Drug Channels News Roundup, June 2025: PBM Rebate Flow, 340B’s 2024 Boom, IRA Fallout, MFN Legal Risks—and Mark Cuban’s PBM Rant

Happy 249th birthday, America! Before you launch your July 4 festivities, Drug Channels humbly offers some fact-based fireworks to heal our troubled nation:

• Where the Rebates Really Go

• Another Year of Explosive Growth for the 340B Program

• IRA Fallout for Seniors’ Out-of-Pocket Drug Costs

• Most-Favored-Nation Pricing’s Shaky Legal Foundations

Plus, Mark Cuban's blunt take on why CEOs fuel the PBM status quo.

P.S. Join my nearly 64,000 LinkedIn followers for daily links to neat stuff, along with sharp and thoughtful commentary from the Drug Channels community.

Drug Channels News Roundup, May 2025: MFN Controversy, Plan Sponsors ♥️ Rebates, PBM Profits, and Fun in Congress

Summer unofficially began over the weekend. To mark the occasion, here are a few hot items, freshly seared on the Drug Channels grill:

• Reactions from the Drug Channels community to the Most Favored Nation (MFN) pricing policy

• A reality check on whether plan sponsors truly want rebate reform

• What plan sponsors should know about the evolving profit models of pharmacy benefit managers (PBMs)

Plus: A special moment for DCI on Capitol Hill.

P.S. Join my 63,000+ LinkedIn followers for daily links to neat stuff, along with sharp and thoughtful commentary from the DCI community.

What’s Next for Retail Pharmacy: Data, Debate, and Disruption.

Don’t miss DCI’s June 20, 2025, webinar, featuring Dr. Adam J. Fein and Antonio Ciaccia. We’ll unpack the good, the bad, and the ugly of the pharmacy industry—and explore what it means for you. This dynamic session will blend expert insights and real-time debate. Join us!

Drug Channels News Roundup, November 2024: Employers & Their PBMs, Medicaid vs. 340B, U.S. Drug Prices, and Dr. G Shops for Health Plans

Happy Thanksgiving, everyone! Before you stretch your stomach, stretch your mind with our extra-stuffed helping of food for thought. In this issue:

• Intriguing data on how employers oversee their PBMs

• State Medicaid programs carve out PBMs—and get a 340B windfall

• Are U.S. drug prices really higher than other countries?

Plus, Dr. Glaucomflecken gets us ready for the open enrollment season.

P.S. Join my nearly 60,000 LinkedIn followers for daily links to neat stuff along with thoughtful and provocative commentary from the DCI community.

Coming soon: Drug Channels Outlook 2025, our biggest live video webinar of the year. Join Adam J. Fein, Ph.D., on December 13, 2024, from 12:00 p.m. to 1:30 p.m. ET., as he helps you and your team get ready for 2025 by outlining key issues and uncertainties that will surely affect your planning. Click here to learn more and sign up.

Drug Channels News Roundup, February 2024: Pharmacy Shakeout Update, High Drug Prices, 340B Realities, MDs vs. Pharmacists, and Foo Fighters

February is longer than usual this year, which means that you’ll have extra time to leap into our monthly curated selection of noteworthy news. In this issue:

• An update on the retail pharmacy shakeout

• Arguing for high drug prices

• A leading researcher provides a 340B reality check

• Physicians don’t want pharmacists getting uppity

Plus, Dave Grohl fights for your right to…have healthcare price transparency?

P.S. Join my nearly 53,000 LinkedIn followers for daily links to neat stuff. You can also find my daily posts at @DrugChannels on Twitter/X, where I have more than 17,400 followers. (I recommend that you follow me on LinkedIn, because the quality of comments and engagement is much higher than they are on Twitter. Sorry, no Threads.)

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?

Drug Channels News Roundup, October 2021: PBMs’ Oncology Exclusions, Biosimilar Boom, BCBS vs. Hospitals, U.S. vs. the World, and CRISPR Comedy

Fortunately, Halloween can’t be scarier than any other day this year. So grab your pillow case and stuff it with treats from the great Drug Channels pumpkin patch:

• Spooky! PBMs are conjuring a terrifying number of formulary exclusions for oncology drugs

• Eerie! Brrr..did you hear that? It’s the biosimilar boom!

