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 80,000 subscribers and followers. Learn more...

Friday, February 23, 2024

Four Keys to Success for Retail and Specialty-Lite Hub Services

Today’s guest post comes from Nicole Grycan, VP of Commercialization at Phil, Inc.

Nicole discusses how hubs can improve access and adherence. She outlines four success factors for manufacturers that use a digital hub partner.

To learn more, register for Phil's upcoming webinar: Improving Access, Coverage, and GTN with a Digital Hub.

Read on for Nicole’s insights.

Wednesday, February 21, 2024

Surprise! Thanks to the IRA, Part D Plans Will Prefer High-List, High-Rebate Drugs

Like many of you, I have believed that the Inflation Reduction Act of 2022 (IRA) will encourage Medicare Part D plans to adopt low-list-price products over their high-list/high-rebate counterparts, thereby popping the gross-to-net bubble.

Actually, maybe not.

Below, I explain why the IRA will encourage Part D plans to prefer high-list, high-rebate specialty drugs, even as the government and manufacturers will prefer a low-list-price version. Just another IRA-inflicted hit for biosimilars?

The warped incentives don't stop there. Even more weirdly, both products with a negotiated maximum fair price (MFP) and low-list-price products will raise total costs for the healthcare system and increase beneficiary premiums.

Did I get this latest unintended consequence right? Or have I been spending too much time underwater in Bikini Bottom? Read on and see what you think. As always, I encourage you to share your own thoughts with the Drug Channels community on social media.

P.S. Want to learn more? Join me on April 5 for DCI's next live webinar: Drug Channel Implications of the Inflation Reduction Act. Official announcement coming soon!

Friday, February 16, 2024

The Drug Discount Ecosystem Needs Clarity in 2024 and Beyond

Today’s guest post comes from Gavin Magaha, Senior Director of Value Delivery at Kalderos.

Gavin discusses the problems manufacturers face in accessing and standardizing drug discount data. These data are necessary to avoid duplicate discounts and comply with regulatory requirements.

To learn more about how the Inflation Reduction Act adds to challenges of drug discount programs, download Kalderos’ whitepaper:

Operational Complexity and Evolving Challenges: What Drug Manufacturers Need to Know Now About Drug Discount Programs, the Inflation Reduction Act, and 340B.

Read on for Gavin’s insights.

Wednesday, February 14, 2024

Copay Accumulator and Maximizer Update: Adoption Expands as Legal Barriers Grow

It's Valentine’s Day—and commercial plan sponsors remain smitten with copay accumulators and maximizers.

Our latest update finds that as of late 2023, about half of commercial lives were in plans that utilize a copay accumulator and/or a maximizer. These programs’ growth continues to divert the value of a manufacturer’s copay support payments away from patients and toward plans and PBMs. Check out the data below.

Patient advocacy groups and some big legal wins are starting to reverse Cupid’s arrow. But given the money at stake, I suspect that plans will keep looking for love in all the wrong places.

Friday, February 09, 2024

New Survey Reveals Manufacturers’ Patient Services Priorities for 2024

Today’s guest post comes from Nasir Ali, Chief Product Officer at CareMetx.

Nasir shares findings from CareMetx’s new 2024 Patient Services Report research study: Revealing Manufacturer Priorities: Patients Naturally Take Center Stage.

As he explains, manufacturers want hub partners that can take a holistic approach and address each patient’s individual needs. Nasir also discusses how hub selection criteria are evolving.

Read on for Nasir’s insights.

Wednesday, February 07, 2024

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

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

As you will see, retail and mail prescription drug spending remain a consistently small share of the $4.5 trillion that we spend on U.S. healthcare.

And contrary to what you might read, drug spending growth was *not* driven by purportedly “skyrocketing” drug prices. In reality, nearly all drug spending growth occurred due to growth in the number of people treated, prescriptions dispensed, and other nonprice factors.

Tomorrow, we’ll be treated to a Senate show trial featuring pharmaceutical company executives. Sadly, 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. Will drug pricing flat earthers (#DPFE) ever acknowledge the data?

Tuesday, February 06, 2024

Informa Connect’s Access USA

Informa Connect’s Access USA
March 19-21, 2024 | Pre-Conference Workshops on March 18, 2024
Philadelphia Marriott Downtown in Philadelphia, PA
Exclusive Offer – Be sure to use your exclusive promocode 24AUSA10 to save 10% off* of your registration.

