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 50,000 subscribers and followers. Learn more...

Tuesday, May 17, 2022

The State of Specialty Pharmacy 2022: Reflections, Trends, and Photos from #Asembia22

Two weeks ago, Paula and I had the pleasure of attending Asembia’s 2022 Specialty Pharmacy Summit at the wonderful Wynn Las Vegas.

Below, I violate Vegas code and tell you what happened there. I offer reflections on my keynote session with Scott Gottlieb, share my experiences during the featured session, and highlight three crucial specialty industry trends.

You’ll also find a link to my general session slides and some fun photos.

Enjoy!

Friday, May 13, 2022

Opportunities to Improve Critical Medication Access in Oncology

Today’s guest post comes from Shawn Seamans, Chief Commercial Officer at CoverMyMeds.

Shawn discusses the unique challenges cancer patients face in accessing, affording, and adhering to treatment. He explains how patient-centric technology, combined with access to caring experts, can alleviate these challenges.

Read more about access, affordability, and adherence opportunities for oncology patients in the CoverMyMeds 2022 Medication Access Report: Oncology Edition.

Read on for Shawn’s insights.

Tuesday, May 10, 2022

Gross-to-Net Bubble Update: 2021 Pricing Realities at 10 Top Drugmakers

Time for Drug Channels’ annual update on pricing at the largest pharmaceutical manufacturers. This year’s review includes 10 companies: Eli Lilly and Company, Genentech, GlaxoSmithKline, Janssen, Merck, Novartis, Novo Nordisk, Sanofi, Takeda, and UCB. 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 2021. 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, average net drug prices have declined for the past five years—though a few companies had net price gains or slower declines in 2021.

As I have pointed out many times, pharma industry perma-critics refuse to accept that brand-name drug prices are falling—or that prescription drug spending is a small and stable portion of overall U.S. healthcare expenditures. That’s why I refer to them as drug pricing flat earthers (#DPFE).

As famous economist John Maynard Keynes reportedly said: “When the facts change, I change my mind.” What will the DPFEs do?

Monday, May 09, 2022

Informa Connect’s Hub and Specialty Pharmacy Models East

Informa Connect’s Hub and Specialty Pharmacy Models East
Delivered as a Hybrid Event
June 28-30, 2022 | Sheraton Parsippany | Parsippany, NJ
www.informaconnect.com/hub-specialty-pharmacy

Drug Channels readers will save 10% off the current registration rate when they use code 22DC10*.

This important event convenes key stakeholders including manufacturers, specialty pharmacies, hub providers and more for unrivaled collaboration to leverage innovation and optimize access. Be a part of the critical conversation at this timely meeting to explore proven strategies and cutting-edge approaches to drive an all-encompassing, state-of-the-art hub.

Live Keynotes Delivering Novel Approaches and Maximized Engagement on High-Impact Topics
  • Multi-Stakeholder Panel — Elevate Hub Effectiveness Through Advancement of Stakeholder Partnerships
  • Innovative Model Showcase — Emerging Manufacturer Hub Models Transforming the Patient Experience
  • Specialty Pharmacy Spotlight — Enhancing Speed-to-Therapy while Increasing Patient Engagement
  • Utilize Digital Engagement for End-to-End Patient Support for Specialty Products
Customize Your Experience with Tailored Content
  • Choose between two streams of content focusing on:
    • Leverage Specialty Data and Analytics for Hub Efficiency and Value
    • Hub Model Optimization to Streamline and Enhance Processes
  • Build your own agenda with 4 focused breakouts on critical topic areas
Featured Speakers:
  • Dave MacLeod, Head of Global Patient Services and Commercial Distribution, Amylyx Pharmaceuticals
  • Liam Moy, Senior Director, Patient Services, Neurology, Alexion Pharmaceuticals, Inc.
  • Emily Phillips, Reimbursement, Patient Advocate, & Government Affairs Leader
  • Melissa Beatty, Director, Patient Services and Reimbursement, CTI Bio Pharma
  • Chad Bower, Executive Director, Field Reimbursement & Oncology Solutions, US Market Access, Daiichi Sankyo, Inc.
  • Lee M. Cortes, Executive Assistant U.S. Attorney, U.S. Attorney’s Office, District of New Jersey
  • Lauren Powell, MPA, PhD, Vice President, US Health Equity & Community Wellness, Takeda Pharmaceuticals
PLUS! For 2022 only, Hub and Specialty Pharmacy Models and PAP – Patient Assistance & Access Programs are under the same roof.

The two events will be co-located for shared learning, extended networking opportunities and the option to pick your favorite sessions and move between conferences if desired!

Drug Channels readers will save 10% off the current registration rate when they use code 22DC10*.

Download the full agenda and save your seat today!

*Offer applies to current 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. To find out how you can promote an event on Drug Channels, please contact Paula Fein (paula@drugchannels.net).

Wednesday, May 04, 2022

DCI’s Top 15 Specialty Pharmacies of 2021—And Three Factors That Will Reshape 2022

In Drug Channels Institute’s list of the top 15 pharmacies of 2021, we show that central-fill, mail pharmacies operated by large PBMs and health insurers have displaced retail chains as the largest prescription drug dispensers by revenues.

To complement that broader ranking, we present below our exclusive and updated list of the top 15 pharmacies based on specialty drug dispensing revenues in 2021. You will see that PBMs and insurers retained their dominance over specialty dispensing.

But as I explain below, 2022 will be a year of transition. Significant volume will shift to the larger players, as Centene plots its exit, Walgreens’ specialty pharmacy business collapses, and manufacturers’ 340B contract pharmacy restrictions continue.

This week, I’m attending Asembia’s Specialty Pharmacy Summit. In a future article, I’ll violate Vegas code and tell you what happened.