• Creepy! Scream as Blue Cross Blue Shield frightfully overpays hospitals

• Shocking! Believe it or not, U.S drug spending shambles into the middle of the herd

Plus, The Onion summons the only humorous article about CRISPR.

P.S. Please join the more than 12,700 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 have more than 20,000 followers.

Recent posts have covered: Walgreens’ new direction; controversary over independent pharmacy counting; insurer consolidation; retail pharmacy M&A; drug pricing policy; Prime Therapeutics; 340B contract pharmacy litigation; pharmaceutical antitrust; oncology care model; and Peter Bach’s nuptials.

Drug Channels News Roundup, September 2021: Hospitals’ 340B Profits, Drug Prices Deflate, U.S. vs. EU, Amazon vs. CVS, and More Bad Blood for Theranos

Autumn is here! Curl up with your favorite pumpkin-spiced blog and savor these stories harvested from the Drug Channels patch:

• Fresh insights about hospitals’ specialty drug profits

• SSR Update: Drug prices keep dropping

• My $0.02 on international benchmarking goes viral

• Amazon is finally disrupting CVS—but not how you expected

Plus, the best article ever about Elizabeth Holmes’s Theranos trial.

P.S. Please join the more than 12,500 consumers of my daily commentary and links to neat stuff at @DrugChannels on Twitter. You can also find me on LinkedIn, where I have more than 20,000 followers.

My recent social media topics have included: the ASPE report, biosimilar reimbursement, non-profit hospital shenanigans, HRSA’s reorganization, MTM in Part D, PBMs’ GPOs, pharmacy GPOs, channel strategy, white bagging, and the soothing sounds of pills being counted.

Drug Channels News Roundup, November 2020: Rebate Rule Redux, MFN (maybe), Amazon’s Pharmacy Customers, Drug Spending, GPO M&A, and RxTrace

Happy Thanksgiving, everyone! Before you stretch your stomach, stretch your mind with this extra-stuffed helping of food for thought. In this issue:

• Rebate rule redux

• Most Favored Nation and healthcare benchmarking

• Amazon’s pharmacy customer opportunity

• Drug spending realities updated

• GPO consolidation

Plus, I congratulate Dirk Rodgers of RxTrace on his retirement.

P.S. Join the more than 10,600 followers of my curated links published on @DrugChannels on Twitter. My recent tweets have highlighted: doctors against step therapy, distribution of COVID-19 therapies, biosimilar savings, copay accumulator data, prospects for smaller PBMs, the new transparency rule, specialty pharmacy profit metrics, the future of oncology practices, and an update on Diplomat founder Phil Hagerman. You can also join my more than 13,500 followers on LinkedIn.

Trump’s Executive Orders on Drug Pricing: The Drug Channels Guide to Industry Implications

Surprise! President Trump signed four executive orders (EO) last Friday afternoon. They cover:

• Pass-through of 340B discounts for insulin and EpiPens

• Rebate reform (!)

• Importation

• Most Favored Nation (MFN) pricing for drugs

The fourth order on MFN has not been publicly released, so I will reserve comment for now.

I see significant challenges in implementing these far-reaching orders. Below, you’ll find the text of the first three along with my commentary and links to Drug Channels articles that will help you make sense of them.

Read on and see if you agree with me.

My Visit to Boots UK: An International Pharmacy Photo Essay (rerun)

This week, I’m rerunning some popular posts. Let’s get ready for Walgreens’ new U.S. beauty strategy by revisiting my holiday photos from a Boots UK store visit. Click here to see the original post and comments from September 2013. (Yes, this is a deep cut from the archives!)

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In August, my family and I spent a wonderful 9 days in a surprisingly sunny London. In addition to the usual tourist haunts, I visited a few Boots pharmacies. (Of course I did!) I gained valuable insight into a key overseas pharmacy player that is now part of Walgreens.