Access USA, industry’s resource for accelerating access, partnerships and collaboration to deliver superior patient outcomes, is back and better than ever!

Exclusive Offer – Choose your preferred event and register today – Be sure to use your exclusive promocode 24AUSA10 to save 10% off* of your registration.

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

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.

Which event is for you?

PAP – Patient Assistance & Access Programs

Download Agenda | See Who’s Speaking

The experts will be taking the most pressing challenges industry is facing head on, including:
  • Emerging Policy Changes and Enforcement Actions
  • The Impact of AFPs on PAPs
  • Program Automation for Operational Efficiency
  • Ensuring Health Equity Where It Matters Most
  • Patient Education: Reaching the Patient and Continued Communication
  • Keeping Up with Growing Demand for Patient Assistance
Rare Disease Summit

Download Agenda | See Who’s Speaking

Unite to create life-transforming therapies and breakthroughs for rare diseases, with sessions led by experts in the field:
  • Navigate FDA Updates on Rare Disease Product Development
  • Discuss the Use of AI in the Rare Space
  • Review Investment Success through Valuation, Risk and Innovation
  • Deep Dives into Product Launch, Gene Therapy, Funding and Partnering, Reimbursement Strategies and More
  • Listen in on a Rare Caregivers Report, a NIH Address on moving your Rare Disease research forward, a Fireside Chat with CEO pharma pioneers, a Case Study from an early stage bio/pharma company, a Payer Perspective and more!
Hub and Specialty Pharmacy Models East

Download Agenda | See Who’s Speaking

Industry stakeholders collaborate on top-of-mind topics for hub professionals, including:
  • Enhancing Hub/PSP Design & Operations
  • Bridging the Gap Between Hubs and Specialty Pharmacies
  • Customization to Serve a Diverse Patient Base
  • Working Cross Functionally and Across Stakeholders
  • Utilizing Technology and AI to Increase Patient Engagement
Exclusive Offer – Choose your preferred event and register today – Be sure to use your exclusive promocode 24AUSA10 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, February 02, 2024

New Report: How GoodRx Improves the Economics of Healthcare

Today’s guest post comes from Divya Iyer, SVP of Go-to-Market Strategy at GoodRx.

Divya shares highlights from GoodRx’s new research report: The GoodRx Effect: How GoodRx Improves the Economics of Healthcare. She highlights how GoodRx’s integrated pharma copay cards help to improve medication access, therapy adherence, and overall health outcomes.

Click here to download the full report and learn more about partnering with GoodRx to drive patient access for your brand.

Read on for Divya’s insights.

Tuesday, January 30, 2024

Drug Channels News Roundup, January 2024: 2024 List Price Surprises, GSK vs. PBMs, Walgreens’ 340B Profits, Gen Z vs. Pharmacy, and PE + Hospitals

Super Bowl LVIII is almost here. Time for some blow-out beer commercials, occasionally interrupted by a football game. In case you haven’t heard, Taylor Swift is dating the brother of Paula’s favorite Eagles player.

But who needs the Super Bowl when you can tackle this month’s selection of notable news stories, intercepted for you from the Drug Channels gridiron:
  • Punt: Average list prices are unchanged for 2024
  • Trick Play: GSK tussles with PBMs over lower-priced products
  • Rush! Senator Cassidy tries to tackle CVS and Walgreens—and I give you a peek at a Walgreens 340B contract
  • Offsides: To Gen Z, being a pharmacist is cheugy.
Plus, Dr. Glaucomflecken peeks inside a hospital owned by a private equity firm.

P.S. A big THANK YOU for all the warm wishes and congratulations on DCI’s acquisition by HMP! Check out the wonderful comments on this LinkedIn post. Great things ahead.

Tuesday, January 23, 2024

Medicare Part D in 2024: Smaller Pharmacies Abandon Preferred Pharmacy Networks

In a previous article, I highlighted the largest pharmacy chains that will participate in the 2024 Medicare Part D prescription drug plans (PDP).

Today, I update DCI's exclusive analysis of how smaller pharmacies will participate as preferred cost sharing pharmacies via the pharmacy services administrative organizations (PSAOs) that represent them in negotiations with plans.

As you will see below, the largest PSAOs have effectively abandoned PDP’s preferred networks in 2024. Plans from Aetna, Humana, WellCare, and UnitedHealthcare will not have any independent pharmacies participating via PSAOs as preferred pharmacies.