Friday, April 29, 2022

A Game-Changing Shift: Why Pharma Commercial Teams Are Turning to HEOR

Today’s guest post comes from Chris Harvey, Director of Solutions Engineering at Panalgo, and Carolyn Zele, Senior Manager of Solution Enablement at MMIT.

Chris and Carolyn discuss the insights that health economics and outcomes research (HEOR) professionals bring to commercial teams. They explain how that pairing benefits both manufacturers and patients.

For more on how MMIT and Panalgo help pharma manufacturers leverage HEOR and real-world data for commercial strategies, click here to learn about the Patient Access Analytics tool.

Read on for Chris’ and Carolyn’s insights.

Tuesday, April 26, 2022

Drug Channels News Roundup, April 2022: 340Boom, 340B Profits for Pharmacies & PBMs, Fixing Insulin, Walgreens’ Robots, and Doctors’ Day

Baseball season is in full swing! Oil up your glove, lace up your cleats, and let's run the bases around this month's news stories. Remember: Sometimes you win, sometimes you lose, and sometimes it rains.

In this issue:
  • Green Monster: The 340B market hits new highs in 2021
  • Not-Free Agents: Big 340B profits for CVS, Walgreens, Express Scripts, et al
  • Batter Up: Fixing the insulin market
  • Pinch Hitters: Walgreens bets on robots
Plus, Dr. Glaucomflecken helps UnitedHealthcare celebrate Doctors’ Day!

P.S. For my daily pitches on the industry’s hits and misses, join my nearly 27,000 LinkedIn followers for daily links to neat stuff. You can also find my daily posts at @DrugChannels on Twitter, where I have more than 13,800 followers.

Next week, I'll be live and in-person at Asembia's Specialty Pharmacy Summit. During Tuesday's general session, I'll be joining Dr. Scott Gottlieb for a fireside chat at 8:00 AM and will then present my "State of Specialty Pharmacy 2022" at 9:30 AM. Hope to see you there!

Monday, April 25, 2022

Informa Connect’s Patient Support Services Congress

Informa Connect’s Patient Support Services Congress
Hybrid Event | June 14-16 in Philadelphia, PA
www.informaconnect.com/patientsupport

Exclusive Offer – Be sure to use your exclusive promo PSS22DC to save 10% off* of your registration.

A proven industry staple, Patient Support Services Congress is back June 14-16, 2022 and ready to arm industry with next-generation approaches to patient services for optimal program performance. Taking place in a hybrid format in Philadelphia, PA, prepare to join leaders from across industry as they come together for innovative discussions on access strategy, patient interactions, case management, compliance practices and more.

This event unites both compliance and operations teams. You will benefit from collaboration and next-level benchmarking to drive program success. Take advantage of tailored, tracked content featuring detailed case studies on control enhancement and operational excellence to further advance your programming.

Exclusive Offer – View the agenda and register today – Be sure to use your exclusive promo code PSS22DC to save 10% off* of your registration.

In two-and-a-half days, walk away with critical insights on industry standards, forward-thinking strategies to propel program performance, and so much more.

Can’t miss content highlights:
  • Industry Address – Dive into Market Trends Impacting Access, Adherence and the Patient Journey
  • Enforcement Update – Explore Rising Oversight and High Priority Risk Areas for Patient Services Compliance
  • Engage, Educate, Exchange — Optimize Relationship Management between Manufacturers and Patients for Enhanced Outcomes
  • The Rise of Technology – Accelerate Enrollment Through AI-Driven Approaches
  • Address Disparities in Access Through Patient Support Program Design to Improve Outcomes
  • And more!
PLUS! Customize Your Experience with Two Tailored Tracks:

Compliance and Legal
  • Implement Internal Controls to Reduce Compliance Risks with Nurse Educators and HCP/Patient Interactions
  • Manage Third-Party Compliance to Optimize Patient Interactions
  • Enhance Patient Data Monitoring for Greater Strategic Outcomes
  • Monitor Virtual Programs and Field Team Compliance for Successful Adaptation
  • Create Compliant Bridge and Quick Start Programs for Rare Disease
  • And more!
Innovation and Operations
  • Discover Hybrid and Alternative Patient Solutions Models to Best Support Patients and HCPs
  • Build and Maintain Patient Engagement for Rare Disease
  • Utilize Predictive Analytics to Build a Better Patient Services Program
  • Streamline Patient Education to Create Meaningful Communication
  • Enhance Access, Reimbursement and Benefit Support Through Programming
  • And more!
  • How Does Hybrid Work?
    • ALL ACCESS PASS includes the in-person event June 14-16 AND all benefits of the virtual experience pass
    • VIRTUAL EXPERIENCE PASS includes live streaming of select sessions June 14-16 as well as recorded presentations from the in-person events available for 10 business days beginning June 21
    Exclusive Offer – View the agenda and register today – Be sure to use your exclusive promo code PSS22DC 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. To find out how you can promote an event on Drug Channels, please contact Paula Fein (paula@drugchannels.net).

    Friday, April 22, 2022

    Four Reasons Why PBMs Gain As Maximizers Overtake Copay Accumulators (rerun)

    This week, I’m rerunning some popular posts while I prepare for today’s live video webinar: PBM Industry Update: Trends, Controversies, and Outlook.

    Click here to see the original post and comments from February 2022.


    More than four years ago, I warned about the emerging trend of copay accumulators and outlined the costly consequences for patients.

    The latest data reveal that copay accumulator adjustment programs are now in the word list for a growing share of pharmacy benefit designs. What’s more, adoption of copay maximizers now exceeds that of copay accumulators. Maximizers avoid the brutal patient adherence problems of accumulators, while allowing plan sponsors to extract even more patient support funds.

