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 65,000 subscribers and followers. Learn more...

Friday, March 24, 2023

Winning the Race for Patient Access: Identifying Copay Accumulator Impact

Today’s guest post comes from Logan Melchione, Senior Director of Account Management at Paysign.

Logan discusses the financial impacts of copay accumulators on manufacturers and patients. She describes how to reduce the strain on manufacturers' programs while  also increasing patient access. Click here to learn about the Paysign Solution.

Email affordability@paysign.com to set up a meeting with Paysign at Asembia’s Specialty Pharmacy Summit, April 30-May 4.

Read on for Logan’s insights.

Tuesday, March 21, 2023

Drug Channels News Roundup, March 2023: My $0.02 on Insulin Price Cuts, AbbVie vs. AFPs, Optum Expands, ASAP340B, and Hooray for Pharmacists

Spring is here in sunny downtown Philadelphia, worldwide headquarters of Drug Channels. The vernal equinox has brought us an unexpected bounty of noteworthy news:
  • Thoughts on the recent insulin price cuts by Lilly, Novo, and Sanofi
  • AbbVie gets tougher on alternative funding programs
  • Optum quietly adds a new drug channel role
  • A novel partnership emerges to modernize the 340B program
Plus, a celebration of pharmacists’ activities during the COVID-19 pandemic.

P.S. Join my more than 38,000 LinkedIn followers for daily links to neat stuff. You can also find my daily posts at @DrugChannels on Twitter, where I have more than 16,000 followers.

Join me for my new live video webinar, Discount Cards, Cost-Plus Pharmacies, and PBMs: Trends, Controversies, and Outlook, on March 31, 2023, from 12:00 p.m. to 1:30 p.m. ET. Click here to learn more and sign up.

Monday, March 20, 2023

Informa Connect’s Annual Life Sciences Commercial Contracts & Chargebacks Congress

Informa Connect’s Annual Life Sciences Commercial Contracts & Chargebacks Congress
May 16-17, 2023
The Omni Shoreham Hotel | Washington, DC
Hybrid Event
informaconnect.com/contracts-chargebacks

Exclusive Offer for Drug Channels Readers: Register Now to SAVE 10%* using promo code 23DC10

Informa Connect’s 19th Annual Commercial Contracts & Chargebacks Congress, taking place May 16-17 in Washington, DC, 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 two-day event offering extended content and actionable strategies in key interest areas in the ever-evolving contracting landscape.

Featured Faculty Driving the Conversation:
  • Rosalind Davis, Government Pricing & Contracts Director, Vifor Pharma, Inc.
  • Stephani Kupski, Director, U.S. Pricing & Government Reporting, CSL Behring
  • Mallory O’Connor, Public Policy Executive Director, Mallinckrodt
  • Cad Snyder, Director, Global Finance Shared Services, Cardinal Health
  • Beth Stevens, Associate Director, Contracts and Pricing, Tolmar Inc.
  • Roxana Santiago, Director Controlling Revenue Accounting, Fresenius Kabi USA LLC
  • Jennifer Plemmons Crosswell, Director, Contracts & Pricing, Accounting, Azurity Pharmaceuticals
  • Mitesh Ghia, Director, Chargebacks, Membership, Rebates & Contract Administration, Novartis Pharmaceuticals Corporations
  • Elizabeth Johnson, President, National Association of Medication Access & Patient Advoacacy
  • Erika Chiles-George, Pricing & Trade Director, Contracts, Neurocrine Biosciences
  • And many more!
Hight Impact Topics Transforming the Market Include:
  • Commercial Contract Model Landscape
  • Assessing the Impact of IRA on Product Calculations
  • 340B Drug Discount Program — Ongoing Monitoring of 340B Program Risks & Best Practices
  • Multi-Stakeholder Panel — Membership and Class of Trade
  • Updated Review and Interpretation of the Inflation Reduction Act
  • GTN Forecasting Across Different Channels
  • PLUS! — Customize Your Learning by Choosing Between Two Thought-Provoking Tracks:
    • Contracts and Chargebacks Excellence
    • Analytical and Technology Innovation
  • and more!
NEW THIS YEAR! The 2023 Summit is Part of Life Sciences Pricing & Contracting USA Uniting three industry leading events — Medicaid & Government Pricing Congress, Drug Pricing Transparency Congress and Life Sciences Commercial Contracts & Chargebacks — Life Sciences Pricing & Contracting USA is the industry’s go-to resource for gaining critical insight on regulatory requirements, policy initiatives and best practices to enhance pricing and contracting models. Attend your preferred event and prepare for critical content tailored to your focus area, plus benefit from a more diverse speaking faculty and greater networking opportunities to expand your network and establish powerful partnerships.