Below are my observations on how Boots compares with U.S. drugstore chains. From my photos, you’ll see some similarities but also very intriguing differences. And by publishing this post, I can convert my entire vacation into a business expense. (Shhh, don’t tell the IRS.)

Bonus: I’ve included a photo of my amazing visit to (full-size) Stonehenge. Drug Channels goes to 11!

Why European Pharmacy Markets Are Less Efficient Than the U.S. Market

The Pharmaceutical Group of the European Union (PGEU), a trade association that represents community pharmacies throughout the EU, recently released its 2015 Annual Report. (Free download) The report is filled with loads of interesting data about the EU pharmacy industry, which shares many issues with the U.S. market.

One significant difference, however, is the greater efficiency of the U.S. pharmacy market.

Below, I crunch the PGEU data and compare the five biggest EU countries with the United States. As you can see, the U.S. has a much more competitive marketplace.

Extensive regulatory barriers may make the EU look like a paradise for independent pharmacies. Alas, such protections inconvenience consumers and raise drug costs. C’est la vie!

Catching Up With Cardinal Health China

Pharma distribution nerds, rejoice! Cardinal Health has just released its 10-K annual report for its 2015 fiscal year, which ended on June 30. Unfortunately, Cardinal continues to reduce the amount of information it discloses to investors and others. This year, working capital stats and associated chargeback adjustments have mysteriously vanished from Cardinal's SEC reports and earnings presentations. (When I asked, Cardinal would only say that "it's not a required disclosure." Hmmm...)

Despite the troubling opacity, let's review Cardinal’s China position. As the chart below shows, FY15 revenues at Cardinal Health China were $3.0 billion and accounted for 3% of the company’s total corporate revenues. I include a recent interview with CEO George Barrett, who provides useful insights into China’s political and economic climate.

P.S. Our updated 2015-16 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors will be released in early October. In the meantime, the 2014-15 edition is on sale until September 9.

Walgreens Boots Alliance: Analysis of its New U.S. Pharmacy Strategy (rerun)

I’m taking a break from blogging this week and rerunning some popular posts from early 2015. Click here to see the original post and comments from April 2015 Today's rerun is a good primer for WBA's earnings call tomorrow..

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Last week, Walgreens Boots Alliance (WBA) held its first analyst day as a combined company. Click here to download the slides and transcripts. (More detailed links below.)

WBA is a complex, global business with three major divisions and annual revenues of nearly $125 billion. Hence, the analyst “day” was a 2-day, 12 hour affair in which management presented 282 slides and generated a 125 page transcript!

Never fear, Drug Channels reader. I scoured every ounce of this material to find you the most valuable kernels. Below, I highlight my observations about WBA’s Retail Pharmacy USA division, a.k.a. Walgreens. My themes include the U.S. businesses’ changing focus, hypercompetition in the pharmacy industry, payer relationships, specialty pharmacy strategy, previous management’s missteps, and more. Read on for the sweet and salty details.

Walgreens Boots Alliance: Analysis of its New U.S. Pharmacy Strategy

Last week, Walgreens Boots Alliance (WBA) held its first analyst day as a combined company. Click here to download the slides and transcripts. (More detailed links below.)

WBA is a complex, global business with three major divisions and annual revenues of nearly $125 billion. Hence, the analyst “day” was a 2-day, 12 hour affair in which management presented 282 slides and generated a 125 page transcript!

Never fear, Drug Channels reader. I scoured every ounce of this material to find you the most valuable kernels. Below, I highlight my observations about WBA’s Retail Pharmacy USA division, a.k.a. Walgreens. My themes include the U.S. businesses’ changing focus, hypercompetition in the pharmacy industry, payer relationships, specialty pharmacy strategy, previous management’s missteps, and more. Read on for the sweet and salty details.

Will Walgreens Boots Alliance Buy Rite Aid?

Believe it or not, a crazy rumor about a Walgreens Boots Alliance (WBA)-Rite Aid transaction is making the rounds on Wall Street.