    Despite this impressive growth, you may not yet have considered PBMs’ business model for these tools. Below, I outline why PBMs have incentives to prefer maximizer programs over accumulators and alternatives such as specialty carve-out programs.

    I look forward to hearing your thoughts on these developments in the comments below or on social media: LinkedIn (preferred) or Twitter.

    Thursday, April 21, 2022

    Follow the Vial: The Buy-and-Bill System for Distributing and Reimbursing Provider-Administered Outpatient Drugs (rerun)

    This week, I’m rerunning some popular posts while I prepare for tomorrow’s live video webinar: PBM Industry Update: Trends, Controversies, and Outlook.

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


    By reader request, we present below a channel flow chart illustrating the buy-and-bill process for provider-administered drugs. This chart complements Follow the Dollar: The U.S. Pharmacy Distribution and Reimbursement System for Patient-Administered, Outpatient Brand-name Drugs.

    To further help you understand this channel, I have also included a brief video to explain the buy-and-bill system. The video is excerpted from my recent Drug Channels Update: Buy-and-Bill Trends video webinar.

    This post is adapted from Chapter 3 of our new 2021–22 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors.

    Wednesday, April 20, 2022

    Five Takeaways from the Big Three PBMs’ 2022 Formulary Exclusions (rerun)

    This week, I’m rerunning some popular posts while I prepare for this Friday’s live video webinar: PBM Industry Update: Trends, Controversies, and Outlook.

    Click here to see the original post and comments from January 2022.


    For 2022, the three largest pharmacy benefit managers (PBMs)—Caremark (CVS Health), Express Scripts (Cigna), and OptumRx (United Health Group)— increased the number of drugs they excluded from their standard formularies.

    Each exclusion list contains 400 to 500 products. Growth in the number of excluded drugs slowed, due partly to the fact that so many drugs have already been dropped from PBMs’ formularies.

    Below, I highlight five observations about this year’s lists, including unexplainable differences in how PBMs handle specialty drugs, biosimilars, and insulin.

    I also offer some thoughts on non-medical switching and what we still don’t know about how exclusions affect patients.

    Let me know what you think by commenting below or on social media.

    Tuesday, April 19, 2022

    Why PBMs and Payers Are Embracing Insulin Biosimilars with Higher Prices—And What That Means for Humira (rerun)

    This week, I’m rerunning some popular posts while I prepare for this Friday’s live video webinar: PBM Industry Update: Trends, Controversies, and Outlook.

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

    An ironic postcript: Less than two months after my article was published, Cigna CEO David Cordani bragged about the cost savings from "aggressive adoption" of biosimilars. Anyone want to tell him about the Express Scripts formulary for insulin biosimilars?


    The Food & Drug Administration (FDA) recently approved the first interchangeable biosimilar insulin product: the insulin glargine-yfgn injection from Viatris. Read the FDA’s press release.

    Alas, I’m sad to report that the warped incentives baked into the U.S. drug channel will limit the impact of this impressive breakthrough.

    Viatris is being forced to launch both a high-priced and a low-priced version of the biosimilar. However, only the high-list/high-rebate, branded version will be available on Express Scripts’ largest commercial formulary. Express Scripts will block both the branded reference product and the lower-priced, unbranded—but also interchangeable—version. Meanwhile, Prime Therapeutics will place both versions on its formularies, leaving the choice up to its plan sponsor clients.

    Consequently, many commercial payers will adopt the more expensive product instead of the identical—but cheaper—version. As usual, patients will be the ultimate victims of our current drug pricing system.

    Below, I explain the weird economics behind this decision, highlight the negative impact on patients, and speculate on what this all could mean for biosimilars’ future. Until plan sponsors break their addiction to rebates, today’s U.S. drug channel problems will remain.

    Monday, April 18, 2022

    Informa Connect’s PAP – Patient Assistance & Access Programs

    Informa Connect’s PAP – Patient Assistance & Access Programs
    Hybrid Event | June 28-30 in Parsippany, NJ
    www.informaconnect.com/pap

    Exclusive Offer – Be sure to use your exclusive promo code 22DCPAP10 to save 10% off* of your registration.

    Informa Connect is pleased to announce that PAP – Patient Assistance & Access Programs will return as a hybrid event June 28-30 in Parsippany, NJ and virtually through the ConnectMe platform. As the barriers for medication assistance become increasingly significant and out-of-pocket costs and the number of uninsured and functionally uninsured patients increase, it is essential for stakeholders to collaborate on how to further access to care, understand current changes in legislation and policy, and optimize PAPs for better patient outcomes. This event unites pharma, foundations, health clinics and more. Do not miss this opportunity to benchmark on industry standards and stay on top of evolving trends to propel program performance.

    Exclusive Offer – View the agenda and register today – Be sure to use your exclusive promo code 22DCPAP10 to save 10% off* of your registration.

    Whether you choose to attend in-person or virtually, PAP will deliver unparalleled strategies to drive patient assistance and affordability. Ensure you are at the table with leaders from across industry as they collaborate on and discuss the most timely and crucial topics, including industry standards for patient assistance, changing legal trends, tools and technologies to empower patients to better manage OOP costs, next-generation models for assistance, and so much more.