ENHANCE YOUR EXPERIENCE!

Attendees of Commercial Contracts & Chargebacks 2023 have the option to add a third day of content to their schedule and join the Medicaid & Government Pricing Congress attendees for their final day. Benefit from a fireside chat, in-depth sessions and learning streams, plus additional networking opportunities!

Drug Channels readers are eligible for an exclusive savings of 10% off* the standard rate by using promo code 23DC10, so download the complete conference agenda and reserve your seat today!

*Expires 5/16/2023; applies to current 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. To find out how you can promote an event on Drug Channels, please contact Paula Fein (paula@drugchannels.net).

Friday, March 17, 2023

It's Not All Bad News: Data Shows There's a Collaborative Future for 340B

Today’s guest post comes from Rhiannon Naslund, Chief Marketing Officer at Kalderos.

Rhiannon discusses the growing collaboration between manufacturers and covered entities regarding 340B discount claims. She goes on to describe the Kalderos Discount Hub solution that reviews claims that have a high likelihood of being a duplicate discount.

To stay up-to-date with the latest drug discount developments, sign up for the Kalderos newsletter.

Read on for Rhiannon’s insights.

Tuesday, March 14, 2023

NOW AVAILABLE: The 2023 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers

I am pleased to announce our new 2023 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 April 3, 2023.

The 2023 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers, our 14th 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.

12 chapters, 480+ pages, 241 charts/exhibits/data tables, 966 endnotes: There is nothing else available that comes close to this encyclopedic resource.

The chart below illustrates the depth and breadth of the 2023 edition. The numbers indicate the report chapter that corresponds to, explains, and analyzes each channel flow.

[Click to Enlarge]

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.

Read on for some additional details.

Monday, March 13, 2023

Informa Connect’s Medicaid & Government Pricing Congress

Informa Connect’s Medicaid & Government Pricing Congress
May 16-18, 2023 in Washington, DC
www.informaconnect.com/medicaid2023
Drug Channels readers save 10% with code 23DRCH10*

Join the life science industry on May 16-18, 2023 in Washington, DC at the Medicaid & Government Pricing Congress to conquer complex Medicaid regulatory guidelines and evolve strategies to contract, report and comply with federal and state healthcare programs.

View the agenda for Medicaid & GP 2023 to see the complete picture – the program, speakers, and more, and visit www.informaconnect.com/medicaid-government-pricing for further details and to register. Drug Channels readers will save 10% off when they use code 23DRCH10 and register prior to April 7, 2023.*

When you join Informa Connect in Washington, DC, you'll hear from leading GP experts on the latest MDRP trends and strategies that impact you and your business. Some of the companies leading the dialogue include Ascendis Pharma, AstraZenca, Bayer, Blueprint Medicines, Bristol Myers Squibb, CSL Behring, Department of Health & Human Services, Endo, Genentech, Gilead, Mallinckrodt, Neurocrine Biosciences, Novartis, Pfizer, PhRMA, Sanofi, Takeda, Teva, UCB, United Therapeutics, Viatris and more.

Here are just a few of the sessions you'll attend:
  • Everything Inflation Reduction Act – Both interpretation and implementation guidance
  • Your Medicaid wish list – 30+ years into the program, what would your recommendations to CMS be?
  • The latest and greatest 340B litigation and operational updates
  • Refresh of the inclusion of territories, and hear from Puerto Rico Medicaid on their processes
  • Panel on market access and pricing strategy considerations for early R&D
  • Join a senior-level work group on policy reform for Medicaid and government pricing programs
  • Discuss the intersection of line extensions and AMP cap in-depth
  • Back by popular demand – Fundamentals of GP, the fireside chat with external counsel, and the state-by-state review of SPTR
  • Topics on class of trade, strategies for product launch, moving your data to the cloud, intro to blockchain for GP professionals, discussion on bots and automation and much more!
Informa Connect is also thrilled that this year's Congress is part of Pricing & Contracting USA! You'll have the benefit of networking with like-minded executives from across the life science industry as we bring together attendees from three industry leading events (the Medicaid & Government Pricing Congress, the Drug Pricing Transparency Congress and the Commercial Contracts & Chargebacks Summit) in the pricing and contracting arena.

