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 35,000 subscribers. Learn more...

Thursday, February 27, 2020

Drug Channels News Roundup, February 2020: Amazon Care, Generics in Part D, Rebates vs. List Prices, Walmart Health, and Cheetos

February is longer than usual this year, which means that you’re more than ready to leap into our monthly curated selection of noteworthy news. In this issue:
  • Amazon Care ventures into prescription delivery
  • More problems with Part D formularies
  • Do list prices drive rebates, or vice versa?
Plus, Walmart promotes its new primary care services … with Cheetos!

P.S. Join the more than 8,900 followers of my daily musings and links to neat stuff at @DrugChannels on Twitter. My recent tweets have highlighted such topics as the chaos at retail pharmacies, vertical integration, importation, Amazon’s retail misadventures, hypocrisy at the AARP, the future of pharmacy reimbursement, a very naughty wholesaler, and more.

Monday, February 24, 2020

Latest Express Scripts Data: Slow Drug Spending Growth—And Big Plan Savings from Manufacturer Copay Programs

Last week, Cigna’s Express Scripts business released its 2019 Drug Trend Report. The results are presented as a webpage, so there’s no download this year. (For 2021, I presume it will delivered via TikTok.)

Contrary what you hear from our politicians, we again see that drug spending is not skyrocketing.

For commercial plan sponsors, pharmacy benefit spending grew by only 2.3%. The majority of spending growth was due the growth in the number of people being treated and the number of prescriptions being dispensed—not to increases in the net, post-rebate costs of the drugs.

Express Scripts also disclosed some startling savings from SaveonSP, an offering run by a secretive private company. As I explain below, SaveonSP declares specialty drugs to be “non-essential health benefits” and then extracts funds from manufacturers’ copay programs to pay for the drugs anyway. Is SaveonSP saving money, or merely exploiting a loophole by diverting funds that manufacturers provide for patient support?

Informa Connect – CBI’s 5th Annual IDN and Bio/Pharma Partnering Summit

Informa Connect – CBI’s 5th Annual IDN and Bio/Pharma Partnering Summit
April 1-3, 2020 | The Notary Hotel | Philadelphia, PA
www.cbinet.com/IDN

The 5th Annual IDN and Bio/Pharma Partnering Summit explores the partnership goals of both IDNs and manufacturers and provides a valuable opportunity to collaborate with established players in order to improve patient outcomes and population health, advance access, streamline efficiencies and improve compliance.

Exclusive Offer for Drug Channels Readers:
to SAVE $400* using promo code DRG400

This year's robust agenda features an unprecedented speaking faculty leading the dialogue including Blue Cross Blue Shield of Michigan, Pfizer, Vanderbilt University Medical Center, Sobi, WellCare Health Plans, University of Pennsylvania Health System, Shionogi, Atrium Health, Ambry Genetics, Fairview Health, Sunovion and many more.

2020 Program Highlights:
  • Two In-Depth Workshops
    • A. Specialty Pharmacy Integration
    • B. Contracting with Employers
  • Benefit from the Payer Perspective on the Current Landscape and Emerging Trends in Total Patient Care
  • Address Improving Population Health on a Broad Scope
  • Define and Develop Standards for Measuring Patient Outcomes
  • Hear Vanderbilt Address Adherence in Specialty Pharmacy
  • Learn how to Illustrate the Value of Working with IDNs to Executive Leadership
  • Engage with Industry Veterans and Hear Best Practices from IDNs and Manufacturers
  • Engage in Partnering Meetings to Collaborate with Stakeholders and Cultivate Relationships
Download the conference agenda for the complete speaker and session lineup, then register using promo code DRG400 to receive $400 off* the standard rate!

*Discount expires 3/31/2020; not valid on workshop only and 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, February 21, 2020

Connecting the Dots for Specialty Medications–Improving Provider Workflows Through Technology

Today’s guest post comes from Erica Conroy, Vice President of Specialty at CoverMyMeds.

Erica discusses access challenges that specialty medications pose for the providers who prescribe these medications. She describes AMP: Access for More Patients from CoverMyMeds and RxCrossroads by McKesson, a tech-enabled hub service designed to help providers and patients.

To learn more, connect with CoverMyMeds at HIMSS20 in Orlando.

Read on for Erica’s insights.

Wednesday, February 19, 2020

Specialty Pharmacy M&A in 2019: CVS, OptumRx, and Private Equity Highlight a Slowing Market

Specialty pharmacy is losing some of its sizzle.

Below you’ll find our list of ten deals from last year, along with trends since 2014. Our analyses show that merger and acquisition activity is down sharply from its 2016 peak.

Some highlights:
  • Pharmacy benefit managers (PBMs) were busy again. CVS Health bought two more specialty pharmacies. OptumRx bought one-time industry leader Diplomat Pharmacy.
  • Private equity firms continued to invest in specialty pharmacy, but deals seem to be smaller and more focused.
Go-go growth and a vibrant M&A market look like distant memories. Fewer new specialty pharmacies are starting up, the two biggest companies have been acquired, and market share continues to concentrate with the PBM-owned specialty pharmacies. This is your wake up call.

Tuesday, February 18, 2020

Informa Connect-CBI’s Formulary and Access 2020

Informa Connect-CBI’s Formulary and Access 2020
April 1-3, 2020 | San Francisco, CA
www.cbinet.com/formulary

As patient affordability barriers increase, the pharma/biotech industry must evolve to meet these challenges and ensure patient access to critical, life-saving therapies. Challenges continue to arise for manufacturers, including accumulator programs, state-level copay legislation, formulary exclusions, high deductible plans and changes in benefit design.

Visit www.cbinet.com/formularyfor further details and to register. Drug Channels readers will save $300 off the standard rate when they use code MZN973 and register prior to March 13th.*

At the 6th Annual Formulary and Access Summit a dynamic group of experts will drive the dialogue to prepare you for ongoing changes impacting patient access and formulary placement. Some of the speakers will include representatives from Allergan, Portola Pharmaceuticals, Prime Therapeutics, Sunovion Pharmaceuticals, CVS Health and more.

The 2020 agenda features a wide variety of topics, with highlights including:
  • Copay Accumulator Topic Intensive where you’ll unravel program complexities and navigate the impact of this cost-shifting benefit design.
  • Workshops on Keeping Up with Copay Industry Trends and Access and Reimbursement Executive Exchange.
  • Tailored Tracks on Access and Affordability, Rebates and Contracting, and Strategic Launch Planning.
  • Partnership Pavilion where you’ll navigate the future of pharma, PBM and payer relationships.
  • Employer Perspective Fireside Chat where you’ll assess reimbursement strategies, contract and pricing and the state of health plan design, and explore the impact of distribution, retail and wholesale for brand and generic on PAPs.
  • Patient Spotlight where you’ll take an inside look at the patient experience and real-world access challenges.
PLUS! Just added to the agenda is a case study from Matt Cook, VP of Payer Access and Commercial Strategy at Omada Health, which was selected for Express Scripts Industry-First Digital Health Formulary.

Download the complete agenda and speaker list to get the full picture of what to expect in April.

Visit www.cbinet.com/formulary for further details and to register. Drug Channels readers will save $300 off the standard rate when they use code MZN973 and register prior to March 13th.*

Informa Connect-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, 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.