    Can’t miss content highlights:
    • State of the Industry: Policy Updates and Regulatory Advancements Driving Affordability and Access
    • Panel: Current Trends and Industry Benchmarks for PAPs
    • Navigate the Legal Underpinnings of Patient Assistance and Gain Insight on OIG Oversight
    • Foundation and Advocate Insights: Collaborating to Evolve PAPs and Accelerate Patient Access
    • Ensuring the Continuity of Care Across the Patient Journey
    • Patient Perspective Fireside Chat
    • Three Customizable Tracks by Company Classification
      • Bio/Pharma Manufacturers
      • Patient Advocates
      • Hospitals/Clinics/Health Systems
    • Diversity, Equity and Inclusion Summit: Advance Advocacy and Innovation to Achieve Health Equity
      • Part One: Racial and Income Disparities in Healthcare
      • Part Two: Explore Proactive Approaches to Increase Access to Healthcare
    • Emerging Best Practices and Industry Trends in Free Drug Programs
    • And more!
    PLUS, 2022 EXCLUSIVE:

    PAP will be co-located with Hub & Specialty Pharmacy Models! That’s right – Benefit from shared learning, extended networking opportunities and the option to pick your favorite sessions and move between conferences if desired at no additional cost (and that includes access to the Hub & Specialty Pharmacy Models virtual platform as well)!

    How Does Hybrid Work?
    • ALL ACCESS PASS includes the in-person event June 28-30 AND all benefits of the virtual experience for PAP AND Hub & Specialty Pharmacy Models East
    • VIRTUAL EXPERIENCE PASS includes live streaming of all general sessions June 28-30 as well as recorded presentations from the in-person events available for 10 business days beginning July 5
    Exclusive Offer – View the agenda and register today – Be sure to use your exclusive promo code 22DCPAP10 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. To find out how you can promote an event on Drug Channels, please contact Paula Fein (paula@drugchannels.net).

    Friday, April 15, 2022

    Kristy’s Story: Navigating Specialty Medication Challenges

    Today’s guest post comes from Megan Marchal, Director of Specialty Pharmacy Strategy at CoverMyMeds.

    Megan discusses the access and affordability challenges faced by specialty therapy patients. She describes how CoverMyMeds’ centralized technology solutions—paired with experts familiar with each therapy—help patients navigate these challenges. And, she shares one patient’s personal journey.

    To learn more about CoverMyMeds’ technology solutions, visit Booth 229 at the Asembia Specialty Pharmacy Summit in Las Vegas, May 2-5, 2022.

    Click here to sign up for CoverMyMeds’ Asembia Specialty Pharmacy Summit recaps.

    Read on for Megan’s insights.

    Tuesday, April 12, 2022

    Who Will Pay for Prescription Drugs in 2030? (Hint: It’s Us)

    The econowonks at the Centers for Medicare & Medicaid Services (CMS) recently released the latest projections for U.S. spending on healthcare. (See links below.) These data provide our first official look at post-pandemic U.S. healthcare spending.

    As you will see below, outpatient prescription drugs dispensed by retail and mail pharmacies are projected to remain a small share (8.4%) of total U.S. healthcare spending. What’s more, taxpayers—via Medicare and Medicaid—will continue to crowd out the private insurance market. One bright spot: consumers will account for an ever-smaller share of drug spending.

    Thus, the government actuaries expect that pharmaceuticals will not be the key driver of U.S. healthcare spending growth. Will someone tell our elected officials?

    Speaking of prescription drug payment, be sure to sign up for my new live video webinar, PBM Industry Update: Trends, Controversies, and Outlook, on April 22, 2022, from 12:00 p.m. to 1:30 p.m. ET.

    Monday, April 11, 2022

    Informa Connect's Life Sciences Commercial Contracts & Chargebacks 2022 Hybrid

    Informa Connect's Life Sciences Commercial Contracts & Chargebacks 2022 Hybrid
    May 24-25, 2022 | Philadelphia, PA
    www.informaconnect.com/contracts-chargebacks
    Save 10% by using code 22DC10

    The Life Sciences Commercial Contracts and Chargebacks conference returns as a hybrid event May 24-25 with the options of attending in-person in Philadelphia or virtually.

    Visit informaconnect.com/contracts-chargebacks to view the complete agenda, then register using the exclusive Drug Channels discount code 22DC10 to receive 10% off!

    Join industry leaders from bio/pharma manufacturers, wholesalers, GPOs and more for interactive dialogues and strategic best practices to optimize commercial contract models, maximize chargeback efficiencies and streamline eligibility management.

    The content-rich agenda boasts an incredible speaking faculty joining the event, including experts from Ingenus Pharmaceuticals, McKesson, Hikma Pharmaceuticals, Cardinal Health, Teva Pharmaceuticals, Tolmar Pharmaceuticals, FFF Enterprises, IntegriChain, Mallinckrodt Pharmaceuticals, UCB Pharma, Chronicled, Fresenius-Kabi USA, Premier Inc., NS Pharma, and Atrium Health, to name a few.

    You will benefit from learnings on timely topics in an innovative format, including:
    • Manufacturer/Wholesaler Team-to-Team Meet and Greets
    • Membership Management Optimized and Reimagined
    • GPO Leadership: Revolutionary Practices to Adapt and Implement
    • Regulatory Highlight: Plan for 2022 and Beyond
    • Case Study: MediLedger Network for Data & Trading Partner Alignment as Best Practice for Error Elimination
    Visit informaconnect.com/contracts-chargebacks to view the complete agenda, then register using the exclusive Drug Channels discount code 22DC10 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. To find out how you can promote an event on Drug Channels, please contact Paula Fein (paula@drugchannels.net).

    Friday, April 08, 2022

    Four Solutions Manufacturers Should Consider For Retail and Specialty-lite Products

    Today’s guest post comes from Michael Carr, CoAssist Group Vice President at AssistRx

    Michael discusses patient support challenges that are unique to specialty-lite pharmaceuticals. He goes on to describe four new categories of patient solutions and pharmacy models specific to this growing market segment.

    To learn more about CoAssist and AssistRx specialty therapy initiation and patient support services, click here to schedule a meeting with AssistRx at the Asembia Specialty Pharmacy Summit on May 2-5, 2022.

    Read on for Michael’s insights.