View the agenda for Medicaid & GP 2023 to see the complete picture – the program, speakers, and more, and visit www.informaconnect.com/medicaid-government-pricing for further details and to register. Drug Channels readers will save 10% off when they use code 23DRCH10 and register prior to April 7, 2023.*

*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 10, 2023

Taking A Technology-First Approach In Your Affordability Program

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

Stacey discusses digital hubs and the affordability advantages they offer both patients on specialty therapies and their health care providers. To learn more, click here to schedule a meeting with AssistRx at Asembia’s Specialty Pharmacy Summit on April 30 to May 4, 2023.

Download AssistRx's free 61-page eBook here: Specialty Drug Patient Support Programs: 2022 Progress Report.

Read on for Stacey’s insights.

Wednesday, March 08, 2023

The Top 15 U.S. Pharmacies of 2022: Market Shares and Revenues at the Biggest Companies

Next week, Drug Channels Institute will release our 2023 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. It’s the 14th edition of our popular and comprehensive examination of the entire U.S. drug pricing, reimbursement, and dispensing system.

The exhibit below—one of 241 in our new report—provides a first look at the 15 largest organizations, ranked by total U.S. prescription dispensing revenues for calendar year 2022. U.S. prescription dispensing revenues reached a record $548 billion in 2022.

Not to put too fine a point on it—but they might be giants. The largest 15 pharmacies accounted for more than 75% of total dispensing revenues from retail, mail, long-term care, and specialty pharmacies. The top 15's share dipped slightly compared with their 2021 share, due primarily to the significant revenue losses for Walgreens Boots Alliance’s AllianceRx Walgreens Pharmacy.

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 April 3, 2023.

How will GoodRx and Mark Cuban Cost Plus Drug Company affect the pharmacy industry? Find out at my upcoming live video webinar, Discount Cards, Cost-Plus Pharmacies, and PBMs: Trends, Controversies, and Outlook, on March 31, 2023, from 12:00 p.m. to 1:30 p.m. ET. Click here to learn more and sign up.

Tuesday, March 07, 2023

Discount Cards, Cost-Plus Pharmacies, and PBMs: 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:

Discount Cards, Cost-Plus Pharmacies, and PBMs:
Trends, Controversies, and Outlook

This event will be broadcast live on Friday, March 31, 2023,
from 12:00 p.m. to 1:30 p.m. ET.

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

This event is part of The Drug Channels 2023 Video Webinar Series. Anyone who registered for the entire series will receive an email with a link to access the March event.

WHAT YOU WILL LEARN

The rapid expansion of patient-paid prescriptions—via cash-pay pharmacies and discount card vendors—is transforming the prescription market. Join Dr. Fein as he helps you and your team deepen their understanding of this important issue and its crucial implications. He will draw from exclusive information found in DCI's new 2023 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers.

During the event, Dr. Fein will cover a wide range of topics, including:
  • What’s driving the boom in patient-paid prescriptions
  • The warped economics of the generic prescription channel
  • Cash-pay prescriptions vs. discount cards
  • Why Usual & Customary (U&C) prices matter
  • The latest market data on the discount card market and its key participants
  • The complex economics of discount cards
  • How PBMs profit from—and are challenged by—patient-paid prescriptions
  • Pharmacy strategies and reactions
  • Why and how plans are placing discount cards within pharmacy benefits
  • Commentary on GoodRx, Mark Cuban Cost-Plus Drug Company, and more
  • Outlook for disruption of the pharmacy benefit market
  • Controversies and unresolved questions
  • And more!
PLUS: During the webinar, Dr. Fein will give participants an opportunity to unmute themselves and ask live questions. The webinar will last 90 minutes to accommodate audience 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.

