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...

Wednesday, June 03, 2020

Pharmacist Job Market in 2019: Salaries Grew, Retail-to-Hospital Employment Shift Accelerated

The Bureau of Labor Statistics (BLS) recently released its employment data for 2019. That means it’s time to update our annual Drug Channels analysis of pharmacist salaries and employment.

Average base salaries were about $125,000, though there was substantial variation across practice settings.

Total pharmacist employment grew in 2019. Consistent with our previous analyses, the share of pharmacists who work at hospitals reached a new high.

However, the number of pharmacists working in retail settings decreased. The challenges facing the retail pharmacy industry, which I discuss in this video, are now showing up in the employment data. It’s more bad news for the pharmacists who are working for the weakened.

Monday, June 01, 2020

Visit Asembia’s Specialty Pharmacy Summit Virtual Experience

Like many of you, I was disappointed that Asembia had to cancel its 2020 Specialty Pharmacy Summit.

As a small consolation, Asembia is providing a series of on-demand business sessions. You can view them for FREE if your registration to the 2020 Specialty Pharmacy Summit was transferred to the 2021 Summit. Everyone else will have to pay a small fee.

Click here to register for access to Asembia’s Specialty Pharmacy Summit Virtual Experience. (You must register and create a new account, even if you are eligible for free access.)

Virtual business sessions cover such topics as market trends, the specialty pipeline, accreditation, federal health policy, digital health, and more.

Two highlights:
  • The State of Specialty Pharmacy 2020: Market Data and Trends—Adam J. Fein, Drug Channels Institute (That’s me!)
  • US Specialty Pharmaceuticals Trends, Issues and Outlook—Doug Long, IQVIA
For the full Las Vegas experience, I suggest that you review this important story before viewing the business sessions.

In the meantime, mark your calendars for the 2021 Specialty Pharmacy Summit, which is scheduled for May 2 to 5, 2021.

Wednesday, May 27, 2020

Drug Channels News Roundup, May 2020: COVID-19 and Formularies, Retail-to-Mail Trends, ABC on Biosimilars, and Social Distancing the CVS Way

FWIW: Summer is finally here. Before you venture outside for your lockdown barbeque, check out these noteworthy items off the Drug Channels grill:
  • Payers predict how COVID-19 will affect formularies
  • Our analysis of the 2020 retail-to-mail shift
  • AmerisourceBergen profiles biosimilars
Plus, CVS pharmacy offers a clever way to measure appropriate social distancing.

P.S. Join the nearly 9,400 followers of my curated links to neat stuff at @DrugChannels on Twitter. My recent tweets have highlighted: hospital profits, drug spending, prior authorization at specialty pharmacies, legal issues for drug importation, private equity funding for a start-up PBM, physicians vs. PBMs, trends in Google Trends, and more. I continue to tweet under-the-radar stories about how the coronavirus is affecting drug channels and healthcare spending.

Friday, May 22, 2020

Electronic Prescription Management and Enrollment for Specialty Medications—Expanding Provider Adoption of Tech-Enabled Hub Services

Today’s guest post comes from Kyle Grimslid, Market Development Director at CoverMyMeds.

Kyle describes the complications that providers and patients encounter in the specialty prescription process. He describes how AMP: Access for more Patients™ enhances access, affordability and adherence—including a reported 27% reduction in time to therapy.

Click here to learn more about how CoverMyMeds and RxCrossroads by McKesson are using technology to solve patients' medication access challenges.

Read on for Kyle’s insights.

Thursday, May 21, 2020

Why Do CVS And Express Scripts Rely on Secretive Private Companies to Run Their Copay Maximizer Programs?

In Copay Maximizers Are Displacing Accumulators—But CMS Ignores How Payers Leverage Patient Support, I explained a new Centers for Medicare and Medicaid Services (CMS) final rule regarding health plans’ use of copay accumulator adjustment. I also highlighted why plans have responded to the negative patient impact from accumulators with copay maximizer programs.

However, maximizers are being implemented very differently from accumulators.

The two largest PBMs—CVS Health’s Caremark and Cigna’s Express Scripts—have each partnered with secretive and independent private companies to operate specialty drug maximizer programs for their plan sponsor clients. What’s more, at least one of these private companies earns fees equal to 25% of the manufacturer’s copay support program.

These arrangements are very odd. Why do multi-billion-dollar public companies rely on these private companies to administer their maximizer programs? Why do these small companies deserve such outrageous fees? Why are beneficiaries required to affirmatively sign up with the companies—or face ludicrous costs that far exceed their plan’s out-of-pocket maximums? Does any oversight exist for these arrangements?

Here’s what I managed to uncover about these businesses. See what you think.