    Tuesday, April 05, 2022

    The Top Pharmacy Benefit Managers of 2021: The Big Get Even Bigger

    The highly-consolidated PBM market notched another year of increased concentration.

    Consider Drug Channels Institute's latest estimates of pharmacy benefit manager (PBM) market share, shown in the chart below. For 2021, we estimate that the three biggest PBMs accounted for 80% of total equivalent prescription claims. Significant business relationships among the largest companies continue to shift market share.

    As I explain below, the prospects for market disruption remain low, so the controversial warped incentives of the rebate system will continue to distort the drug channel.

    To get a handle on this complex market, join me on April 22 for a new live video webinar, PBM Industry Update: Trends, Controversies, and Outlook. I’ll examine DCI’s latest PBM market data, the emergence of PBM purchasing groups, specialty market developments, PBMs’ evolving compensation models, and much more. Click here for more details.

    Monday, April 04, 2022

    Informa Connect's Rare Disease Innovation & Partnering Summit

    Rare Disease Innovation & Partnering Summit
    Hybrid Event
    May 17-19, 2022 | Boston, MA
    www.informaconnect.com/rare

    Don’t miss the Rare Disease Innovation & Partnering Summit, coming up May 17-19, 2022 in Boston, MA.

    Visit www.informaconnect.com/rare for further details and to register. Drug Channels readers will save 10% off when they use code 22DRCH10 and register prior to April 29, 2022.*

    When you join us this spring, you’ll be part of the important discussions surrounding patient access, reimbursement, commercialization, launch, partnering and more. Come together with experts from across the rare disease community, in-person or virtually, to unite in areas of unmet medical need and create life-transforming therapies and breakthroughs.

    We’ll cover the hottest topics impacting you today, from speakers representing Alexion, Angelman Syndrome Foundation, bluebirdbio, Cognito Therapeutics, CURECMT4J, Cydan, the FDA, Global Genes, NS Pharma, Rafael Pharma, Sanofi, TaretCancer Foundation, Tremeau Pharma, Ultragenyx, and more.
    • Strengthening Patient Relationships Authentically to Enhance Therapeutic Development
    • The Search for Novel Funding - Preparing for and Expanding Successful Partnering
    • Understanding the Patient Journey
    • Clinical Management of Patients with Complex Conditions
    • Discovering Patient Support Program Needs for Patients
    • Patients and Payers: Perspectives on Developing Gene Therapies for Rare Diseases
    • Prioritizing RWE Collection in a New Era of Novel Gene Therapy
    • Optimizing Strategic Partnership Models and Investment for Orphan Drug Products
    • Developing and Scaling Digital Therapeutics
    • Leveraging Genetic Testing for Value
    • Fostering Relationships Between Industry and Advocacy
    • Uncovering Risk Disclosures for Gene Therapies
    • Optimizing Decentralized Trials to Support the Future of Rare Disease Research
    • PLUS - Your registration to the Summit includes a complimentary pass to Selections from The DISORDER Channel, an annual viewing of short films addressing the day-to-day challenges and struggles of rare disease patients and their families.
    View the agenda to see the complete picture – the program, speakers, and more!

    Visit www.informaconnect.com/rare for further details and to register. Drug Channels readers will save 10% off when they use code 22DRCH10 and register prior to April 29, 2022.*

    *Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rates or 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. To find out how you can promote an event on Drug Channels, please contact Paula Fein (paula@drugchannels.net).

    Friday, April 01, 2022

    How the Medicaid Copay Accumulator Rule Will Hurt Prescription Affordability

    Today’s guest post comes from Fauzea Hussain, Vice President of Public Policy at McKesson.

    Fauzea succinctly describes the complicated and contradictory aspects of the Centers for Medicare & Medicaid Services' Final Rule on Best Price, a.k.a. the Medicaid copay accumulator rule. She then outlines how the rule, if implemented, is likely to hurt patients.

    For information about the Best Price Rule and how CoverMyMeds can help identify solutions, contact them at: InfoBP@mckesson.com. To learn more about solutions to help patients access, afford and adhere to their medications, read CoverMyMeds’ 2022 Medication Access Report.

    Read on for Fauzea’s insights.

    Thursday, March 31, 2022

    Drug Channels News Roundup, March 2022: UM and Health Equity, Insurers ♥ White Bagging, Biosimilar Boom, A New Angle on Copay Support, and the Pharmacy Metaverse

    Ah, it’s finally spring in downtown Philadelphia, our home base. (Photographic evidence on your right.) Along with sunshine and fine weather, this vernal equinox has ushered in a crop of new and noteworthy stories:
    • Health inequities in utilization management
    • Insurers compute big white bagging savings
    • The biosimilar boom accelerates
    • The patient upside of manufacturers’ copay support
    • Whoa. CVS Health takes the red pill.
    P.S. Join my more than 26,000 LinkedIn followers for daily links to neat stuff. You can also find my daily posts at @DrugChannels on Twitter, where I am approaching 13,700 followers.

    Register for my new video webinar, PBM Industry Update: Trends, Controversies, and Outlook. This event will be broadcast live on April 22, 2022, from 12:00 p.m. to 1:30 p.m. ET.

    Tuesday, March 29, 2022

    PBM Industry Update: Trends, Controversies, and Outlook (NEW Live Video Webinar)

    Dr. Adam J. Fein, CEO of Drug Channels Institute (DCI) and the author of Drug Channels, invites you to join him for a new video webinar:

    PBM Industry Update: Trends, Controversies, and Outlook
    Broadcast live on April 22, 2022, from 12:00 p.m. to 1:30 p.m. ET

    The webinar will be broadcast from the Drug Channels studio in beautiful downtown Philadelphia. This page describes the event and explains how to purchase a registration to participate in the event.