Smaller pharmacies' ability to navigate away provides more bad news for stand-alone Part D market—and another unexpected consequence of the Inflation Reduction Act of 2022. Look out below!

Monday, January 22, 2024

Informa Connect’s PAP – Patient Assistance & Access Programs

Informa Connect’s PAP – Patient Assistance & Access Programs
March 19-21, 2024 | Pre-Conference Workshops on March 18, 2024
Philadelphia Marriott Downtown in Philadelphia, PA
Exclusive Offer – Be sure to use your exclusive promo code 24DC10 to save 10% off* of your registration.

It is our responsibility as an industry to ensure patients have access to the life-changing therapies they need.

How does PAP – Patient Assistance & Access Programs help us reach this goal?

Download the agenda and register today – Be sure to use your exclusive promo code 24DC10 to save 10% off* of your registration

With the demand for patient assistance growing each year, industry collaboration is vital in meeting patients’ needs and navigating the access and reimbursement barriers we face daily.

What policy disruptions await in the new year that will inevitably slow access and affordability? Is your program up to par with industry standards? How are we improving health equity to bridge the gaps in healthcare?

PAP – Patient Assistance & Access Programs, taking place March 19-21 in Philadelphia, PA, provides an essential forum for industry to collaborate and uncover the answers to these questions and more to define best practice for PAP programs. Experts come together and provide clarity on current changes in legislation and policy, methods for program optimization, the risks associated with AFPs, improving patient education for better patient outcomes and so much more. Never a shortage of timely discussions, join stakeholders from across the industry as they dive into methods and strategies to take on the challenges ahead.

What can you expect?

Tackle the hottest topics facing industry right now, including:
  • State of the Industry—The Changing Landscape of Healthcare Coverage and Access
  • Illuminating Health Equity—Bridging the Gaps in Healthcare, Education, and Partnerships
  • Enforcement Panel—Focal Points and Priorities for 2024 and Beyond
  • 3 Focused Tracks for a Customized Experience:
    • Legal and Policy
    • Patient Education
    • Technology, Innovation and Operations
  • Legal Address—Examining the Implications and Risks of Patient Assistance
  • PAP 101- Back to the Basics
  • Ensuring Compliance with Free Drug and Medication Assistance Programs
  • Impacts of the Inflation Reduction Act – Dive into How Organizations are Planning for 2025 Changes
  • Ask Me Anything Session with Leading Charitable Foundations
  • PLUS! Join your peers one day early on March 18th for 3 hot topic, intensive workshops:
    • Advocacy and Engagement
    • Alternative Funding Programs
    • Product Launch and Commercialization
Vital insights from industry’s leading access and affordability experts, including:
  • Corey Ford, MHA, Vice President of Reimbursement and Policy Insights, Cencora
  • Kevin L. Hagan, President and CEO, PAN Foundation
  • Doreen Rice, Director, Patient Assistance Programs, AstraZeneca
  • Page Buchanan, Vice President, Amgen Safety Net Foundation; Senior Manager, Patient Assistance Programs and OUS Product Donations, Amgen
  • Harmeet Dhillon, Head of Public Policy, GlaxoSmithKline
  • Joshua Walsh, Director of Patient Access, AbbVie
  • Rachel Thorpe, Executive Director, Otsuka Patient Assistance Foundation, Inc.
  • Liz Austin, Patient Foundation Head, Genentech
  • Amy Yarcich, Executive Director, Rx Partnership
  • Alisa Vidulich Casavant, Policy Director, Arthritis Foundation
  • And more!
PLUS, Continued Extended Networking in 2024!

PAP is back 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!), expand your network and establish powerful partnerships.

Exclusive Offer – Download the agenda and register today – Be sure to use your exclusive promo 24DC10 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, January 19, 2024

Rethinking Financial Services in Biopharma Patient Affordability Programs

Today’s guest post comes from Bob Raffo, Senior Vice President of Financial Services & Strategic Commercial Development at Cencora.

Bob discusses the challenges faced by patient affordability programs managed by third-party vendors. He explains three ways that biopharma companies can benefit by working with a financial services provider specializing in patient affordability programs.

Click here to learn about Cencora Financial Services.

Read on for Bob’s insights.

