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...

Tuesday, May 18, 2021

The Specialty Pharmacy Accreditation Boom Slows: DCI’s Exclusive Update on the U.S. Market

It’s time for Drug Channels Institute’s annual update of the number of U.S. specialty pharmacies. Fortunately, I had outstanding research assistance. (See photo at right.)

As you will note below, the specialty pharmacy industry remains quite diverse—despite the concentration of dispensing revenues within a small number of companies.

Our proprietary analyses have identified more than 1,200 locations that have achieved specialty pharmacy accreditation from one of the two major independent accreditation organizations. 

Overall accreditation growth appears to be slowing. However, pharmacy locations owned by healthcare providers—hospitals, health systems, physician practices, and providers’ group purchasing organizations—now account for nearly 40% of all accredited specialty pharmacy locations.

Read on for a bite of our arithmomania.

Monday, May 17, 2021

LexisNexis Webinar: Using SDoH Data to Supercharge Outreach and Engagement

Lexis Nexis Webinar: Using SDoH Data to Supercharge Outreach and Engagement
June 24, 2021 | 1:00 pm ET | Virtual Event

The shift to real-world evidence and real-world data has driven a significant transformation in healthcare. While EMR, medical, and pharmacy claims data is important and has traditionally been the main source of information for life science companies, that data doesn’t give a complete picture of the patient. Studies show that medical determinants are only accountable for 20% of healthcare outcomes, whereas social determinants of health account for as much as 50%.

Join experts from LexisNexis® Risk Solutions to:
  • Learn how your organization can accelerate its growth by applying data and analytics
  • Gain new insight into additional opportunities for R&D
  • Support outreach efforts to targeted patient populations
A wealth of data can be extracted from vast sources of public records and proprietary data sources, but more data isn’t always better. Combining the right, clinically validated data points can transform your business and the outcomes you are working to improve.

Register for the June 24 LexisNexis webinar today.


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

Friday, May 14, 2021

Prescribing and Policy Trends Affecting Medication Access in 2021

Today’s guest post comes from Kyle Grimslid, Clinical Solutions Director at CoverMyMeds.

Kyle discusses the prescribing trends and policies that emerged in 2020. He highlights the growing importance of pharmacists and the role of technology in improving patient access, affordability, and adherence.

Read more in CoveryMyMeds’ 2021 Medication Access Report: Legislative and Regulatory Edition. (free download)

Read on for Kyle’s insights.

Wednesday, May 12, 2021

How Cigna’s Growing Pharmacy Platform Expands Its Channel Power

Last week, Cigna released its earnings for the first quarter of 2021. Links below.

I was struck by how quickly Cigna’s Express Scripts PBM business has increased revenues and prescriptions from its retail pharmacy network. Our second chart below highlights this growth.

The businesses in Cigna's Evernorth segment—especially Express Scripts, Ascent Health Services, and InsideRx—are already providing rebate negotiation, network management, and/or a sourcing platform for Prime Therapeutics, Kroger, Humana, GoodRx, and Amazon. 

I expect Cigna’s influence over the drug channel to expand further as other businesses step onto this burgeoning platform.

Monday, May 10, 2021

Informa Connect’s Formulary, Reimbursement and Access Summit 2021

Informa Connect’s Formulary, Reimbursement and Access Summit 2021
July 27-29, 2021 | Virtual Event
www.informaconnect.com/formulary-access/

Formulary, Reimbursement and Access Summit provides a forum for industry to convene, benchmark and gain strategies to explore new and impending access and managed market challenges within the value-based landscape while providing insights on valuable patient services and support programs, healthcare market coverage and strategies to improve overall access and reimbursements of commercialized drugs.

Drug Channels readers are eligible for an exclusive savings of 10% off* the current rate by using promo code 21FRADC10, be sure to reserve your seat today!

Gain critical insights from a distinguished speaking faculty including:
  • Michael Thompson, President & CEO, National Alliance of Healthcare Purchaser Coalitions
  • D.R. McCale III, MDY, RMC, Director, Market Access and Reimbursement, Akcea Therapeutics
  • Shannon D. Ashmon, MBA, Senior Manager, Access & Reimbursement, Oncology Business Unit, Eisai, Inc.
  • Peter Avalos, National Reimbursement Director, Daiichi Sankyo, Inc.
  • Jeff Blake, Senior Vice President, Payer Relations, Hemophilia Alliance
  • Shawn Gremminger, Health Policy Director, Pacific Business Group on Health
  • And many more!
Transform Access Strategies with Compelling Discussions Around
  • Formulary Insights – Advancements in Design and Management
  • The Future of Rebate Reform – Explore Current and Pending Legislation
  • Assess the Landscape for Prior Authorization and Reimbursement Support - Reexamining the Roles of the Manufacturer and the Pharmacy
  • Value-Based Contracting Frameworks and Considerations
  • Digital Therapies and Telehealth – Define their Role in the Evolving Healthcare Landscape
  • And so much more!
Plus! Choose between 3 Interactive Workshops on Day 2!

Drug Channels readers are eligible for an exclusive savings of 10% off* the current rate by using promo code 21FRADC10, be sure to reserve your seat today!

*Offer may not be combined with other offers, category rates, promotions or applied to an existing registration. Offer not valid 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.

Friday, May 07, 2021

Predicting Enrollment Changes in the COVID Era

Today’s guest post comes from Jill Brown Kettler, Executive Editor at AIS Health, a division of MMIT.

Jill discusses MMIT's proprietary data on how the COVID-19 pandemic affected enrollment in commercial plans, Medicaid, and health insurance exchanges. 

To learn more about 2020 enrollment changes and the 2021 outlook, register for MMIT’s free webinar on May 18 at 1:00 pm ET: Meet the Expert: Predicting Enrollment Changes in the Covid Era.

Read on for Jill’s insights.