    This event is part of The Drug Channels 2022 Video Webinar Series. Anyone who registered for the entire series will receive an email with a link to access the April event.

    WHAT YOU WILL LEARN

    Join Dr. Fein as he helps you and your team stay on top of the latest trends, market data, and strategies for pharmacy benefit management. He will draw from exclusive information found in our new 2022 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers.

    During the event, Dr. Fein will cover a wide range of topics, including:
    • The industry position and strategies of the largest PBMs, including DCI’s exclusive market share data
    • The emergence and strategies of PBM-owned purchasing groups
    • The opportunities and challenges for insurer/PBM/specialty pharmacy/provider organizations
    • DCI’s latest data on PBMs’ position in the specialty pharmacy market
    • How PBM compensation models are evolving
    • PBMs’ battle for specialty benefit management and the risks from specialty carve-out vendors
    • Our latest insights on copay accumulators and maximizers
    • Risks from disruption of 340B contract pharmacies
    • Prospects for smaller PBMs
    • Assessment of state and federal PBM legislation
    • And more!
    PLUS: During the webinar, Dr. Fein will give participants an opportunity to unmute themselves and ask live questions.

    As always, Dr. Fein will clearly distinguish his opinions and interpretations from the objective facts and data.

    Read on for full details on pricing and registration.

    Monday, March 28, 2022

    Informa Connect’s Medicaid & Government Pricing Congress

    Informa Connect’s Medicaid & Government Pricing Congress
    Hybrid Event
    In-Person: May 23-25, 2022, Philadelphia, PA | Virtual: June 1-2, 2022
    www.informaconnect.com/medicaid-government-pricing

    Don’t miss the Medicaid & Government Pricing Congress, coming up May 23-25, 2022 (in-person in Philadelphia) and June 1-2, 2022 (virtually)! You'll be part of the important discussions surrounding the critical policy updates and approaches to effectively contract, report and comply with state and federal healthcare programs.

    Visit www.informaconnect.com/medicaid-government-pricing for further details and to register. Drug Channels readers will save 10% off when they use code 22DRCH10 and register prior to April 29, 2022.*

    The 2022 format includes 3 days of in-person programming, plus a virtual offering of select sessions and recorded presentations available on-demand for 10 business days. Both the in-person and virtual options will include networking opportunities to connect with industry peers and colleagues.

    The Medicaid & GP Congress features coverage on the hottest topics impacting you today, from speakers representing United Therapeutics, AstraZeneca, Pfizer, Gilead, GSK, Eisai, Novartis, Vertex and more!
    • A block of sessions covering the CMS 2023 Medicare Advantage and Part D Proposed Rule and potential Federal Drug Pricing Changes under what’s currently called the Build Back Better Act
    • Updates to the Mandated OIG Prescription Drug Studies
    • Portal User Sessions – Step-by-Step reviews of some of the most frequently used portals for managing government reporting with representatives from Gainwell Technologies and Magellan AND MDP System Updates: The Mechanics, Changes and Processes from the new CMS Portal
    • An in-depth interactive session on Product Unit of Measurement and Understanding NDC Numbers in the MDRP
    • FSS and Government Pricing and Contracting Strategies for Combination Products, Duals, Med Device and MedTech
    • And more!
    View the agenda to see the complete picture – the program, speakers, and more!

    Visit www.informaconnect.com/medicaid-government-pricing for further details and to register. Drug Channels readers will save 10% off when they use code 22DRCH10 and register prior to April 29, 2022.*

    *Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rates or 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. To find out how you can promote an event on Drug Channels, please contact Paula Fein (paula@drugchannels.net).

    Friday, March 25, 2022

    The Evolving Medical Benefits Landscape—Are you Ready for It?

    Today’s guest post comes from Ian Ocilka, Senior VP of Client Solutions at ConnectiveRx.

    Ian explains some of the challenges associated with negotiating the medical benefit for both patients and providers. He goes on to describe the need for combining technology solutions and meaningful human connection for improved patient outcomes.

    To learn more, join experts from ConnectiveRx on April 26th at 1 pm ET for a free, online panel discussion: The Evolving Medical Benefits Landscape—Are you Ready for It? Email inquiries@ConnectiveRx.com with any questions.

    You can also visit ConnectiveRx in booth 411 at Asembia's 2022 Specialty Pharmacy Summit on May 2-4.

    Read on for Ian’s insights.

    Tuesday, March 22, 2022

    Warped Incentives Update: The Gross-to-Net Bubble Exceeded $200 Billion in 2021

    Time for Drug Channels Institute’s annual update on the gross-to-net bubble—the ever-growing dollar gap between sales at brand-name drugs' list prices and their sales at net prices after rebates and other reductions.

    We estimate that the gross-to-net bubble reached $204 billion for patent-protected brand-name drugs in 2021. If we include brand-name drugs that have lost patent protection and face competition from generic equivalents, the bubble was even higher, at $236 billion.

    Pharmaceuticals are the only part of the U.S. healthcare system in which the difference between list and net prices is monetized as rebates and redistributed via intermediaries to payers. This bubble reflects—and drives—both patients’ affordability problems, intermediaries' warped incentives, and politicians’ misunderstandings of U.S. drug prices.

    Read on for our latest data—and a reminder why SpongeBob SquarePants remains a fixture on Drug Channels.

    Friday, March 18, 2022

    The 340B Noncompliance Data Gap Leaves Drug Manufacturers in the Dark

    Today’s guest post comes from Ashwin Mundra, Chief Revenue Officer at Kalderos.

    As Ashwin explains, manufacturers face a gap between visible, non-compliant drug discounts and the actual level of non-compliant discounts. He describe Kalderos’ technology-enabled, machine learning-based methods for identifying drug discount non-compliance.