Tuesday, May 19, 2020

Copay Maximizers Are Displacing Accumulators—But CMS Ignores How Payers Leverage Patient Support

COVID-19 has not stopped the wheels of policy bureaucracy from grinding. Last week, the Centers for Medicare and Medicaid Services (CMS) released its final Notice of Benefit and Payment Parameters for the 2021 benefit year. You’ll find the document links below.

This final rule permits insurers to exclude the value of a pharmaceutical manufacturer’s copay support program from a patient’s annual deductible and out-of-pocket maximum obligations.

Translation: CMS has confirmed that insurers have the option to use copay accumulator adjustment for their pharmacy benefit programs.

Patients on specialty drugs lose big from accumulators, while plans profit from the lower spending that results. Consequently, copay maximizers have emerged as a more patient-friendly alternative to accumulators. Below, I remind you of the math behind these alternatives.

Plan sponsors are publicly denouncing copay support programs—while they’re privately embracing them. CMS’s final rule ignores the troubling reality behind maximizers and accumulators: They encourage plans to use pharmacy benefit deductibles as a scheme that allows payers—not patients—to reap the greatest benefits from a manufacturer’s patient support program.

Thursday, May 14, 2020

The State of Specialty Pharmacy in 2020 (video)

I received good feedback on Tuesday's video about retail pharmacy.

So below, you'll find another brief video excerpt from my May 1 Industry Update and COVID-19 Impact video webinar.

In this clip, I highlight the growth and consolidation dynamics facing the specialty pharmacy industry. I also discuss the competitive challenges facing smaller pharmacies.

Never fear, Drug Channels traditionalists. I'll be back with a new article next week.

Tuesday, May 12, 2020

The State of Retail Pharmacy 2020 (video)

Thanks to everyone who joined me for DCI's Industry Update and COVID-19 Impact video webinars. I enjoyed putting these events together and hope you benefited from watching them. If you missed these two live events, click here to find out how you can watch the replays.

Below is a brief video excerpt from my May 1 video webinar. In this clip, I summarize the perilous competitive dynamics facing retail pharmacies.

P.S. We are still experimenting with how best to use our new Drug Channels Video platform. Please drop me a line with any feedback or suggestions.

Friday, May 08, 2020

Surprise! Brand-Name Drug Prices Fell in 2019 (rerun)

This week, I’m rerunning some popular posts while I prepare for today’s video webinar: Industry Update and COVID-19 Impact: PBMs & Payers.

Click here to see the original post and comments from January 2020.



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.

Thursday, May 07, 2020

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

This week, I’m rerunning some popular posts while I prepare for this Friday’s video webinar: Industry Update and COVID-19 Impact: PBMs & Payers.

Today's rerun highlights one of the most effective tactics that PBMs have developed to extract deeper discounts from brand-name drug makers. COVID-19 seems likely shift the U.S. payer mix away from commercial health plans. Expect even tighter formulary management and more restrictions as PBMs work even harder to cut costs for their plan sponsor clients.

Click here to see the original post and comments from January 2020.




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.

Wednesday, May 06, 2020

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

This week, I’m rerunning some popular posts while I prepare for this Friday’s video webinar: Industry Update and COVID-19 Impact: PBMs & Payers.

Part D reform has faded from the policy debate. This rerun explains why it is still needed. FYI, this is my favorite article from 2020 (so far).

Click here to see the original post and comments from January 2020.



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, May 05, 2020

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

This week, I’m rerunning some popular posts while I prepare for this Friday’s video webinar: Industry Update and COVID-19 Impact: PBMs & Payers.

I suspect this deal will remain profitable for the participating companies even as COVID-19 alters the US. prescription payer mix. Click here to see the original post and comments from January 2020. National market shares for the largest PBMs in 2019 appears as Exhibit 88 of our 2020 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers.

P.S. Sorry that today's meme is one day too late for Star Wars day.



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, May 04, 2020

Insurers + PBMs + Specialty Pharmacies + Providers: Will Vertical Consolidation Disrupt Drug Channels in 2020? (rerun)

This week, I’m rerunning some popular posts while I prepare for this Friday’s video webinar: Industry Update and COVID-19 Impact: PBMs & Payers.

Life was very different when I originally published today’s article. 2020 is not turning out to be quite what any of us expected. However, the pandemic has exposed some intriguing pros and cons of vertical consolidation. Click here to see the original post and comments from December 2019.


The largest insurers, PBMs, and specialty pharmacies have now combined into vertically-integrated organizations. As I explain below, these companies have also been rapidly integrating with healthcare providers.

I also provide an updated look at these companies and highlight strategies that they are using—or could use—to control the channel. I believe that these insurer / PBM / specialty pharmacy / provider organizations are poised to restructure U.S. drug channels by exerting greater control over patient access, sites of care/dispensing, and pricing.