Tuesday, May 04, 2021

DCI’s Top 15 Specialty Pharmacies of 2020: PBMs Expand Amid the Shakeout—While Walgreens’ Outlook Dims

In Drug Channels Institute's list of the top 15 pharmacies of 2020, we show that many of the largest U.S. market participants 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. You will see that PBMs and insurers have increased their dominance over specialty drug channels. Many of the largest independent companies have been acquired.

As we look ahead, CVS Health and Cigna’s Express Scripts seem best positioned for further growth. However, AllianceRx Walgreens Prime—the joint venture between Walgreens Boots Alliance and Prime Therapeutics—faces significant market share loss.

Read on for all the details.

Monday, May 03, 2021

Informa Connect’s Annual Commercial Contracts & Chargebacks Congress

Informa Connect’s Annual Commercial Contracts & Chargebacks Congress
June 23-25, 2021 | Virtual Event
informaconnect.com/contracts-chargebacks

Informa Connect’s 17th Annual Commercial Contracts & Chargebacks Congress, taking place virtually June 23-25, offers crucial updates on policy changes and contracting best practices to increase efficiency, reduce revenue leakage, and streamline chargeback excellence. 

This annual event has become a must-attend for pricing and contracting professionals in the life sciences industry with seasoned leaders and forward-thinking strategies on display. Join industry stakeholders, including manufacturers, wholesalers, GPOs and more, for a robust three-day event offering extended content and actionable strategies in key interest areas in the ever-evolving contracting landscape.

Drug Channels readers are eligible for an exclusive savings of 10% off* the standard rate by using promo code 21CCCDC10, so download the complete conference agenda and reserve your seat today!

Featured Faculty Driving the Conversation:
  • John Shakow, Partner, King and Spalding
  • Susanne Somerville, Chief Executive Officer, Chronicled
  • Edward McAdam, Director, Government Pricing, Contracting Operations & Analytics, Indivior
  • Mike Domanico, Vice President Finance, Revenue, Sandoz (Novartis)
  • Beth Stevens, Associate Director, Contracts & Pricing, TOLMAR Pharmaceuticals
  • Sherice Koonce, Director of Contracts, Hikma Pharmaceuticals
  • Fred Fieder, Director, Contract Administration, McKesson
  • Susan Lowe, Senior Vice President, Supply Chain Operations, FFF Enterprises
  • Brian Green, Head of Contract Operations, UCB Pharma
  • Felicia Manning, Associate Director, Market Access, Pricing & Reimbursement, Theravance BioPharma US
  • And many more!
Hight Impact Topics Transforming the Market Include:
  • Policy Update on 340B and Pharmacy Channel Evolution
  • Contract Management Reimagined — Operational Excellence Strategies for Increased Process Efficiencies and Reduced Revenue Leakage
  • Strategic Contracting Industry Insights Panel — The Confluence of Data, Financial Analytics and Value
  • Revolutionize and Automate Transactions using Blockchain
  • GPO Panel featuring Vizient, Premier Inc. and more!
  • Contract Administration Industry Insights Panel — Process Improvement in Contract Administration and Management — Streamlining Chargeback Operations, GPO Rosters and Channel Operations
Drug Channels readers are eligible for an exclusive savings of 10% off* the standard rate by using promo code 21CCCDC10, so download the complete conference agenda and reserve your seat today!

*Expires 6/25/20210; applies to standard rate only and may not be combined or applied to existing 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.

Friday, April 30, 2021

How Non-Commercial Pharmacies Accelerate Patients Into Prescription Programs

Today’s guest post comes from Natalie Tyler, Director of Pharmacy Operations & Strategy at ConnectiveRx.

Natalie discusses how non-commercial pharmacies boost patient access and adherence to specialty therapies. They also help physicians deliver better care.

On May 24 at 1:00 pm ET, ConnectiveRx will host an online panel discussion on non-commercial pharmacy services with experts from ConnectiveRx and AstraZeneca. Click here to register here for this free event. Email inquiries@ConnectiveRx.com with any questions.

Read on for Natalie’s insights.

Tuesday, April 27, 2021

Drug Channels News Roundup, April 2021: Cigna’s $500 Gift, 340B & Specialty Pharmacy, GoodRx Deep Dive, and U.S. Drug Pricing Policy

While we all roll up our sleeves for a full reopening, let’s spring into this month’s selection of noteworthy news:
  • Thoughts on Cigna’s payments to patients for non-medical switching
  • 340B’s explosive specialty pharmacy growth
  • An excellent analysis of GoodRx
Plus, my $0.02 on U.S. drug pricing policy.

P.S. Join the more than 11,600 followers of my daily links to neat stuff at @DrugChannels on Twitter. Recent posts have covered biosimilars, pharmacist workloads, formularies, pricing, PSAOs, Part D spending, copay accumulators, H.R.3, and more. You can also join my more than 17,000 followers on LinkedIn.

Monday, April 26, 2021

Making Health Policy Work for Patients: How Platform Solutions Enable More Affordable Drugs (Kalderos)

At Kalderos, we use data-driven solutions to deliver unifying technologies to solve problems facing the U.S. healthcare system, so that everyone can focus on the health of patients. We created the world’s first Drug Discount Management platform. This platform uses sophisticated models and machine learning to identify and then resolve noncompliance in drug discount programs.

On April 20, we released Making Health Policy Work for Patients: How Platform Solutions Enable More Affordable Drugs (free download), our first-ever annual report. 

Our 2021 annual report shares our perspective on challenges with discount and rebate programs in the drug channel and reports on our rapid growth as a health tech platform. It explores:
  • How systemic inefficiencies mean patients pay more for drugs
  • Why past drug price interventions have failed the patients who need them most
  • The tech-enabled, data-driven way to fix drug distribution and put patients first
The report also includes never-before-published insights leveraged from Kalderos’ proprietary data, drawing on our tech-enabled solutions for Discount Monitoring in the 340B Drug Pricing Program:
  • Our estimated total amount of duplicate discounts between 340B and Medicaid in 2019 based on our platform gathering more than four years of good-faith inquiry data from covered entities
  • Key metrics describing Kalderos’ growing network of relationships with stakeholder partners and increasing impact in 340B
The 2021 annual report also sets a vision for our company’s future as we continue our trajectory of rapid scaling, with a product roadmap that includes an expansion into data-driven, transparency-minded platform solutions for other drug discount programs.