PRICING OPTIONS

You can register for this unique educational opportunity for only $380 per viewing device. Within 24 hours of your purchase, you will receive an email from Zoom with a unique link to access the webinar replay video.

We are offering substantial discounts for multiple registrations from the same organization. We know that many of you may still be working from home, so rates for multiple registrations are as low as $265 per device—a 30% savings. An unlimited number of people may watch at one location if they can watch from a single device.

Click here to order. All discounts will be automatically computed based on the number of registrations you enter in your cart. (You can reset the cart by entering 0 in the quantity field.)


Please contact Paula Fein (paula@drugchannels.net) if you have any questions. If you purchase access for multiple devices, we will contact you for a list of your participants and their email addresses. Or, download this spreadsheet and email your registrants’ information to Tamra Feldman (admin@drugchannels.net).

Click here to register for the full Drug Channels 2023 Video Webinar Series

Payment can be made 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.

IMPORTANT THINGS TO KNOW
  • Watch and listen via any device with a web browser (computer, iPad, iPhone/Android, etc.) There is no access via telephone.
  • We use Zoom technology for this webinar. Every registrant will receive an email from Zoom with a link to watch the event. This link is unique to the registrant and can only be accessed once. We recommend that every registrant download the Zoom client software/app.
  • Prior to the event, every registrant will receive an email from Zoom with a link to access the event and add it to their calendar. Every registrant will also receive reminder emails from Zoom one week, one day, and one hour before the event.
  • Organizations that purchased corporate access for The Drug Channels 2023 Video Webinar Series will receive a custom, branded signup link so employees can easily register. We will automatically refund payments from anyone at a company with corporate access who purchases a single registration using their corporate email account.
  • Unfortunately, we are unable to offer refunds.


Monday, March 06, 2023

Informa Connect’s Drug Pricing Transparency Congress

Informa Connect’s Drug Pricing Transparency Congress
May 16-17, 2023 in Washington, DC
Drug Channels readers can save 10% with code 23DRCH10
www.informaconnect.com/drug-pricing-transparency

Join Informa Connect on May 16-17, 2023 in Washington, DC at the Drug Pricing Transparency Congress to stay on the pulse of federal and state reporting requirements, policy initiatives and strategic best practices for compliance. Experts from across the industry will discuss how current and future drug pricing transparency regulations will impact commercialization, reimbursement, pricing and compliance practices. Plus, assess how companies are internally planning for these changes.

View the agenda for Drug Pricing Transparency 2023 to see the complete picture – the program, speakers, and more, and visit www.informaconnect.com/drug-pricing-transparency for further details and to register. Drug Channels readers will save 10% off when they use code 23DRCH10 and register prior to March 31, 2023.*

Here's just a little sneak peek at what's to come:
  • You'll hear perspectives from the who's who in drug pricing and transparency, including companies such as Actelion, Ascendis Pharma, BIO, Chiesi, ClassOne Insight, Endo, Gilead Sciences, Hyman, Phelps & McNamara, iContracts, King & Spalding, Latham & Watkins, Mallinckrodt, Maryland Prescription Drug Affordability Board, Model N, Neurocrine Biosciences, Novartis, Novo Nordisk, PhRMA, Porzio Life Sciences, Riparian, Sanofi, Teva, U.S. Attorney's Office for the Districts of MA and NJ, and Viatris
  • You'll take a deep dive into the hottest topics keeping you up at night, including
    • Drug Pricing Transparency Pressures
    • DOJ Drug Pricing Transparency Priorities
    • Legal Updates on Authorized Generics and the U.S. Drug Pricing of Brand Name Drugs
    • Resource Allocation for Your Medicaid, Market Access and GP Teams
    • Updated Review Including CMS Guidance of the Inflation Reduction Act
    • Implication of Stacked and Value Based Contract Product Agreements on Medicaid Pricing
    • And much more!
Informa Connect is also thrilled that this year's Congress is part of Pricing & Contracting USA! You'll have the benefit of networking with like-minded executives from across the life science industry as we bring together attendees from three industry leading events (the Medicaid & Government Pricing Congress, the Drug Pricing Transparency Congress and the Commercial Contracts & Chargebacks Summit) in the pricing and contracting arena.