The rumor accelerated after recent comments by Stefano Pessina, WBA’s acting CEO and current global channels overlord. (See the Reuters article below.) Below, I highlight other recent articles that are feeding the rumor, along with perspective from two reputable investment banks.

I'm skeptical that such a deal will happen, especially because there are other logical acquisition targets (AmerisourceBergen, Diplomat Pharmacy, ULTA Beauty). But given Pessina’s track record and ambitions, we can’t ignore the possibility.

Read on and see if you agree. In case you are wondering: this is not an April Fool's post.

Manufacturers: Get Ready for Global Trade Account Management

The latest Pharmaceutical Commerce includes my new editorial: Manufacturers: Get Ready for Global Trade Account Management. Read the article below or on the PC site.

In the article, I argue that manufacturers should plan for the global expansion of US-based pharmacies and wholesalers. (Examples below.) Some channel companies are now asking—or demanding—that manufacturers establish global relationships.

Many manufacturers, however, are not yet organized to respond effectively to these "requests." I offer four suggestions to help manufacturers prepare for this new world.

It's a world of channels and a world of fears. Let me know what you think.

With the Cordis Deal, Cardinal Goes Its Own Way With Med-Surg

Yesterday, Cardinal Health announced its purchase of Johnson & Johnson’s Cordis medical device business. Read the company’s informative fact sheet.

The deal supports Cardinal’s medical supply focus on Physician Preference Items (PPI)—products with limited clinical differentiation but high brand loyalty from doctors. These items drive hospitals bananas, so Cardinal sees an opportunity to help its customers standardize on the lowest-cost cardiovascular, wound management, and orthopedic products.

It’s a sensible transaction that continues Cardinal’s diversification from its core drug distribution business. For its overall business mix, Cardinal is following a different path than AmerisourceBergen and McKesson. Cordis also provides Cardinal with some intriguing international expansion opportunities. See my analysis below.

News Roundup, January 2014: AmerisourceBergen, Walgreens Boots Alliance, Express Scripts, and New 340B Abuses

Winter has arrived at our worldwide headquarters. While you are snowed in, please enjoy this month’s hand-picked artisanal selection of articles from the Drug Channels universe.

• Meet Ornella Barra, the Walgreens Alliance Boots Exec Joining AmerisourceBergen’s Board

• Express Scripts Preannounces its Next Specialty Drug Formulary Battle

• A Nonprofit 340B Hospital Sues Its Poorest Patients: The Unsafety Net?

Plus, The Onion publishes an important anti-vaccination article. It’s your must-forward article of the week!

P.S. Follow @Drug Channels for my daily updates on noteworthy news and analysis.

Watch Stefano Pessina Discuss the New WBA

Last week, executives from the newly-formed Walgreens Boots Alliance (WBA) rang the Opening Bell at the NASDAQ Stock Market. Action shot below.

So, it’s a good time to meet Stefano Pessina, the industry’s new billionaire global overlord. This week, Pessina was making the rounds at the JP Morgan healthcare conference. He's been with Jeff Berkowitz, who is on the short list of possible CEO candidates (I hear). Check out the video below.

For a refresher of how we got here, see Walgreens Loses Its CEO: How Did We Get Here? What’s Next?

For fun and/or jealousy, you can track Mr. Pessina's Real Time Net Worth at Forbes. This morning, it was $11.3 billion.

December 2014 news update: Walgreens, Express Scripts, Diplomat, AmerisourceBergen, and CVS Health

December at last! It’s time for our final news roundup of 2014. To help you with the next four nights of Hanukkah, here are four stories that go behind the headlines and highlight notable individuals atop some well-known drug channels companies.

• Greg Wasson, Walgreen—A behind-the-scenes look at his departure

• Steve Miller, Express Scripts—A humanizing profile of this vocal PBM executive

• Phil Hagerman, Diplomat Pharmacy—A cool first-person perspective on growth and going public

• Peyton Howell, AmerisourceBergen—A worthwhile peek at ABC’s global ambitions

Plus, The Onion reports that CVS is having trouble quitting cigarette sales. It’s your must-read article of the week!