Download the full report from Kalderos.


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

Friday, April 23, 2021

The Value of Patient-Centricity in Tech-Enabled Medication Access Solutions

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

Erica discusses four technology areas that the healthcare network can embrace to increase speed to therapy, affordability, and adherence.

To learn more about CoverMyMeds' specialty medication access solutions, download their new whitepaper: Helping Patients Access Specialty Therapies: Autoimmune Conditions. (Free download)

Read on for Erica’s insights.

Tuesday, April 20, 2021

Express Scripts 2020 Update: Utilization Drove Drug Spending Growth—While Maximizers Gained Further Traction

Cigna’s Evernorth business has recently released its 2020 Drug Trend Report. The results, which reflect the Express Scripts PBM business, are presented as a series of animated webpages. As you can see, Chief Innovation Officer Dr. Glen Stettin is newly cartooned.

For commercial plan sponsors, pharmacy benefit spending grew by 4.0%. However:
  • More than three-quarters of this spending growth was due to the growth in utilization—the number of people being treated and the number of prescriptions being dispensed.
  • The net, post-rebate costs of drugs rose by only 0.9%.
Details and comments about some therapeutic classes below. 

SaveonSP, the secretive copay maximizer partner of Express Scripts, apparently again drove big specialty savings for some plans in 2020. I wonder how many plan sponsors have probed the profits and operations of this business?

Monday, April 19, 2021

Informa Connect’s Compliance Congress for Specialty Products

Informa Connect’s Compliance Congress for Specialty Products
June 22-24, 2021 | Virtual Event
www.informaconnect.com/specialty-compliance/

Exclusive Offer: Use promo code SPECIALTY10 to save 10% off* your registration fee.

Up your compliance game at this important event serving the unique sector of Specialty Products, the 7th annual Virtual Compliance Congress for Specialty Products. Join the compliance community for dynamic discussions on the top risk areas for specialty pharmaceutical companies, including speaker programs, patient support programs, charitable donations, specialty pharmacy relationships, patient advocacy group interactions, mergers and acquisitions, medical affairs activities, drug pricing, transparency and more!

The Compliance Congress for Specialty Products serves as a three-day conference experience, featuring top experts ready to lead robust discussions on the current and changing environment, industry best practices, hot-button topics and more, including:
  • Enforcement Trends & Prosecutor Perspectives
  • COVID-19 Impacts & Aftermath
  • Crisis Management & Business Continuity
  • Patient Interactions & Support Programs
  • Virtual/Digital Engagement & Monitoring
  • Transparency & Aggregate Spend
  • Drug Pricing Legislation & Transparency
  • Compliance Training & Culture Development
  • Speaker Programs
  • And more!
Outstanding Virtual Capabilities:
  • Interactive presentations and panels
  • Live Q&A and polling
  • Live and on-demand sessions, all available 30-days post-event to review at your leisure
  • 1-1 meeting opportunities and peer-to-peer engagement
  • Sophisticated and seamless scheduling tools
PLUS: Advance Your Career with CLE, CPE & CCB accredited content!

Exclusive Offer – View the full agenda and register today. Use promo code SPECIALTY10 to save 10% off* your registration fee.

Informa Connect will see you there!

*Cannot be combined with other offers, promotions or applied to an 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. To find out how you can reach the Drug Channels audience, please contact Paula Fein (paula@DrugChannels.net).


Friday, April 16, 2021

Choosing the Optimal Pharmacy Model for Retail and Specialty-Lite Products

Today’s guest post comes from Jeff Spafford, President and CEO at AssistRx.

Jeff discusses aspects of our drug pricing system that lead to decreased new and refill prescription volume, higher out-of-pocket costs for patients, and therapy abandonment.

To learn more about AssistRx’s technology solutions register for their Optimizing Program Performance: An Innovative Approach for Retail and Specialty Products webinar series.

Read on for Jeff’s insights.

Wednesday, April 14, 2021

Gross-to-Net Bubble Update: Net Prices Drop (Again) at Six Top Drugmakers

Time for Drug Channels' annual update on pricing at six of the largest pharmaceutical manufacturers—Eli Lilly, GlaxoSmithKline, Janssen, Merck, Novartis, and Sanofi. You can find links to each company’s data below.

When rebates and discounts were factored in, brand-name drug prices declined—or grew slowly—in 2020. Consistent with our previous analyses, rebates and discounts reduced the selling prices of brand-name drugs to less than half of their list prices. What’s more, net drug prices have declined for the past four years.

Alas, many pharma industry perma-critics refuse to accept that brand-name drug prices are falling—or that they remain the only part of U.S. healthcare where prices have been declining. That’s why they are drug pricing flat earthers (DPFE.) Consider today’s data deluge as my small contribution to making the world a slightly smarter and more fact-based place.

Monday, April 12, 2021

Informa Connect’s Patient Support Services Congress

Informa Connect’s Patient Support Services Congress
June 15-17, 2021 | VIRTUAL EVENT (All-Digital Format)
www.informaconnect.com/patient-support-services/

Patient Support Services is a dialogue driven meeting that arms the industry with trends and next-generation approaches to patient services for optimal performance. Showcasing innovative discussions on access strategy, patient interactions, case management, compliance practices and more, this two-and-a-half-day event navigates a myriad and mounting level of compliance hurdles while strengthening and innovating patient-oriented programs.

Drug Channels readers save 10% off the current registration rate with promo code 21PSSDC10.* Register today.