If they can effectively coordinate their sprawling business operations, they will pose a substantial threat of disruption to the existing commercial strategies of pharma companies.

Will they succeed by better managing care and costs, or merely by extracting higher profits from our convoluted system?

Friday, May 01, 2020

Elsevier: Challenges and Trends to Watch in 2020 (Guest Post)

Today’s guest post comes from Trygve Anderson, Vice President of Commercial Pharmacy at Elsevier.

Trygve discusses trends and challenges to watch in 2020, including drug pricing transparency, the approval and interchangeability of biosimilars, and stakeholder access to timely and accurate data.

Learn more about Elsevier’s information analytics capabilities from its video: Evaluating Drug Data Yields Business Value.

Read on for Trygve’s insights.

Thursday, April 30, 2020

Drug Channels News Roundup, April 2020: Drug Pricing Outlook, COVID-19 Data Tracker, Community Oncology Clinics, and My Favorite Chart of 2020

Rumor has it that Spring has finally reached our worldwide headquarters here in beautiful downtown Philadelphia. (See photo at right.) While we wait to go outside, please enjoy this month’s selection of noteworthy news:
  • The outlook for drug prices
  • A outstanding (and free!) resource for tracking COVID-19 daily data
  • What’s up with community oncology practices?
Plus, I share my favorite chart of 2020 (so far).

P.S. Join the more than 9,200 followers of my curated links to neat stuff at @DrugChannels on Twitter. My recent tweets have highlighted: Prime Therapeutics new gene therapy offering, AmerisourceBergen’s laudable deal with the Justice Department, the Costco/Instacart deal, Rite Aid’s new CEO, clinical trial trends, vaccine pricing, and much more! I have also been tweeting under-the-radar stories about how the coronavirus is affecting drug channels.

Tomorrow (May 1), Drug Channels Institute will host the first of two live video webinars: Industry Update and COVID-19 Impact: Retail & Specialty Pharmacies. We'll host the second video webinar—Industry Update and COVID-19 Impact: PBMs & Payers—on May 8. CLICK HERE TO LEARN MORE AND SIGN UP. Contact Paula Fein (paula@drugchannelsinstitute.com) for our special promo codes for multiple viewing sites. DCI will donate 20% of all profits from these events to The Center for Disaster Philanthropy’s COVID-19 Response Fund.

Tuesday, April 28, 2020

The Top 15 Specialty Pharmacies of 2019: PBMs Stay On Top

In Drug Channels Institute's list of the top 15 pharmacies of 2019, we show that many of the largest U.S. pharmacies are now central-fill mail and specialty pharmacies operated by PBMs and insurers.

To complement that broader ranking, we present below our exclusive list of the top 15 pharmacies based on specialty drug dispensing revenues. Consistent with our previous analyses, PBMs and insurers have retained their dominance over specialty drug channels, while smaller pharmacies are facing increased competition and profit pressures.

I see upside for specialty pharmacies in the aftermath of the pandemic. This growth will come at the expense of provider-administered drug channels. I expect the top companies’ share will increase in 2020, due to mergers and business transitions among the largest PBMs. However, the increasing role of government payers may create opportunities for smaller pharmacies.

This Friday, I’ll discuss how COVID-19 will affect the specialty pharmacy market during the first of my two live video webinars.

Over the next two weeks, Drug Channels Institute will host two live video webinars: Industry Update and COVID-19 Impact: Retail & Specialty Pharmacies (May 1) and Industry Update and COVID-19 Impact: PBMs & Payers (May 8). CLICK HERE TO LEARN MORE AND SIGN UP. Contact Paula Fein (paula@drugchannelsinstitute.com) for our special promo codes for multiple viewing sites. DCI will donate 20% of all profits from these events to The Center for Disaster Philanthropy’s COVID-19 Response Fund.

Friday, April 24, 2020

Medication Access During Uncertain Times—Improving Provider Workflows to Help Patients in Need

Today’s guest post comes from Miranda Gill, Senior Director of Provider Network at CoverMyMeds.

Miranda reviews how the pandemic affects the ability of healthcare workers to complete administrative responsibilities like prior authorization. She then outlines how electronic automation is helping patients get needed medications while face-to-face interactions are restricted.

Learn more about healthcare IT solutions for providers and patients in CoverMyMeds’ 2020 Medication Access Report, or schedule a virtual meeting.

Tuesday, April 21, 2020

Three Early Signs That COVID-19 Could Disrupt the Buy-and-Bill Channel

Will home infusion growth be a long-overdue correction for the buy -and-bill channel or a temporary blip that will soon vanish?

For some time, I have been tracking the evolution of the buy-and-bill system for provider-administered drugs. The data have shown that hospital outpatient departments have been displacing physician offices. Amid this shift, home infusion providers have accounted for a minority of commercial medical benefit spending and a tiny share of Medicare Part B spending.