    To learn more, register to receive a copy of Kalderos’ annual report, available April 13, 2022: Conquering the “Great Unknown”: Connecting the data gaps that keep us from knowing the true price of drugs.

    Read on for Ashwin’s insights.

    Tuesday, March 15, 2022

    NOW AVAILABLE: The 2022 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers

    I am pleased to announce our new 2022 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 28, 2022.

    The 2022 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers, our 13th edition, provides a comprehensive, fact-based, and non-partisan tool for understanding the entire U.S. drug pricing, reimbursement, and dispensing system. The report has been thoroughly updated with the latest data and includes loads of new material and new sections.

    The chart below illustrates the depth and breadth of the 2022 edition. The numbers indicate the report chapter that corresponds to, explains, and analyzes each channel flow.

    [Click to Enlarge]

    12 chapters, 430+ pages, 216 charts/exhibits/data tables, 800+ endnotes: There is nothing else available that comes close to this report.

    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 last week. Please contact us if you did not receive the email.

    WHAT’S GOING ON

    Twice a year, I research and write two comprehensive, fact-based, and nonpartisan reports on drug channel economics. In some small way, I try to make the world a better and smarter place.

    Licenses for our DCI reports are regularly purchased by nearly every company involved in the drug channel: pharmaceutical manufacturers, wholesalers, pharmacists, pharmacy owners, hospitals, buyers, benefit managers, managed care executives, policy analysts, investors, consultants, and more. So, you can find out what your customers, partners, and competitors are reading.

    FUN FACTS
    • The 12 chapters are self-contained and do not need to be read in order. (Really!) There are loads of internal hyperlinks to help you navigate the document and customize it to your specific interests and priorities.
    • As always, we have updated all market and industry data with the most current information available, including our annual analyses of the market positions of the largest pharmacies, specialty pharmacies, and PBMs. Many sections and chapters have been expanded and/or reorganized to better cover the latest industry developments. For more details, see the "What’s New in the 2022 Report" section of the report's overview.
    • We are offering the option to download an additional PowerPoint file with images of all 216 exhibits. This popular option helps you share the insights and data with others in your organization.
    • There are a staggering 814 (!) endnotes, most of which have hyperlinks to original source materials. These source materials offer a handy way to build your knowledge base beyond what’s included in the full report.
    • As usual, I have reluctantly stripped out the corny jokes and pop culture references. Sorry, There are therefore zero memes in the 2022 edition.
    • Punctuation nerds will enjoy our all-new approach to hyphens and semicolons.
    If you have any questions (before or after reading the report), please email me.

    Enjoy!

    Monday, March 14, 2022

    Join me in May at Asembia’s 2022 Specialty Pharmacy Summit

    Asembia’s Specialty Pharmacy Summit 2022
    May 2 – 5, 2022 | Las Vegas
    www.asembiasummit.com

    Asembia's Specialty Pharmacy Summit 2022 is back! 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, Dr. Scott Gottlieb, former FDA commissioner and author of Controlled Spread, will deliver the keynote address. (Click here to read my review of Dr. Gottlieb’s excellent book.) Plus, Doug Long from IQVIA and I will again lead the Featured Session, titled The Specialty Pharmacy Industry Update and Outlook.

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

    A MESSAGE FROM ASEMBIA: Access Top Pharmacy & Pharma Industry Executives at Asembia’s Annual 2022 Specialty Pharmacy Summit in May

    Returning to Wynn & Encore Las Vegas this spring, Asembia’s Annual Specialty Pharmacy Summit will welcome back thousands of industry leaders focused on the rapidly expanding specialty pharmacy channel.

    Asembia’s Summit is back on its normal schedule and kicks off with pre-conference continuing education (CE) programming on Sunday May 1, 2022 followed by 3 days of informative business sessions, additional CE programs, collaborative networking opportunities, interactive exhibits, featured presentations and more. For the latest agenda, session & speaker information and other event details, visit www.asembiasummit.com.

    As previously announced, a highlight of the upcoming Summit will be Keynote Speaker, Dr. Scott Gottlieb, who takes center stage on Tuesday May 3, 2022 at 8AM to share his expert perspectives on the evolving industry followed by a fireside chat with Dr. Adam J. Fein of Drug Channels Institute.

    Dr. Gottlieb is a physician, Former Commissioner of the FDA, Former Senior Advisor to CMS, Contributor, CNBC & CBS’s Face the Nation and New York Times Belling Author of Uncontrolled Spread: Why COVID-19 Crushed Us and How We Can Defeat the Next Pandemic.
    “Throughout the pandemic, no one—and I mean no one—has provided a clearer and more correct picture of what was happening to our country than Dr. Gottlieb. All the while he was sought out to provide more advice to decision-makers on all sides of the aisle than anyone. In Uncontrolled Spread, he is doing perhaps the ultimate service in telling the story to us in a gripping, no holds barred, yet highly constructive fashion. This book will be one of the bibles of this era.” — Andy Slavitt, former White House senior advisor for the COVID-19 response
    Have a question for Dr. Gottlieb and Dr. Fein to review during their interactive fireside chat? Send it to connect@asembiasummit.com. for consideration.

    The Summit will again welcome the full spectrum of organizations working in the pharmacy, life sciences & patient services market. Key decision makers from top pharmaceutical manufacturers and life sciences companies are registering daily along with leading pharmacies, pharmacy benefit managers, digital health companies, health systems, payers, managed care organizations and other key industry stakeholders. To register and join fellow attendees from these companies, visit www.asembiasummit.com today.


    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 promote an event on Drug Channels, please contact Paula Fein (paula@drugchannels.net).