In-Depth Discussions and Actionable Takeaways on Critical Topics:
  • Keep a Pulse on Emerging Trends for 2021 — Update on Drug Pricing Pressures, Patient Assistance Programs, Evolving Copay Card Legislation and Formulary Transformations
  • Enforcement Update — Oversight and High Priority Risk Areas for Patient Services
  • Industry Playbook for Risk Mitigation — Leading Frameworks to Enhance your Compliance Strategy
  • Enhance the Stakeholder Experience — Operational Insights on Specialty Patient Connectivity
  • Capture and Optimize Patient Data to Create an Integrated Experience
Customizable Experience with Two Tailored Tracks:
  • Legal and Compliance
  • Innovation and Operations
Featured Faculty Driving the Conversation:
  • Esther Langer, Head of US Patient Services, Trade and Distribution, Apellis Pharmaceuticals
  • Paul J. Koob, Assistant U.S. Attorney, U.S. Attorney’s Office for the Eastern District of Pennsylvania
  • Jolie Apicella, Assistant U.S. Attorney, Chief, Health Care Fraud, U.S. Attorney’s Office, Eastern District of New York
  • Rahul Khara, Pharm.D., Vice President, Legal and Chief Compliance Officer, Acceleron Pharma Inc.
  • Amy Wilson, Head, U.S. Compliance, Morphosys
  • Karen Tenenbaum, Vice President, Assistant General Counsel, Head of Legal, Salix
  • Liam Moy, Senior Director, Patient Services, Neurology, Alexion Pharmaceuticals
  • Katherine Chaurette, Vice President Healthcare Law and Compliance, Blueprint Medicines
  • Dave MacLeod, Head of Patient Services and Specialty Pharmacy Operations, Amylyx Pharmaceuticals
  • Robert Britting, Director, Patient Services and Strategic Solutions, Teva Pharmaceuticals
  • And so many more!
Comprehensive Content and Dynamic Features Include:
  • 3 days of live content from industry thought-leaders
  • 10+ on-demand sessions, tailored to both access and compliance
  • Over 4 hours of live speaker Q&A
  • AI-powered virtual networking with colleagues and counterparts
  • Private meeting and chat rooms
  • Access to live and on-demand content for 30 days post-event
Drug Channels readers save 10% off the current registration rate with promo code 21PSSDC10. Register today.

*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.

Friday, April 09, 2021

A Framework to Optimize Patient Access And Drive Value in the Care Continuum

Today’s guest post comes from William Dupere, Practice Lead and Vice President of Market Access at TrialCard.

Bill discusses specific barriers to access, affordability, and adherence in the specialty pharmacy patient journey. To learn more about TrialCard’s patient access solutions, please visit their Resources page. You can also contact them at sales@trialcard.com.

Read on for Bill’s insights.

Tuesday, April 06, 2021

The Top Pharmacy Benefit Managers of 2020: Vertical Integration Drives Consolidation

The drug channel is consolidating, both vertically and horizontally.

For evidence, look no further than Drug Channels Institute's estimates of pharmacy benefit manager (PBM) market share, which are shown in the chart below. For 2020, DCI estimates that the three biggest PBMs accounted for more than three-quarters of total equivalent prescription claims.

To help you make sense of recent market changes, I also include a brief video explaining how various transactions and partnerships have concentrated and shifted PBM share among the vertically integrated companies. The video is excerpted from my recent Patients, Payers, and PBMs webinar.

Depending on your role in the drug channel, you may or may not find these data terrifying.

Thursday, April 01, 2021

Streamlining the Specialty Therapy Prescribing and Enrollment Experience

Today’s guest post comes from Megan Marchal, CoverMyMeds Specialty Pharmacy’s pharmacist in charge.

Megan discusses a recent enhancement to AMP: Access for More Patients™ (AMP), a tech-enabled hub and patient access service from CoverMyMeds and RxCrossroads by McKesson. Read more about technology and patient access in CoverMyMeds’ 2021 Medication Access Report.

Read on for Megan’s insights.

Wednesday, March 31, 2021

Drug Channels News Roundup, March 2021: Sanofi’s Gross-to-Net Bubble, Express Scripts Rebates, Health Insurance Hustle, and Vertical Integration Illustrated

Spring has finally reached our worldwide headquarters here in lovely downtown Philadelphia. (See photo at right.) Before your allergies kick in, please inhale this month’s selection of noteworthy news stories:
  • Sanofi: Drug prices drop, but patient costs increase
  • A new rebate disclosure from Express Scripts
  • The health insurance hustle
Plus, a 2021 update to my infamous chart of the seven biggest vertically integrated organizations that combine insurers, PBMs, specialty pharmacies, and healthcare providers.

P.S. Join the more than 11,400 followers of my daily links to neat stuff at @DrugChannels on Twitter. You can also join my more than 16,000 followers on LinkedIn.

Monday, March 29, 2021

Informa Connect's Medicaid and Government Pricing Congress

Medicaid and Government Pricing Congress
June 8-11, 2021 | Virtual Event
www/informaconnect.com/medicaid-congress

Register today using the exclusive Drug Channels discount code 21MDGP10 to receive 10% off!

The Medicaid and Government Pricing Congress, an important event dedicated to critical policy updates and approaches to effectively contract, report and comply with state and federal healthcare programs, returns June 8-11, 2021.

Hear from GP Experts on MDRP trends and strategies and the impacts from the change to a new administration. The 2021 event has a content-rich agenda, providing the most up-to-date content and topics based on the ever-changing political and regulatory environment, fresh perspectives from small to big pharma and more interaction in the virtual environment.

Up-To-Date Content
We’ve got all of the key legal and consultant perspectives on topics like 340B (including contract pharmacy arrangements), State Price Transparency, CMS current and final rules, Most Favored Nations, and more!

Fresh Perspectives
Along with many of the well-respected experts typically on the program from companies like Gilead, Sandoz, CMS, AstraZeneca, Pfizer and Regeneron, we’ve added new speakers form Amgen, Jazz Pharmaceuticals, Novartis and more!