However, the coronavirus pandemic is triggering new growth in home infusion for buy-and-bill products. Below, I highlight the early signs of a marketplace change. I believe that some of these short-term shifts in the buy-and-bill market will persist even after we have recovered from COVID-19. They may even slow the runaway growth of the 340B Drug Pricing Program.

If not, then I suppose we'll just keep living in a world with limited home infusion over and over.

In early May, Drug Channels Institute will host two live video webinars: Industry Update and COVID-19 Impact: Retail & Specialty Pharmacies (May 1) and Industry Update and COVID-19 Impact: PBMs & Payers (May 8). CLICK HERE TO LEARN MORE AND SIGN UP. DCI will donate 20% of all profits from these events to The Center for Disaster Philanthropy’s COVID-19 Response Fund. Watch my video invitation below.

Friday, April 17, 2020

What Is Payer Intelligence—And How Can It Be Combined With Technology to Enhance Patient Access?

Today’s guest post comes from Scott Dulitz, Chief Strategy Officer at TrialCard. Scott discusses how combining payer intelligence with market-leading technology can enhance patient access.

TrialCard recently acquired Policy Reporter, a healthcare software solutions company that provides payer intelligence to the biopharmaceutical, medical device, and diagnostics industries. To learn more, schedule a demo of Policy Reporter or contact Scott (scott.dulitz@trialcard.com).

You can also register for Trialcard’s upcoming webinar: Leveraging Payer Intelligence in Patient Service Programs.

Read on for Scott’s insights.

Wednesday, April 15, 2020

Four Unexpected Ways that the COVID-19 Medicaid Boom Will Affect PBM and Pharmacy Profits

The U.S. economy is in a medically-induced coma. Unemployment is soaring. Companies are teetering on the brink of bankruptcy. It is unclear when our lives will return to their pre-pandemic state.

One thing seems apparent: As people lose jobs and health insurance, Medicaid enrollment will jump, perhaps by as much as 20% to 30%. This will have profound implications for the drug channel.

Today, I focus on how this increase will affect retail pharmacies and pharmacy benefit managers (PBMs). Below, I review Medicaid enrollment trends, how states manage prescriptions, and the factors driving the coming boom in Medicaid enrollment.

As I explain, many (but not all) retail pharmacies will benefit from Medicaid growth. PBMs, however, will not fare as well. Read on and see if you agree.

In early May, Drug Channels Institute will host two live video webinars: Industry Update and COVID-19 Impact: Retail & Specialty Pharmacies (May 1) and Industry Update and COVID-19 Impact: PBMs & Payers (May 8). CLICK HERE TO LEARN MORE AND SIGN UP. DCI will donate 20% of all profits from these events to The Center for Disaster Philanthropy’s COVID-19 Response Fund.

Tuesday, April 14, 2020

Industry Update and COVID-19 Impact: Join Me for Two Live Video Webinars (May 1 and May 8)

This May, join Dr. Adam J. Fein, CEO of Drug Channels Institute (DCI) and the author of Drug Channels, for two live video webinars:

You can purchase replays of these events using the links above.

Dr. Fein will help you navigate this challenging time in U.S. drug channels. These 75-minute live events will be broadcast via Zoom from the new Drug Channels Video studio. See details below.


You can sign up for either one of these crucial educational opportunities for only $300 per site per event. We are offering special pricing of $500 if you sign up for both events.

An unlimited number of people may watch at one location. However, we recognize that it may be difficult to gather your team in one location, so we are offering significant discounts for multiple viewing sites. Please contact Paula Fein (paula@drugchannelsinstitute.com) to get special pricing information for 5 or more locations. If you purchase access for multiple sites, we will contact you for the name and email address of a contact person at each location.

Read on for more information about the events.


To help people affected by COVID-19 and the caregivers who are supporting them , DCI will donate 20% of all profits from these events to The Center for Disaster Philanthropy’s COVID-19 Response Fund. This charity has earned a 4-star Charity Navigator rating and is a trusted philanthropic partner of Google, Coca Cola, UPS, Verizon, and many other organizations. The fund supports preparedness, containment, response, and recovery activities for those affected by the coronavirus and for the responders.


WHAT YOU WILL LEARN

We will help you and your team better understand key industry dynamics and how COVID-19 may alter the industry.

Dr. Fein will share DCI’s latest market data and trends from The 2020 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers.