Tuesday, January 16, 2024

Anti-Obesity Drugs and The Coming Battle Over Utilization Management (video)

My recent Drug Channels Outlook 2024 webinar covered 12 key trends that will shape the commercial environment this year. The video excerpt below highlights my commentary on trend #2: the rapid growth of anti-obesity GLP-1 agonist drugs.

As I explain, this growth will challenge payer and channel economics, while boosting profits for patient reimbursement hub businesses and pharmacy benefit managers (PBMs).

The widespread use of these products will also lead to greater scrutiny of utilization management—the tools that PBMs use to influence and manage prescription costs.

If this clip whets your appetite for more, register to watch a replay of the full 100 minute Drug Channels Outlook 2024 video webinar.

Click here to sign up for The Drug Channels 2024 Video Webinar Series. My first webinar will be on April 5, 2024.

Click here if you can’t see the video above.

Friday, January 12, 2024

Repairing the Patient Journey: How Pharma Can Fix the Obvious–and Not So Obvious–Breaking Points of Nonadherence

Today’s guest post comes from Maria Kirsch, President, Patient Services, Krista Pinto, President, Deployment Solutions, and Mike Scott, Senior Vice President, Specialty Consulting at EVERSANA.

Maria, Krista, and Mike discuss the key reasons why patients abandon drug therapy. They then describe EVERSANA’s approach for helping manufacturers and healthcare providers improve adherence and health outcomes.

Learn more about EVERSANA’s solutions from this complimentary whitepaper: Repairing the Patient Journey: How Pharma Can Fix the Obvious–and Not So Obvious–Breaking Points of Nonadherence.

Read on for the authors’ insights.

Tuesday, January 09, 2024

The Big Three PBMs’ 2024 Formulary Exclusions: Biosimilar Humira Battles, CVS Health’s Weird Strategy, and the Insulin Shakeup

For 2024, the three largest pharmacy benefit managers (PBMs)—Caremark (CVS Health), Express Scripts (Cigna), and OptumRx (United Health Group)—have again each excluded 600 or more drugs from their standard formularies. You can find our updated counting below.

This year, Humira and its 14 biosimilars will provide the most intriguing formulary drama. Unfortunately, the gross-to-net bubble will remain a fixture for this category, despite a price war led by almost half of the biosimilars. CVS Health will lean into the craziness with an unusual Humira strategy.*

There are also unusual formulary developments for insulin products, many of which experienced massive list price cuts for 2024.

Read on for my deep dive into these two therapeutic categories. I also highlight recent research that raises troubling questions about the patient impact of these ever-growing exclusion lists. As always, I welcome your comments below or on LinkedIn.

Thursday, January 04, 2024

BIG NEWS! HMP Global Acquires Drug Channels Institute

Paula and I have some exciting news to share with you: Drug Channels Institute is joining the HMP Global family! HMP is a leading omnichannel healthcare education, events, and market insights company. It’s a great fit for DCI.

Here’s the press release: HMP Global Expands Market Reach with Strategic Acquisition of Drug Channels Institute; Launches Market Intelligence Unit

Paula and I will continue to lead DCI as part of HMP. We love bringing you great content, and plan to continue doing so. HMP will be making significant investments to help us grow. Stay tuned for some exciting announcements!

Thank you all for your support and encouragement over the years. Please enjoy our special video message to the Drug Channels community:

Click here if you can’t see the video.

Wednesday, January 03, 2024

Tales of the Unsurprised: U.S. Brand-Name Drug Prices Fell for an Unprecedented Sixth Consecutive Year (And Will Fall Further in 2024)

It's time for Drug Channels’ annual reality check on U.S. drug pricing.

For 2023, brand-name drugs’ list prices again grew at mid-single-digit rates. However, net prices dropped for an unprecedented sixth consecutive year. What’s more, after adjusting for overall inflation, brand-name drug net prices plunged by more than 7%. Details below.

Employers, health plans, and PBMs determine whether patients share in this ongoing deflation. Meanwhile, these data challenge drug pricing flat earthers (#DPFE) who remain committed to a false narrative of “skyrocketing” drug prices.

As I discuss below, manufacturers will face ongoing pressure on net prices from both commercial and government payers. They will also have new incentives to limit growth in list prices—and will even reduce list prices on certain drugs (as some are already doing).

Perhaps these factors will finally start to deflate the gross-to-bubble and reduce its negative effect on patients and public policy discussions. Hope has to triumph over experience eventually, doesn’t it?