More Interaction
In addition to our select Panel Discussions and the insightful Fireside Chat with Outside Counsel, we’ve added interactive working groups led by expert Facilitators from manufacturers, law firms, and consulting groups to discuss everything from Product Launch, Divestiture and Acquisition Challenges to State Dispute Resolution and Collaboration during the pandemic, to State Price Transparency and Reporting.

PLUS our world-class content including topics like the in-depth GP 101 Bootcamp, operational effectiveness sessions, updates from OIG and more! Register today using the exclusive Drug Channels discount code 21MDGP10 to receive 10% off!


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

Friday, March 26, 2021

What I told Congress about the 340B Program (rerun)

This week, I’m rerunning some popular posts while I prepare for today's live video webinar: Drug Channels Quarterly Update: Patients, Payers, and PBMs.

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


ICYMI, House Energy and Commerce Committee Republican Leader Greg Walden (R-OR) and Senate Health, Education, Labor and Pensions (HELP) Committee Chairman Lamar Alexander (R-TN) recently asked for input on how to improve the 340B Drug Pricing Program. Comments were due last Friday (October 30).

Your friendly neighborhood blogger submitted an 11-page letter, which you can read below. I shared my $0.02 on the overall market, explained channel distortions from 340B contract pharmacies, and offered some policy recommendations.


For your reference, I also include links to published comments from the American Hospital Association and the Pharmaceutical Research and Manufacturers of America.

The new Congress has an ambitious agenda. Let’s hope modernizing 340B gets on the do list.

Thursday, March 25, 2021

Drug Pricing Policy in 2021: Four Crucial Consequences of Pharmacy Benefits Today (rerun)

This week, I’m rerunning some popular posts while I prepare for tomorrow's live video webinar: Drug Channels Quarterly Update: Patients, Payers, and PBMs.

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


When Americans complain about “drug prices,” most are actually complaining about the share of costs they pay—and how those costs are computed. Addressing patient affordability issues therefore requires a deep understanding of the U.S. drug channel.

Today, I review four crucial issues that the new Congress could tackle to address affordability, patients' out-of-pocket obligations, and prescription prices. I also highlight some of the existing and proposed legislative efforts. 

Our complex channel cannot be fixed with simplistic solutions. It may seem unlikely that we will get bipartisan legislation that sensibly addresses the distortions and challenges in our drug pricing system. But I can dream, can’t I?

Wednesday, March 24, 2021

Disruption Delayed: Making Sense of Amazon’s Latest Pharmacy Moves (rerun)

This week, I’m rerunning some popular posts while I prepare for this Friday’s live video webinar: Drug Channels Quarterly Update: Patients, Payers, and PBMs.

Amazon Care, the company's virtual primary care offering, has announced a major expansion since the article below was published. However, I've read few overwrought predictions of doom for current telehealth and payer competitors—a welcome and notable difference from the 2017-18 mania about Amazon's imminent (and still unfulfilled) "disruption" of the pharmacy and PBM industries. 

Click here to see the original post and comments November 2020.


Amazon is getting more serious about pharmacy. ICYMI: Introducing Amazon Pharmacy: Prescription Medications Delivered.

This announcement is much less disruptive than it appears to be. Amazon is copying the GoodRx discount card model—including GoodRx’s partnership with Express Scripts. At the same time, Amazon is launching a mail pharmacy that will accept insurance and be in PBM pharmacy networks.

Amazon’s actions are another negative headwind for retail pharmacies, but not a fatal blow to the system. Perhaps Amazon will one day become a true disrupter. For now, Amazon is choosing to join the drug channel, not fundamentally change it.

Tuesday, March 23, 2021

Surprise! Brand-Name Drug Prices Fell (Again) in 2020 (rerun)

This week, I’m rerunning some popular posts while I prepare for this Friday’s live video webinar: Drug Channels Quarterly Update: Patients, Payers, and PBMs.

Click here to see the original post and comments from January 2021.


It was another year of unexpected drug price developments.

In 2020, brand-name drug net prices dropped for the third consecutive year. Meanwhile, brand-name drug list prices grew at their slowest rate in at least 20 years. See our updated analysis below.

I also review the factors behind declining brand-name drug prices. These factors are firmly in place for 2021.
.
Our new Congress may try tackle drug prices in the new year. Let’s hope that their policy perceptions catch up to today’s realities.

Monday, March 22, 2021

The Big Three PBMs Ramp Up Specialty Drug Exclusions for 2021 (rerun)

This week, I’m rerunning some popular posts while I prepare for this Friday’s live video webinar: Drug Channels Quarterly Update: Patients, Payers, and PBMs.

Click here to see the original post and comments from January 2021.


Once again, the three largest pharmacy benefit managers (PBMs)—Caremark (CVS Health), Express Scripts (Cigna), and OptumRx (United Health Group)—have increased the number of drugs they have excluded from their standard formularies. 

Today, I update our annual tracking of the number of exclusions by each PBM. I also highlight the expansion of exclusions into major specialty therapy classes. The 2021 formulary exclusion lists are available below for your downloading pleasure.

The growth in excluded products shows how competitive many specialty therapy categories have become—and the undisclosed but presumably significant rebates generated by these products. Patient impact is also increasing, as products move on and off formularies.

Eight years ago, I outlined the inevitability of formulary exclusions. But I didn’t anticipate just how far PBMs would push this tool. Expect much more controversy as exclusions hit previously untouched but sensitive sole-source products in oncology, rheumatology, and beyond—and even start moving into Medicaid.

Friday, March 19, 2021

Reducing Patient Fallout: Transform How They Get and Stay on Medication

Today’s guest post comes from Brian Haenni, Vice President of Hub Solutions at ConnectiveRx.

Brian discusses the benefits of digital patient support services. To learn more about ConnectiveRx’s patient support capabilities, register for their April 14, 2021 webinar, Transforming the Patient Support Experience.

Read on for Brian’s insights.