View the agenda for Drug Pricing Transparency 2023 to see the complete picture – the program, speakers, and more, and visit www.informaconnect.com/drug-pricing-transparency for further details and to register. Drug Channels readers will save 10% off when they use code 23DRCH10 and register prior to March 31, 2023.*

*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 03, 2023

What a Technology-First Approach Really Means for Your Patient Support Program

Today’s guest post comes from Jan Nielsen, Patient Solutions Division President at AssistRx.

Jan discusses digital hubs and the benefits they offer both patients on specialty therapies and their health care providers. To learn more, download AssistRx's free 61-page eBook: Specialty Drug Patient Support Programs: 2022 Progress Report.

Read on for Jan’s insights.

Tuesday, February 28, 2023

Drug Channels News Roundup, February 2023: Mark Cuban vs. PBMs, MDs on Humira Biosimilars, States vs. PBMs, 340B Transparency, and Health Insurer Humor (?)

The era of artificial-intelligence chatbots has arrived! I am pleased to report that this month’s Drug Channels news roundup was most definitely not written by ChatGPT. No promises about future articles. (See our forecast to the right.)

In this issue:
  • Mark Cuban explains his anti-PBM strategy
  • What physicians think about Humira biosimilars
  • States go after PBMs
  • HHS is confused about 340B transparency
Plus, The Onion tests your knowledge of United Healthcare’s policies.

P.S. Join my nearly 38,000 LinkedIn followers for daily links to neat stuff. You can also find my daily posts at @DrugChannels on Twitter, where I have nearly 16,000 followers.

Friday, February 24, 2023

Exclusive Report: Manufacturers Identify the Three Critical Drivers of Hub Success

Today’s guest post comes from Matt Hall, President of Patient Solutions at CareMetx.

Matt shares three key findings from CareMetx’s exclusive new survey on patient support services for specialty pharmaceuticals. To learn more, download CareMetx’s free 2022 Report - Patient Services Trends

Read on for Matt’s insights.

Wednesday, February 22, 2023

Copay Accumulator and Maximizer Update: Adoption Plateaus as Insurers Battle Patients Over Copay Support

Is the gold rush in copay accumulators and maximizers slowing down?

Our latest update finds that for 2022, about 40% of commercial lives have adopted these benefit designs. Accumulator adoption has plateaued, while maximizer use has overtaken accumulators. Patients who take a single-source, brand-name specialty drug for autoimmune conditions, multiple sclerosis, and oncology increasingly face these benefit designs. Check out the plan and patient data below.

Patients are caught in the middle of a complex battle among insurers, PBMs, and drugmakers. They are rightfully unhappy that their plans are grabbing the copay support funds. That’s why legislation, lawsuits, and patient advocacy are growing. Manufacturers are also pushing back on plans’ copay games.

These reactions will slow the financial windfall for plans and PBMs—and raise the risk that plans will push the ethical boundaries even farther.

Tuesday, February 21, 2023

Available for Preorder: The 2023 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers

On March 14, 2023, Drug Channels Institute will release The 2023 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. This report—our fourteenth edition—remains the most comprehensive, fact-based tool for understanding the entire U.S. drug pricing, reimbursement, and dispensing system.

12 chapters, 480+ pages, 241 exhibits, 900+ endnotes: There is nothing else available that comes close to this valuable resource.

We are providing you with the opportunity to preorder this thoroughly updated, revised, and expanded 2023 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 14.


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 April 3, 2023.

The 2023 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. Throughout the report, we have added new industry data, deepened our coverage of many topics, and added more trending information. Material that addresses COVID-19 and its impact on the pharmacy and PBM industries has been integrated into our analyses throughout the report.

This 2023 edition includes substantial new material. A new Section 12.5. addresses the Inflation Reduction Act of 2022. In Subsection 12.5.1., we summarize the key provisions of the law that relate to the topics in this report. In Subsection 12.5.2., we highlight potential implications of the IRA for the drug channel.

There are 241 exhibits in the 2023 edition, compared with 216 in the 2022 edition. What’s more, 35 of the exhibits in the 2023 edition include new data sources that have not been used in previous editions. Download a free report overview for more details on the new sections and content.

The chart below illustrates the depth and breadth of the 2023 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!