Topics for Industry Update and COVID-19 Impact: Retail & Specialty Pharmacies:
  • The key trends for retail and specialty pharmacy markets
  • The new normal for prescription demand
  • How COVID-19 will change the U.S. payer mix
  • Will the 340B program be disrupted?
  • What’s next for specialty pharmacies
  • The outlook for prescription profits
  • The future for the drugstores’ front-end profits
  • New opportunities for pharmacists as providers
  • My reflections on life in a pandemic world and beyond

Topics for Industry Update and COVID-19 Impact: PBMs & Payers:
  • The key trends for PBMs
  • An update on the latest prescription data
  • What the changing U.S. payer mix means for PBMs and insurers
  • The outlook for benefit design
  • PBMs' role in Managed Medicaid
  • More on the 340B Drug Pricing Program
  • Disruption to the buy-and-bill channel
  • Promise and perils of vertical diversification
  • Further reflections on life in a pandemic world

PLUS: Dr. Fein will take your questions during the event. CLICK HERE to submit questions to Dr. Fein in advance of the events.

IMPORTANT STUFF TO KNOW
  • After you register, you will receive an email with the information you will need to access our live video webinar and add it to your calendar. We will also send you reminder emails one day and one hour before the event.
  • Watch and listen via any device with a web browser (computer, iPad, iPhone/Android, etc.)
  • After each event, you’ll receive a downloadable PDF with the event slides.
  • If your plans change and you can’t make it on May 1 or May 8, we will provide an opportunity to watch a replay of the live video events. Unfortunately, we are unable to offer refunds.
  • Pembroke Consulting clients receive free access to the webinar. Contact Tamra Feldman (admin@drugchannels.net) for details. We will automatically refund payments from anyone at a Pembroke client who purchases access using their corporate email account.

Thursday, April 09, 2020

Introducing: Drug Channels Video!

In 2006, I launched the Drug Channels website to explore the economics of the U.S. reimbursement and distribution system for prescription pharmaceuticals. More than 30,000 professionals in the pharmaceutical and related industries rely on Drug Channels for timely analysis and provocative, fact-based insights.

Today, I am pleased to announce the launch of our new delivery platform: Drug Channels Video!

You can look forward to:
  • Information and analysis via our new YouTube channel (Never fear. I’ll still be publishing articles on the website every week.)
  • Livestream video webinars (Stay tuned next week for an announcement about our first two events.)
  • Private, live virtual keynotes and remote presentations (Email me to schedule a safe social distancing event for your team.)
  • Online video courses (Coming later in 2020)
Please watch my brief video introduction below. (Click here if you can’t see the video.)



I hope you and your families stay safe and healthy in these challenging times. I look forward to reconnecting with you in person soon.

Tuesday, April 07, 2020

The Latest CMS Outlook for Drug Spending—And How COVID-19 Will Change It

ICYMI, the boffins at the Centers for Medicare & Medicaid Services (CMS) recently released their new projections for U.S. National Health Expenditures (NHE). Unfortunately, the coronavirus almost immediately made these predictions obsolete.

It’s still useful to analyze these forecasts for a pre-pandemic examination of U.S. healthcare spending. A few highlights of the 2024 outlook:
  • Total U.S. spending on healthcare was projected to grow, from $3.6 trillion in 2018 to $5.0 trillion in 2024.
  • Spending on hospitals and professional services was expected to grow by a combined $800 billion—more than 60% of CMS’s projected $1.4 trillion increase in U.S. healthcare spending. That’s consistent with historical trends.
  • Net spending on outpatient prescription drugs in 2024 was projected to shrink to less than 9% of total U.S. spending. That would be its lowest level since 2000.
As usual, the actual facts run counter to the popular narrative that drug spending is skyrocketing relative to any other aspect of U.S. healthcare. Of course, the coronavirus will alter these projections. Below, I speculate how COVID-19 and its aftermath will affect healthcare and prescription drug spending.

Prediction is very difficult, especially if it's about the future. Feel free to add your own outlook in the comment section below.

Tuesday, March 31, 2020

Drug Channels News Roundup, March 2020: Sanofi’s Gross-to-Net Bubble, Drug Pricing Findings, Amazon Replaces Express Scripts, and Drug Channels Video

First, let me say thank you to all of the healthcare workers who are putting themselves at risk during this crisis.

As I noted last week, many of the crucial issues for our healthcare system will remain after we all get through this challenging period. In that regard, here’s a look at some noteworthy news from the past month:
  • Sanofi discloses new data about insulin prices
  • Excellent new academic research on list vs. net drug prices
  • Three notable researchers overturn their earlier research on drug costs
  • Amazon switches PBM vendors for some of its employees
Plus, we unveil the teaser trailer for Drug Channels Video!