Thursday, March 18, 2021

How GoodRx’s Rapid Growth Creates Conflict between PBMs and Payers

Pharmacy pricing and benefit design are fundamentally broken.

For proof, look at GoodRx’s 2020 financial results for its discount card business. The company accounted for an estimated $3.4 billion in U.S. prescription revenues—and earned nearly $500 million in fees from PBMs.

Incredibly, three out of four consumers who used GoodRx already had commercial, Medicare, or Medicaid insurance. This means that someone—the consumer, their employer, and/or the government—paid insurance premiums for a pharmacy benefit managed by a PBM. Yet it was still worthwhile for people to bypass their plan’s out-of-pocket costs and PBM network rates in favor of a different PBM’s rates. As I explain below, such arbitrage creates potent conflicts between PBMs and their plan sponsor clients.

Don’t blame GoodRx for this mess. I give it credit for helping consumers navigate a crazy system that incentivizes people to bypass their own insurance plans. But it’s hard not to dislike a system that enables these games. Read on and let me know what you think.

The unusual alliance between PBMs and discount card vendors is among the many topics that I’ll address in DCI’s upcoming live video webinar, Drug Channels Quarterly Update: Patients, Payers, and PBMs , on March 26, 2021, from 12:00 p.m. to 1:30 p.m. ET. CLICK HERE TO LEARN MORE AND SIGN UP.

Tuesday, March 16, 2021

NEW: The 2021 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers

I am pleased to announce our new 2021 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 31, 2021.

The 2021 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers is a truly unique resource. With 211 proprietary charts, exhibits, and data tables, this 12th 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 412 pages. I can confidently say there is nothing else available that comes close to this report.

The chart below illustrates the depth and breadth of the 2021 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.

Friday, March 12, 2021

Predicting Payer Uptake With Precision

Today's guest post comes from Carolyn Zele and Ritupriya Yamujala, Senior Solution Consultants at MMIT.

Carolyn and Ritupriya discuss the challenges that manufacturers face in getting payer coverage for new drugs. They argue that a manufacturer can use analogs to improve messaging to payers, identify coverage challenges, and accurately predict payer uptake.

To learn more about these techniques, register for MMIT’s April 6, 2021 webinar: Predicting Payer Uptake With Precision.

Read on for Carolyn’s and Ritupriya’s insights.

Tuesday, March 09, 2021

The Top 15 U.S. Pharmacies of 2020: Market Shares and Revenues at the Biggest Companies

Next week, Drug Channels Institute will release our 2021 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. It’s the 12th edition of our popular and comprehensive examination of the entire drug pricing, reimbursement, and dispensing system. (You can preorder at special discounted prices.)

The exhibit below—one of 211 in our new report—provides a first look at the 15 largest organizations, ranked by total U.S. prescription dispensing revenues for calendar year 2020.

U.S. prescription dispensing revenues reached a record $465 billion in 2020. The largest players all had bigger slices of the revenue pie, due to the growth at specialty pharmacies and multiple transactions that shifted market share among the vertically integrated companies.

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 31, 2021.

Join me for DCI’s upcoming live video webinar, Drug Channels Quarterly Update: Patients, Payers, and PBMs , on March 26, 2021, from 12:00 p.m. to 1:30 p.m. ET. I'll review key PBM-related findings from our new report. Plus, I'll take live audio questions from the audience. (Yes, really.)  CLICK HERE TO LEARN MORE AND SIGN UP.

Friday, March 05, 2021

The Importance of Immediate Drug Price Transparency

Today’s guest post comes from Edward Hensley, Co-founder and Chief Commercial Officer at AssistRx.

Edward discusses the impact of providing access to drug price transparency and affordability programs to healthcare providers and patients at the point of care.

To learn more about AssistRx’s solutions, visit AssistRx.com.

Read on for Edward’s insights.

Thursday, March 04, 2021

NEW: Drug Channels Quarterly Update: Patients, Payers, and PBMs (Live Video Webinar)

Join Dr. Adam J. Fein, CEO of Drug Channels Institute (DCI) and the author of Drug Channels, for his latest exclusive live video webinar:

Friday, March 26, 2021 (12:00 p.m. to 1:30 p.m. ET)

This event is part of The Drug Channels 2021 Quarterly Video Webinar Series. Those who have already signed up for the series have been automatically registered for the March webinar.

WHAT YOU WILL LEARN

Dr. Fein will help you and your team stay on top of the latest trends and market data. He will also draw from exclusive information found in our new 2021 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers.

During this event, Dr. Fein will share his latest thinking on a wide range of topics, including:
  • Trends in pharmacy benefit design and consequences for patients' out-of-pocket costs
  • COVID-19's impact on the payer mix at the largest insurers
  • The industry position and strategies of the largest PBMs, including DCI's exclusive market share data
  • A look at PBMs' changing business models
  • An update on vertical integration, consolidation, and alliances
  • A review of DCI's exclusive analyses of the specialty pharmacy marketplace
  • Reflections on drug pricing policy under the Biden administration
  • And more!
PLUS: Dr. Fein will take your questions throughout the event, making this our most interactive webinar yet. Plus, we've extended the webinar to 90 minutes to accommodate more audience questions. CLICK HERE to submit questions in advance of the event.

Read on for full details on pricing, including substantial discounts for multiple devices. You can also watch a video invitation.

Tuesday, March 02, 2021

Supermarkets Outpace CVS and Walgreens in 2021’s Part D Pharmacy Networks

The Centers for Medicare & Medicaid Services (CMS) has recently released its 2021 data on enrollment in Medicare Part D prescription drug plans (PDPs). Our exclusive analysis of these numbers finds that for 2021, an astounding 99% of seniors are enrolled in PDPs with preferred pharmacy networks.

Below, we use the new enrollment data to examine the major pharmacy chains’ position within the 27 major Part D plans that have preferred networks. As you will see, the big supermarket chains—Albertsons, Kroger, and Publix—outpaced the big three drugstore chains and Walmart.