Friday, February 17, 2023

Improve Access, Affordability, and Brand Performance With GoodRx’s Point-of-Sale Rebate Programs

Today’s guest post comes from Jim Longley, Head of Commercial, Pharma Manufacturer Solutions at GoodRx.

Jim discusses GoodRx Assist, a point-of-sale (POS) rebate program designed to help cash-paying patients start and stay on brand-name medication.

Click here to learn more about GoodRx Assist. Read on for Jim’s insights.

Tuesday, February 14, 2023

Exclusive: Profiling Manufacturers’ Limited and Exclusive Pharmacy Networks for Specialty Drugs

This Valentine's Day, what could be more romantic than a deep dive into the relationships between manufacturers of specialty drugs and the pharmacies they choose for their limited and exclusive specialty pharmacy networks.

Below, we rely on a unique database to provide you with some never-before-published benchmarking data on manufacturer-defined networks for 290 specialty drugs.

As you’ll see, a typical network contains only five specialty pharmacies. However, this average disguises substantial variability in network size. More than one in four specialty products have an exclusive network, while some have as many as 25 participants.

Manufacturers almost always say “be mine” to pharmacy benefit manager (PBM) affiliated partners, but they also swipe right with unaffiliated specialty pharmacies. Alas, PBM and plan strategies can still make smaller pharmacies feel lonesome.

Friday, February 10, 2023

The Top Indicators That a Hub Launch Will Succeed: Discovery and Partnership

Today’s guest post comes from ConnectiveRx’s Lauren Cole, Senior VP of Launch Excellence at ConnectiveRx.

Lauren outlines key success factors when transitioning or launching a patient hub.

To learn more, join Lauren on April 4th at 1:00 p.m. ET for a free online panel discussion: Lessons from the Edge—Six Things That Can Make a Hub Launch Go Wrong.

Lauren will also be exploring hub launch excellence at Informa Connect’s Hub and Specialty Pharmacy Models East conference on March 20-22.

Read on for Lauren’s insights.

Tuesday, February 07, 2023

The Warped Incentives Behind Amgen’s Humira Biosimilar Pricing–And What We Can Learn from Semglee and Repatha

As you've surely heard, Amgen has just launched Amjevita, the first non-interchangeable biosimilar of Humira. Our crazy drug channel led Amgen to launch both a high-list/high-rebate and a low-list/low-rebate version of the drug. Its strategy echoes the pricing of the first interchangeable insulin biosimilars—as I predicted in 2021.

Unfortunately, we should expect most PBMs and plan sponsors to embrace the high-list/high-rebate version. The plans that adopt the higher-priced biosimilar will get bigger rebates, while patients with coinsurance and deductibles end up paying more out-of-pocket.

As Mark Twain said: “History doesn’t repeat itself—but it often rhymes.” So, below, I revisit the surprising market dynamics for the interchangeable insulin biosimilars and highlight Amgen’s experience lowering the list price of its PCSK9i product. The story is more complex than you might expect, so perhaps there is hope that low-list-price versions will connect.

Monday, February 06, 2023

Informa Connect’s Access USA

Informa Connect’s Access USA
Hybrid Event | March 20-23, 2023, Philadelphia Marriott Downtown
www.informaconnect.com/accessusa

Exclusive Offer – Be sure to use your exclusive promo 23AUSA10 to save 10% off* of your registration

We would like to introduce to you Access USA, industry’s resource for accelerating access, partnerships and collaboration to deliver superior patient outcomes.

What is Access USA? Access USA will unite PAP – Patient Assistance & Access Programs, Hub and Specialty Pharmacy Models East and Rare Disease Innovation & Partnership Summit, three industry-leading access conferences under one roof for one week of collaborative discussions and opportunities to expand your network and establish powerful partnerships.

Who will be there? Join leading bio/pharma manufacturers, impactful non-profit organizations, top-tier hospitals, foremost health clinics, top-notch PBMs, inspiring advocates, prominent specialty pharmacies, highly regarded academics, leading solution providers and more as they unite to tackle the barriers of patient access and take the necessary steps toward ensuring no patient worry about access to care.

What does that mean for you? In one week, meet with hundreds of key stakeholders across the access landscape and benchmark with, learn from and network with leaders paving the way in patient access. Just choose your preferred event and prepare to walk away inspired and armed with the knowledge necessary to drive patient access forward.