P.S. Join the more than 9,000 followers of my daily links to neat stuff at @DrugChannels on Twitter. My recent tweets have highlighted such topics as:
  • How GoodRx shares patients’ prescription data
  • 2019 drug trend at Prime Therapeutics
  • Controversy about the independent pharmacy market
  • A new $5 generic mail order program, Medicare Part D reform
  • Retail pharmacy’s future
  • Job openings at Amazon 
  • Frozen cookie dough
  • And much more!
I have also been tweeting many under-the-radar stories about how the coronavirus affects drug channels.

Friday, March 27, 2020

Expanding How CoverMyMeds Helps Patients Access Their Medications

Today’s guest post comes from David Holladay, President of CoverMyMeds and Austin Raper, Healthcare Writer at CoverMyMeds.

First, David discusses how CoverMyMeds supports medication access. Then, Austin highlights key findings from CoverMyMeds’ 2020 Medication Access Report. This new report includes industry research, patient interviews, novel survey data, and strategies for boosting patients’ medication access.

Read on for David’s and Austin’s insights.

Thursday, March 26, 2020

Coronavirus Industry Impact Survey: Winners and Losers (Part 3)

Today is the final installment of our three-part investigation into the coronavirus’ ultimate impact on the drug channel.

Below, I examine expectations about how the coronavirus will affect the public’s perception of various industry participants. We explore what our survey respondents said about:
  • Pharmacies
  • Pharmaceutical manufacturers
  • Hospitals
  • Wholesalers
  • Pharmacy benefit managers and plan sponsors
  • Insurance companies.
In these early stages of this crisis, my crystal ball is as cloudy as yours. Let’s hope that the country will stabilize within a few months. I may then rerun the survey to determine how (if at all) everyone’s perspective has changed.

Wednesday, March 25, 2020

Coronavirus Industry Impact: Manufacturers, Public Policy, and Payers (Part 2)

Today’s post is the second in our three-part investigation of the ultimate impact of the coronavirus on the drug channel. Here is a link to the first part of our survey analysis: Coronavirus Industry Impact: Patients, Pharmacies, and Wholesalers (Part 1). That article includes details about the methodology and respondents.

Today, I review how people in the industry think coronavirus will affect:
  • Federal drug pricing legislation
  • FDA new drug approvals
  • Public support for single-payer health insurance
  • Third-party payment for prescription drugs
I also highlight survey respondents’ comments on whether the current situation will bring overseas pharmaceutical manufacturing back to the United States.

Tomorrow, I’ll examine survey responses that address how the coronavirus may affect the public’s perception of the industry’s participants. In the meantime, remember that every day is no pants day when you work from home.

Tuesday, March 24, 2020

Coronavirus Industry Impact: Patients, Pharmacies, and Wholesalers (Part 1)

I hope you are staying healthy and are managing to navigate your work-at-home mandates.

Last week, I tapped the collective insights of the Drug Channels’ audience. Nearly 700 readers shared their perspectives and projections for how the coronavirus pandemic could ultimately affect behavior, policy, and industry structure. Thank you to everyone who took the time to respond.

I will share the results over three articles this week:
  • Today, in Part 1, I will review the responses relating to patient behavior, pharmacies, and wholesalers. 
  • In Part 2 (tomorrow), I’ll focus on expectations for pharmaceutical manufacturers and third-party payment. 
  • In Part 3 (Thursday), I’ll examine how the coronavirus may affect the public perception of the industry’s participants.
P.S. A special shout out to the respondent who hoped that the coronavirus would not impact the quality of Drug Channels memes. Never fear, dear readers: Drug Channels will remain the internet’s top destination for pharmaceutical-related humor!

Monday, March 23, 2020

Informa Connect-CBI’s 22nd Annual Medicaid and Government Pricing Congress

Informa Connect-CBI’s 22nd Annual Medicaid and Government Pricing Congress
May 19-21, 2020 | Orlando, FL
www.cbinet.com/medicaidandgovernment

Exclusive Offer: Register by April 10th and save $500* (mention promo code MDCDC5).

With a volatile healthcare system combined with an election year upon us, the stakes are incredibly high for life sciences manufacturers. Staying on the pulse of industry trends, policies and regulations has never been more critical. The 22nd Annual Medicaid and Government Pricing Congress delivers critical updates and industry best practices to effectively contract, report and comply with state and federal healthcare programs. Gain timely, up-to-the-minute insights on:
  • State Invoicing and Disputes
  • GTN Models
  • Innovative Contracting Strategies
  • State Price Transparency and Reporting Requirements
  • 340B Oversight and Compliance
  • Preparing, Negotiating and Implementing FSS Contracts
  • Bona Fide Service Fees and FMV
  • And many other critical topics
Download the complete program agenda.