Pharmacies continue to sacrifice margin for store traffic. Don’t expect that to change—especially given the notable failure of the independents-only Indy Health Part D plan.

Tuesday, February 23, 2021

Drug Channels News Roundup, February 2021: Accumulator Problems, Humana + ESI, White Bagging Battles, Buy-and-Bill Economics, and Pharmacy Hero Dave Marley

Let’s melt away this foul February with our monthly selection of scorching news from around the drug channel. In this issue:
  • Payers confess: Patients lose from copay accumulators
  • Humana joins the Express Scripts GPO
  • Hospitals vs. PBMs over specialty pharmacy white bagging
  • Let’s all follow the Buy-and-Bill Dollar!
Plus, entrepreneurial pharmacy owner Dave Marley demonstrates the power of innovation.

P.S. Join the more than 11,000 followers of my daily links to neat stuff at @DrugChannels on Twitter. You can also join my more than 15,000 followers on LinkedIn.

Tuesday, February 16, 2021

The Promise and Limits of Digital Pharmacies

Does pharmacy need to be disrupted?

Venture capitalists clearly think so, judging by the billions they have put behind technology-enabled digital pharmacies. Below, you’ll find our list of 14 leading contenders along with funding levels. These companies have not gained significant pharmacy industry market share, but their revenue growth rates are impressive.

Alas, many of these digital pharmacies seem to have misdiagnosed their relative advantage versus today's pharmacies. 

That’s why I believe that digital pharmacies’ biggest impact will come from forcing the industry incumbents to improve their businesses and approach to patients. Pharmacies and PBMs should absorb the technologies and consumer-oriented mindsets of the start-ups.

Digital pharmacies more intriguing disruption comes from combining prescribing and dispensing. But this novel idea seems to have limited applicability to the broader prescription market.   

Read on and let me know what you think.

Tuesday, February 09, 2021

Available for Preorder: The 2021 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers

On March 16, 2021, Drug Channels Institute will release The 2021 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. This report—our twelfth 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 2021 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 16.


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 31, 2021.

Tuesday, February 02, 2021

Pharmacy Economics Rebound (A Little) Amid Glimmers of Good News

Time to update Drug Channels' exclusive look at independent pharmacy owners’ business economics.

Our analysis reveals that despite what you may have heard, many independent pharmacies have figured out how to survive a highly challenging environment.

Retail pharmacy profits have rebounded—or at least not fallen any further. What’s more, better expense control has allowed the average pharmacy owner’s salary to increase for the first time in years. 

Believe it or not, the pharmacy profit outlook for 2021 also is improving, thanks to the Rutledge v. PCMA decision and the prospect of state Medicaid changes in California, New York, and elsewhere.

Read on for our analysis of pharmacy profits and some thoughts on the hardy retail pharmacy survivors.

Friday, January 29, 2021

The Importance of Humanity in Medication Access

Today’s guest post comes from David Holladay, President of CoverMyMeds.

David highlights the value of empathy in patient care. He also shares crucial findings from CoverMyMeds’ new 2021 Medication Access Report. This report provides a wealth of data about medication access, while also highlighting patients’ own stories and experiences.

Read on for David’s insights.

Tuesday, January 26, 2021

Drug Channels News Roundup, January 2021: Hospital Drug Profits, Details of PBM-Manufacturer Insulin Deals, and My Favorite Chart Updated

For my first Drug Channels news roundup of 2021, I focus on two remarkable, must-read reports that provide extraordinary details about the hidden economics of our drug channel:
  • The Center for Medicare & Medicaid Services’ new transparency rule discloses how much major insurers overpay hospitals for outpatient drugs.
  • A new Senate report reveals unprecedented information about PBMs, manufacturers, and the gross-to-net bubble for insulin.
Plus, a 2021 update to my all-time favorite chart.

P.S. Join the nearly 11,000 followers of my daily links to neat stuff at @DrugChannels on Twitter. You can also join my nearly 15,000 followers on LinkedIn.

Friday, January 22, 2021

Enhance Patient Care And Cost Savings By Improving Data Exchange Within The Systems You Already Have

Today’s guest post comes from Jason Coles, Senior Product Manager for Clinical Effectiveness at Wolters Kluwer, Health.

Jason discusses the benefits of accessing patient information across clinical contexts. He introduces us to the Wolters Kluwer drug data solutions. These solutions promote interoperability and help healthcare businesses meet regulations related to health information exchange.

To learn more, download the Wolters Kluwer interoperability stories ebook.

Read on for Jason’s insights.

Wednesday, January 20, 2021

Latest CMS Data Reveal the Truth About U.S. Drug Spending

ICYMI: The econowonks at the Centers for Medicare & Medicaid Services (CMS) recently dropped the latest National Health Expenditure (NHE) data, which measures all U.S. spending on healthcare. Links below.

Today, I highlight the surprising insights from the latest figures. I examine the growth rates of major spending categories, break down costs vs. utilization, and highlight the unfavorable out-of-pocket dynamics for prescription drugs compared with hospital care.

Bonus: I also debrief you on CMS’s quinquennial comprehensive revision to the national spending data.

Regular readers know the unofficial motto of Drug Channels: "Everyone is entitled to their own opinion, but not their own facts." For 2021, I hope the drug pricing flat earthers (#DPFE) finally start to follow the data and acknowledge what’s really going on.

Tuesday, January 19, 2021

17th Annual Life Sciences Accounting & Reporting Congress

17th Annual Life Sciences Accounting & Reporting Congress
March 16-18, 2021 | Virtual Event
www.informaconnect.com/accounting-reporting-congress

The 17th 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. Join us for a Spring Virtual Update on March 16-18, 2021 as we navigate regulatory reform, increased complexity, dynamic risk environment, COVID industry impacts and more.