Here are just a few can’t miss content highlights from PAP – Patient Assistance & Access Programs. View the full agenda here.
  • State of the Industry: The Changing Landscape of Healthcare Coverage and Access
  • PhRMA Keynote Address
  • Equity Spotlight: Understanding the Importance of Equitable Healthcare, Education and Partnerships
  • Manufacturer PAP Spotlight: Gain Insight on Best Practices and Industry Standards
  • Customizable Track Programming by PAP Legal & Policy, Patient Adherence Strategies or Technology, Innovation & Automation
  • Workshop Breakout – Advocacy Insights to Enhance Patient Care or Partnership and Development to Optimize Patient Access
Here are just a few can’t miss content highlights from Rare Disease Innovation & Partnership Summit. View the full agenda here.
  • Navigate FDA Updates on Rare Disease Product Development
  • Establish and Navigate the Relationship between Industry and Advocacy
  • Advancing Rare Disease Research with Patient Centrality and Precompetitive Approaches – A Screen4Care Case Study
  • Rare Disease Awareness – Delivering Authentic Lived Experiences in a Challenging Regulatory Landscape
  • The 4Ps of Precision Medicine – Patients, Providers, Partners and Pharma
  • Breakout into Tracks – Access and Reimbursement Strategies, Investing and Partnering, and Drug Development and Clinical Innovation
Here are just a few can’t miss content highlights from Hub and Specialty Pharmacy Models East. View the full agenda here.
  • Policy Address – State of the 2023 Industry and Payer Landscape for Industry Trend Updates
  • Hubs Stakeholder Showcase – Opportunities and Challenges in Accelerating Patient Access with Manufacturer, SPP and Consultant Perspectives
  • Copay Landscape – Changes in the Accumulator/Maximizer Landscape and How to Prepare
  • Enforcement Panel – Explore Evolving Regulatory Reform in the Patient Support Services and Hub Models Space
  • Customizable Tracked Programming by Patient Support & Engagement or Digital & Technological Innovation
Exclusive Offer – Choose your preferred event and register today – Be sure to use your exclusive promo 23AUSA10 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).

Tuesday, January 31, 2023

Drug Channels News Roundup, January 2023: My $0.02 on Amazon & OptumRx, PBMs vs. AFPs, WSJ on 340B, Accumulators & Maximizers, and Tipping Culture

Here at our worldwide headquarters in Philadelphia, Eagles Super Bowl fever has landed. The police are already getting extra Crisco for the light poles. (Yes, really.)

Before you start training to gorge at your game day party, tackle this month’s selection of notable news stories, intercepted for you from the Drug Channels gridiron:
  • Offsides: My $0.02 on the latest moves by Amazon and OptumRx
  • Trick play: OptumRx attacks alternative funding programs
  • Offensive line: Shocking Wall Street Journal expose of 340B abuses
  • Touchdown! Accumulators and maximizers go mainstream
Plus, tipping culture comes to healthcare.

P.S. Join the nearly 37,000 people who run after me on LinkedIn. You can also chase me at @DrugChannels on Twitter. Every day, I tackle links to neat stuff for you.

Friday, January 27, 2023

The Evolution of Medical Benefit Contracting: How Pharma Can Prepare

Today’s guest post comes from Saket Patel, Consultant, Advisory Services at MMIT.

Saket discusses market access and contracting strategies for medical benefit products when pharmacy benefit biosimilar therapies launch. He then describes how to automate formulary and medical policies to protect manufacturers from overpayment.

Click here to learn about MMIT’s Contract Validation solution.

Read on for Saket’s insights.

Tuesday, January 24, 2023

The State of Employers’ Pharmacy Benefits: A Review of 2022 and the 2023 Outlook for Copay Programs

Now that 2023 is underway, let’s review employer-sponsored coverage for prescription drugs and speculate on what’s ahead.

Below I examine the latest data on pharmacy benefits: cost sharing tier structures, copayment vs. coinsurance, and out-of-pocket obligations. As you will see, pharmacy benefit designs again increased the use of coinsurance for specialty and fourth-tier drugs.