    Friday, March 11, 2022

    Four Things You Need to Know about Hubs in 2022

    Today’s guest post comes from Stacey Little, Senior Vice President of Business Development and Marketing at AssistRx.

    Stacey analyzes trends in patient support services and reimbursement hubs.

    Learn more about AssistRx’s specialty therapy initiation and patient support services at Asembia's Specialty Pharmacy Summit on May 2-5, 2022. Click here to schedule your meeting.

    Read on for Stacey’s insights.

    Tuesday, March 08, 2022

    The Top 15 U.S. Pharmacies of 2021: Market Shares and Revenues at the Biggest Companies

    Next week, Drug Channels Institute will release our 2022 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. It’s the 13th edition of our popular and comprehensive examination of the entire drug pricing, reimbursement, and dispensing system.

    The exhibit below—one of 216 in our new report—provides a first look at the 15 largest organizations, ranked by total U.S. prescription dispensing revenues for calendar year 2021.

    U.S. prescription dispensing revenues reached a record $501 billion in 2021. The total share of the largest 15 companies decreased slightly compared with their 2020 share, due primarily to below-market growth rates at retail and long-term care pharmacies. As I discuss below, upcoming business changes may reshuffle this list during 2022.

    Read on as we cue up our latest update on the booming pharmacy and PBM marketplace.

    For a sneak peek at the complete report, click here to download our free report overview (including key industry trends, the table of contents, and a list of exhibits). We’re offering special discounted pricing if you order before March 28, 2022.

    Friday, March 04, 2022

    Technology Enables Patient Medication Access Support at Critical Touchpoints

    Today’s guest post comes from Miranda Gill, Vice President of Network at CoverMyMeds.

    Miranda discusses how integrated technology solutions can be used at critical moments in the patient’s journey to increase access, affordability, and adherence to therapies.

    To learn more about CoverMyMeds’ prescription decision support tools for the entire care team, visit CoverMyMeds at HIMSS22.

    Read on for Miranda’s insights.

    Tuesday, March 01, 2022

    Supermarkets Again Dash Past CVS and Walgreens in 2022’s Part D Pharmacy Networks

    The Centers for Medicare & Medicaid Services (CMS) has recently released its 2022 data on enrollment in Medicare Part D prescription drug plans (PDPs). Our exclusive analysis of these numbers finds that for 2022, an astounding 99% of seniors are enrolled in the wonderland of 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. For the second year, the big supermarket chains—Albertsons, Kroger, and Publix—outpaced the big three drugstore chains and Walmart.

    Supermarket pharmacies gained overall prescription market share in 2021, as we discuss in our forthcoming 2022 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. Expect supermarkets to run even faster in 2022. What a strange world we live in!

    Friday, February 25, 2022

    Solving the Copay and Best Price Challenge

    Today’s guest post comes from Jason Zemcik, Vice President of Patient Affordability at TrialCard.

    Jason discusses two approaches to address the CMS Final Rule on manufacturer coupons and Best Price: the pharmacy copay offer and direct reimbursement to the patient. He goes on to describe TrialCard’s reimbursement capability solutions.

    To learn more about TrialCard Pay and how to prepare your copay program for the future, register for Solving the Best Price and Co-Pay Challenge – A Framework for Assessment and Action. This joint TrialCard/IntegriChain webinar is scheduled for Tuesday, March 15, at 1 PM ET. 

    Read on for Jason’s insights.

    Thursday, February 24, 2022

    Drug Channels News Roundup, February 2022: Mark Cuban vs. Generics, Novo Nordisk’s G2N, CVS & 340B, and My Favorite Chart

    Winter—or at least February—is almost over. Celebrate the imminent return of spring with our selection of noteworthy news from around the drug channel. In this issue:
    • Mark Cuban!
    • Novo Nordisk confronts the gross-to-net bubble
    • CVS Health finally acknowledges its profits from the 340B program
    Plus, an update to my all-time favorite chart.

    P.S. Please join the nearly 13,500 consumers of my daily commentary and links to neat stuff at @DrugChannels on Twitter. You can also find my daily posts on LinkedIn, where I am approaching 25,000 followers.

    Tuesday, February 22, 2022

    Available for Preorder: The 2022 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers

    On March 15, 2022, Drug Channels Institute will release The 2022 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. This report—our thirteenth edition—remains the most comprehensive, fact-based tool for understanding the entire U.S. drug pricing, reimbursement, and dispensing system.

    12 chapters, 430+ pages, 216 exhibits, 800+ endnotes: There is nothing else available that comes close to this report.

    We are providing you with the opportunity to preorder this thoroughly updated, revised, and expanded 2022 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 15.


    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 28, 2022.

    The 2022 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers is a definitive, nonpartisan resource that includes the most current information about pharmacy dispensing channels, third-party payers, pharmacy benefit managers (PBMs), patients’ financial contributions, government regulations, and much more.

    As always, we have updated all market and industry data with the most current information available, including our annual analyses of the market positions of the largest pharmacies, specialty pharmacies, and PBMs.

    This 2022 edition addresses COVID-19 and its ongoing impact on the pharmacy and PBM industries. Many sections and chapters have also been expanded and/or reorganized to better cover the latest industry developments. New sections cover: pharmacies’ administration of—and profits from—COVID-19 vaccines; smaller PBMs; PBM purchasing groups and GPOs; 340b split-billing software vendors; and shakeout and consolidation within retail pharmacy. We also present a more unified outlook for specialty drugs, including specialty generics and biosimilars.Download a free report overview for more details.

    The chart below illustrates the depth and breadth of the 2022 edition. The numbers indicate the report chapter that corresponds to, explains, and analyzes each channel flow.

    [Click to Enlarge]

    Thank you for your interest in our work. If you have any questions before purchasing a license to the report, please email me. Enjoy!