Visit www.informaconnect.com/accounting-reporting-congress for further details and to register. Drug Channels readers will save $100 off the current lowest rate when they use code DRCH100 and register prior to February 12, 2021.*

With Expert Keynotes, In-Depth Workshops and Live Q&A Opportunities and other virtual features, you’ll end your week ready to advance your organization to stay ahead in 2021.

Here’s a snapshot of what to expect:

Valuable Virtual Networking, Career Development, and Educational Opportunities:
  • Pre-Congress Offerings including Technology Solution Summits, Controller’s Think Tank, 101 Foundational Course, Talent Acquisition and Team Optimization Summit
  • CEO Fireside Chat – A Candid Conversation on Key Business and Industry Priorities in 2021 and Beyond
  • CFO Keynote Panel – Leading in Finance and Navigating the Course of Change
  • CAO Panel and Q&A – Critical Issues in Technical Accounting and Financial Reporting
  • Healthcare Policy Fireside Chat – Pricing, Policy and Healthcare Outcomes
  • SEC Keynote Address – Oversight, Management and Performance
  • FASB Address – Standards Update and Initiatives
  • Advancement Course – Future Finance: Strategies to Empower the Team, Elevate Talent, Inspire Inclusion and Cultivate a Winning Culture
  • Plus – Hot Topic Workshops focusing on AI and Robotics Automation, IPO Readiness, Clinical Trials and Vendor Study Management, Divestiture Strategies, M&A Integration, New Product Commercialization, ESG Metrics and Disclosures, Cyber and Data Security, Corporate Tax Reform Implications
Visit www.informaconnect.com/accounting-reporting-congress for further details and to register. Drug Channels readers will save $100 off the current lowest rate when they use code DRCH100 and register prior to February 12, 2021.*

*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.

Thursday, January 14, 2021

U.S. Prescription Trends: 2020 Review and 2021 Outlook (video)

Below is a brief excerpt from my recent Drug Channels Outlook 2021 video webinar. I discuss:
  • How COVID-19 affected the retail and mail prescription market during 2020
  • What’s ahead for prescription market
This five minute video provides you with a quick and engaging review of a year that many of us would like to forget. You can purchase a replay of the full 75-minute event, which covered many other topics.

You can also sign up for my new Drug Channels 2021 Quarterly Video Webinar Series, which includes four video webinars during 2021 (including my Outlook 2022 webinar on December 17, 2021). Let's hope this year kicks off the roaring '20s!

Tuesday, January 12, 2021

The Big Three PBMs Ramp Up Specialty Drug Exclusions for 2021

Once again, the three largest pharmacy benefit managers (PBMs)—Caremark (CVS Health), Express Scripts (Cigna), and OptumRx (United Health Group)—have increased the number of drugs they have excluded from their standard formularies. 

Today, I update our annual tracking of the number of exclusions by each PBM. I also highlight the expansion of exclusions into major specialty therapy classes. The 2021 formulary exclusion lists are available below for your downloading pleasure.

The growth in excluded products shows how competitive many specialty therapy categories have become—and the undisclosed but presumably significant rebates generated by these products. Patient impact is also increasing, as products move on and off formularies.

Eight years ago, I outlined the inevitability of formulary exclusions. But I didn’t anticipate just how far PBMs would push this tool. Expect much more controversy as exclusions hit previously untouched but sensitive sole-source products in oncology, rheumatology, and beyond—and even start moving into Medicaid.

Monday, January 11, 2021

PAP Critical Update

PAP Critical Update
March 8-10, 2021 | Virtual Event
www.informaconnect.com/pap21

Set the tone and strategy for 2021 with PAP Critical Update taking place March 8-10 in a fully virtual format, and benefit from critical and timely updates addressing the upcoming challenges for patient access and assistance professionals. In a time of unprecedented need, join influential stakeholders as they come together for collaborative and meaningful discussion and dive into policy updates, COVID-19 impacts, election implications, technology advances and so much more affecting the patient access community.

Exclusive Offer – View the agenda at a glance and register today – Be sure to use your exclusive promo code PAP10 to save 10% off* of your registration.

PAP Critical Update serves as a three-day conference experience, featuring top experts ready to lead robust discussions on the changing legal environment, industry best practices, policy watch‑outs and more, including:
  • State of the Industry of Legislation and Pending Health Policy
  • The Intersection of Access and Affordability
  • Leading Perspectives from Regulatory, Foundations and Payers
  • Technology Advances Ensuring Access
  • COVID-19 and PAP Support
  • Accumulator and Maximizer Programs
Unparalleled Virtual Capabilities:
  • Interactive presentations and panels
  • Live Q&A and polling
  • Live and on-demand sessions, all available 30-days post-event to review at your leisure
  • 1-1 meeting opportunities and peer-to-peer engagement
  • Sophisticated and seamless scheduling tools
Exclusive Offer – View the agenda at a glance and register today – Be sure to use your exclusive promo code PAP10 to save 10% off* of your registration.

Informa Connect will see you there!

*Cannot be combined with other offers, promotions or applied to an 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, January 08, 2021

Preserving Trusted Brand Prescribing Through the Patient Journey

Today’s guest post comes from Julia Phillips, VP of Pharma Accounts and Enablement at CoverMyMeds.

Julia discusses common patient access and affordability issues. She describes CoverMyMeds’ technology solutions that are designed to help patients access, afford, and adhere to their prescribed medications.

To learn more about CoverMyMeds’ medication access solutions, download their Technology Solutions Overview.

Read on for Julia’s insights.

Tuesday, January 05, 2021

Surprise! Brand-Name Drug Prices Fell (Again) in 2020

It was another year of unexpected drug price developments.

In 2020, brand-name drug net prices dropped for the third consecutive year. Meanwhile, brand-name drug list prices grew at their slowest rate in at least 20 years. See our updated analysis below.

I also review the factors behind declining brand-name drug prices. These factors are firmly in place for 2021.
.
Our new Congress may try tackle drug prices in the new year. Let’s hope that their policy perceptions catch up to today’s realities.