These designs significantly raise patients’ out-of-pocket obligations—and contribute to the controversy over copay accumulator adjustment and copay maximizers. In 2023, employers’ savings and PBMs’ profits from these programs will decline—which will trigger a coming crackdown on specialty drug benefits. Beneficiary beware!

P.S. As usual, you will also enjoy some terrible Drug Channels tiers/tears puns.

Monday, January 23, 2023

Informa Connect’s PAP – Patient Assistance & Access Programs | Part of Access USA

Informa Connect’s PAP – Patient Assistance & Access Programs | Part of Access USA
Hybrid Event | March 20-22, 2023, Philadelphia Marriott Downtown
www.informaconnect/pap

Exclusive Offer – Be sure to use your exclusive promocode 23DCPAP10 to save 10% off* your registration.

The last thing a patient should worry about is access to care. With growing demand for patient assistance, accelerating prescription access and affordability is as crucial as ever. PAP – Patient Assistance & Access Programs is back March 20-22 and bringing together key stakeholders to collaborate and strategize on methods to meet that growing demand and navigate the access and reimbursement barriers faced daily.

Join your peers, leading experts and top solution providers for unparalleled networking opportunities and fresh perspectives on how to further access to care, understand current changes in legislation and policy and optimize PAP programs for better patient outcomes. Industry standards are evolving. Secure your spot now to ensure you and your organization are not left behind.

Do not miss this opportunity to unite with pharma, foundations, health clinics and more and benchmark on industry standards and stay on top of evolving trends to propel program performance. Can’t miss content highlights include:
  • State of the Industry: The Changing Landscape of Healthcare Coverage and Access
  • PhRMA Keynote Address
  • Equity Spotlight: Understanding the Importance of Equitable Healthcare, Education and Partnerships
  • Patient Perspective
  • Manufacturer PAP Spotlight: Gain Insight on Best Practices and Industry Standards
  • Three Customizable Tracks
    • PAP Legal & Policy
    • Patient Adherence Strategies
    • Technology, Innovation & Automation
  • Two Workshops
    • Advocacy Insights to Enhance Patient Care
    • Partnership and Development to Optimize Patient Access
  • And more!
PLUS, EXTENDED NETWORKING IN 2023!

PAP 2023 will take place as part of Access USA, the access event bringing together three industry-leading conferences under one roof. Benefit from robust networking opportunities with all Access USA participants (that is an expected 600+ access professionals!) and expand your network and establish powerful partnerships.

Exclusive Offer – View the agenda and register today – Be sure to use your exclusive promocode 23DCPAP10 to save 10% off* 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, January 20, 2023

Harnessing Data to Improve Patient Access and Optimize Gross-to-Net

Today’s blog post comes from Andrew Duncan, Vice President of Business Operations and Analytics at PHIL.

Andrew discusses how manufacturers can use data-driven strategy to understand utilization, increase patient access and adherence, and optimize gross-to-net.

Click here to learn more about PHIL’s access and commercialization solutions.

Read on for Andrew’s insights.

Tuesday, January 17, 2023

Vertical Integration in Healthcare: 2023 Outlook for the Seven Major Players (Video)

Consolidation has brought together large, economically significant insurer/PBM/specialty pharmacy/provider organizations within U.S. drug channels. At least half of all U.S. healthcare spending flows through these seven familiar entities: Blue Cross Blue Shield, Centene, Cigna, CVS Health, Elevance Health, Humana, and United Health Group.

In the brief video clip below, I review these businesses and offer some thoughts on their positioning for 2023. As you’ll see, the vertical strategy shakeout is underway.

If this clip whets your appetite for more, purchase a replay of the full 90 minute Drug Channels Outlook 2023 video webinar. Or register for my forthcoming 2023 video webinar series.

Friday, January 13, 2023

A New Point-of-Prescribing Solution to Help Increase Prescribing Accuracy, Speed to Therapy and Patient Adherence

Today’s guest post comes from Clay Courville, Chief Product Officer at CoverMyMeds.

Clay discusses the ongoing problem of medication errors. He describes CoverMyMeds’ provider alerts solution, which is designed to minimize medication errors. Click here to learn more about CoverMyMeds’ Provider Medication Alerts solution.

Read on for Clay’s insights.