take up drug price legislation. Let’s all hope that our country builds its public policies based upon accurate facts and reliable data. Hope has to triumph over experience eventually.

Tuesday, January 07, 2020

Express Scripts + Prime Therapeutics: Our Four Takeaways From This Market Changing Deal

Just before the holidays, Cigna’s Express Scripts business announced a market-changing deal with Prime Therapeutics. Click here to read the press release.

There's been very little written about this transaction, though it has potentially major implications. Below, I share my thoughts on the following topics arising from the deal:
  • Implications for manufacturers and pharmacies
  • The role of the secretive Ascent Health Services
  • What this all means for Walgreens
  • Why the Federal Trade Commission won’t challenge the deal
A few weeks ago, I explained why integrated insurer / PBM / specialty pharmacy / provider organizations are poised to restructure U.S. drug channels. The Express Scripts / Prime deal signals that the channel will continue its amazing pace of reinvention.

The scale, scope, and interconnectedness of today’s market participants make the system increasingly resistant to massive disruption from either external players like Amazon or a government takeover. Like it or not, the channel will continue to gain power and extract profit. Read on and see if you agree.

Monday, January 06, 2020

CBI’s 16th Annual Life Sciences Accounting & Reporting Congress

CBI’s 16th Annual Life Sciences Accounting & Reporting Congress
March 16-19, 2020 | Loews Hotel | Philadelphia, PA
www.cbinet.com/accounting

Regulatory reforms, increased complexity and materiality of rebate/discount agreements, continued M&A deals and a dynamic risk environment have leaders in Finance and Accounting on the front lines of critical business decisions and external reporting.

CBI’s 16th Annual Life Sciences Accounting & Reporting Congress, an important event for finance, accounting and business leaders within life sciences, provides in-depth CPE education and networking with nearly 600 professionals.

Visit www.cbinet.com/accounting for further details and to register. Drug Channels readers will save $300 off the standard rate when they use code RJF938 and register prior to January 31st.*

Hot topics include SEC reporting, R&D financing, product pricing and contracting, critical audit matters, GTN, robotic process automation, valuation, collaborations and licensing, capital creation and allocation, SOX compliance, M&A, corporate tax, new product commercialization, FP&A, cybersecurity and data privacy, carve-outs and divestitures, revenue recognition, forecasting and financial planning, leases, and third-party oversight. You’ll return to the office ready to advance your organization to stay ahead in 2020.

Here’s a snapshot of what to expect, and don’t forget to download the latest agenda here.

EXTENSIVE INDUSTRY KNOWLEDGE SHARING AND BENCHMARKING FROM OVER 100 EXPERTS, INCLUDING:
  • Chad Cohen, CFO, Adaptive Biotechnologies Corp
  • Gina Consylman, CFO, Ironwood Pharmaceuticals
  • Patrick Coyle, CFO, Eisai
  • Gisele Dion, Chief Accounting Officer, Takeda
  • Rita Karachun, Senior VP and Global Controller, Merck
  • Kevin Mackay, VP, Controller and Chief Accounting Officer, Pfizer
  • Steve Rivera, VP, Global Technical Accounting Advisory Services & Policy, J&J
  • Gary Sender, CFO, Nabriva Therapeutics
VALUABLE NETWORKING AND CAREER DEVELOPMENT:
  • 14+ hours of specially designed networking events and receptions
  • Industry-Only Controllers Roundtable
  • Talent Planning, Diversity, Culture & Inclusion Summit
  • 12 Acuity Activities and Topic Intensive Workshops
  • Four company-specific tracks for:
    1. Mid-Large Pharma
    2. Commercial-Stage Biotech
    3. Clinical-Stage Innovators
    4. Device and Diagnostic
INFLUENTIAL INSIGHTS FROM REGULATORS AND AUDIT FIRMS:
  • John Vanosdall, Deputy Chief Accountant, U.S. SEC
  • Kevin Vaugh, Accounting Branch Chief, Office of Life Sciences U.S. SEC
  • Russ Golden, Chairman, FASB
  • PwC, Deloitte, Ernst & Young, KPMG, CFGI and more!
Visit www.cbinet.com/accounting for further details and to register. Drug Channels readers will save $300 off the standard rate when they use code RJF938 and register prior to January 31st.* CBI will see you there! *Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rate or non-profit rates. Other restrictions may apply.

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