Drug Channels delivers timely analysis and provocative opinions on pharmaceutical economics and the drug distribution system. It is written by Adam J. Fein, Ph.D., one of the country's foremost experts on pharmaceutical economics and channel strategy. Drug Channels reaches an engaged, loyal and growing audience of more than 26,000 subscribers. Learn more...

Tuesday, 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.