The 2020 agenda features 75+ speakers and 50+ sessions customizable by company type and size, as well as 10 hours of dedicated networking. Bio/pharma, regulatory and government experts representing HHS, Pfizer, Daiichi Sankyo, Sobi, Maryland Department of Health, BMS, Jazz, Novartis, Amneal, J&J, Sunovion, Gilead, VA, Granard, Insmed, UCB, Alnylam, Louisiana Department of Health, AstraZeneca, CMS, CSL Behring, Astellas, Lilly, Oklahoma Healthcare Authority, Theravance, Indivior, Sandoz, Alvogen, Takeda, OIG, AMAG, Aimmune, Exelixis, South Dakota Department of Healthcare Services, Regeneron, Sun Pharma, Teva and many others are set to drive the dynamic dialogue.

Drug Channels readers can register today and use promo code MDCDC5 to save $500.

*Discount offer valid through 4/10/2020; applies to standard rates only and may not be combined with other offers, categories, promotions or applied to an existing registration. Offer not valid on workshop-only or 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, March 20, 2020

Three Things to Look for in a Patient Assistance Program

Today’s guest post comes from Rob Brown, Vice President and General Manager of RxCrossroads by McKesson and Biologics by McKesson.

Rob discusses the importance of access, adherence, and affordability for specialty therapy patients who are uninsured, underinsured, or low-income. He describes three criteria companies should use to evaluate patient assistance program solutions.

Click here to learn more about program pharmacy solutions for biopharma from RxCrossroads by McKesson.

Read on for Rob’s insights.

Tuesday, March 17, 2020

The Drug Channels Coronavirus Industry Impact Survey

It’s a unique and troubling time. We are all of course concerned about the coronavirus and its disruption to our personal and professional lives.

I presume that life will return to normal later this year. But what happens then? Will there be long-term changes to how the drug channel operates? Will we see permanent changes in behavior, policy, and industry structure?

To answer these questions, I want to tap the collective insights of Drug Channels’ 30,000+ audience.


This survey should take 10 minutes or less. I will provide a full review of the results next week on Drug Channels. The survey will close on March 20.

You can respond anonymously. Any information you provide will be kept confidential. Per Drug Channels' long-standing policy, I never publish, release, or disclose any personal data without your permission.

Thanks in advance for sharing your insights.

Regards,
Adam

Monday, March 16, 2020

Informa Connect-CBI’s Patient Support Services Congress

RESCHEDULED: This event has been rescheduled for November 11-13, 2020. Click here to learn more.


Informa Connect-CBI’s Patient Support Services Congress
June 16-18, 2020 | The Westin Princeton at Forrestal Village | Princeton, NJ
www.informaconnect.com/patient-support-services-congress

Informa Connect-CBI’s Patient Support Services Congress is a comprehensive meeting for insightful and engaging dialogue around navigating compliance hurdles while strengthening and innovating patient-oriented programs.

Visit www.informaconnect.com/patient-support-services-congress for more information. Drug Channels readers will save $500 off the standard registration rate when they use code BNP667*.

Download the agenda here and see in-depth coverage on industry trends and next-generation patient services, such as:
  • Critical Regulatory Updates and Effective Strategies for Monitoring & Oversight
  • Novel Approaches to Services, Program Architecture and Operational Management
  • The pros and cons of different support service models
  • Measuring the Success of Patient Support Programs
  • Innovation, AI, Changing Distribution Models and Market Mergers
  • Transparency with Charitable Organizations
Create Your Own Customized Learning Experience for 2020!

Choose from Two In-Depth Tracks
  • Legal and Compliance
  • Innovation and Operations
Plus! Four Tailored Summits
  • Summit A: Patient Adherence – Educate, Engage and Collaborate to Enhance Outcomes
  • Summit B: Case Management for Novel and Innovative Therapies
  • Summit C: Strategic Planning for Product Launch
  • Summit D: Primer Course for Partnering with Patients

Leading Perspectives from Industry Trendsetters:
  • Robert Britting, Director, Patient Services and Strategic Solutions, Teva Pharmaceuticals
  • Stella Vnook, Chief Executive Officer, Diverse Biotech
  • Katherine Chaurette, Vice President healthcare Law and Compliance, Blueprint Medicines
  • Kimberly Goldberg, Director, U.S Data Privacy Counsel, Novartis
  • Imtiaz Hussain, Senior Director, Patient Services, Bayer
  • Cory Potomis, Associate Director, Ethics & Compliance Operations, Novo Nordisk, Inc.
  • And so many more!

Visit www.informaconnect.com/patient-support-services-congress for more information. Drug Channels readers will save $500 off the standard registration rate when they use code BNP667*.

*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.

Tuesday, March 10, 2020

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

I am pleased to announce our new 2020 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, 2020.

The 2020 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers is a truly unique resource. With 203 proprietary charts, exhibits, and data tables, this 11th edition provides a comprehensive, fact-based, and non-partisan tool for understanding the entire U.S. drug pricing, reimbursement, and dispensing system.

The full document clocks in at 374 pages. I can safely say there is nothing else available that comes close to this report.

The chart below illustrates the depth and breadth of the 2020 edition. The numbers indicate the report chapter that corresponds to, explains, and analyzes each channel flow.

[Click to Enlarge]

Below, you can read more info and some behind-the-scenes tidbits.

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 09, 2020

Informa Connect – CBI’s PCC 2020 – The 17th Annual Pharmaceutical Compliance Congress

Informa Connect – CBI’s PCC 2020 – The 17th Annual Pharmaceutical Compliance Congress
April 29 – May 1, 2020 | Grand Hyatt | Washington, DC
www.informaconnect.com/pcc

PCC 2020 – The 17th Annual Pharmaceutical Compliance Congress, taking place April 29-May 1, 2020 in Washington, DC, unites more than 500 bio/pharma professionals with responsibilities for compliance, ethics, legal affairs, commercial operations and patient support programs.

Exclusive Offer – use promo code PCCDC5 and save $500 if you register by March 27, 2020.*

The jam-packed, customizable agenda delivers innovative strategies to address the many emerging, high-risk areas impacting the industry today, including:
  • Hub and SP oversight
  • PAPs, PSPs and coupons
  • Drug pricing
  • Speaker programs
  • Data privacy
  • Medical and clinical affairs oversight
  • HCP engagement
  • Auditing and monitoring
  • Field compliance
  • And much more
Additional Congress highlights include:
  • 100+ expert speakers
  • Customizable programming featuring 18 workshops, 6 summits and 5 tracks
  • Enforcement insights from FDA, OIG, SEC and DOJ, with representation from six U.S. Attorneys
  • A “chasing miracles – when drug research is personal” chat with Amicus Therapeutics’ CEO and CRO on the criticality of compliance in advancing lifesaving therapies
  • An inside account from a former sales rep charged with violating the Anti-Kickback Statute
  • CLE, CPE and CCB-accredited** content
Save $500 if you use promo code PCCDC5 and register by March 27, 2020. Learn more at www.informaconnect.com/pcc.

*Discount offer valid through 3/27/2020; applies to standard rates only and may not be combined with other offers, categories, promotions or applied to an existing registration.
**Pending approval



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

Friday, March 06, 2020

Insights into Prescription Decision Support Through the Patient Journey

Today’s guest post comes from Miranda Gill, Senior Director of Provider Network at CoverMyMeds.

Miranda discusses some of the findings in CoverMyMeds’ most recent industry report on medication access.

To learn more about prescription support and access, read the complete CoverMyMeds' Medication Access Report.

Read on for Miranda’s insights.

Tuesday, March 03, 2020

The Top 15 U.S. Pharmacies of 2019: Specialty Drugs Drive the Industry’s Evolution

Next week, Drug Channels Institute will release our 2020 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. It’s the 11th edition of our popular and comprehensive examination of the entire drug pricing, reimbursement, and dispensing system.

The exhibit below—one of 203 in our new report—provides a first look at the 15 largest pharmacies, ranked by total U.S. prescription dispensing revenues for calendar year 2019. I also highlight business developments that shifted market share among the biggest players.

As you will see, pharmacy industry prescription dispensing revenues reached a record $446 billion in 2019. Revenues were highly concentrated due to the rapid growth of large specialty pharmacies and the multiple transactions that we discuss throughout our report.

For a sneak peek at the complete report, click here to download a free pre-publication draft overview (including the table of contents and a list of exhibits). We’re offering special discounted pricing if you order before March 22, 2019.

Monday, March 02, 2020

Join Me for Asembia’s Specialty Pharmacy Summit 2020

Asembia’s Specialty Pharmacy Summit 2020
May 3 – 7, 2020 | Las Vegas
www.asembiasummit.com

Please join me at Asembia's Specialty Pharmacy Summit 2020 which will take place from May 3 to May 7, 2020 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 Ahead for the Next Decade? 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: The State of Specialty Pharmacy 2019: Industry Trends and Photos from #Asembia19.

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

A MESSAGE FROM ASEMBIA

As the nation’s largest annual conference for specialty pharmacy, Asembia’s 2020 Specialty Pharmacy Summit will welcome 6,500+ attendees from more than 1,200 organizations, including pharmacy providers, health systems, pharma/biotech manufacturers, payers, drug wholesalers and many other stakeholders.

Attendees will gain an in-depth understanding of all facets of the nearly $200+ billion specialty pharmacy channel from a range of industry speakers sharing expert insights on critical industry trends.

The value-packed 2020 agenda includes interactive business seminars, continuing education sessions, engaging exhibits and unparalleled networking.

Register at asembiasummit.com.

Watch 2019 Video Highlights.


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

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.