Informa Connect’s Copay, Reimbursement and Access Congress

Informa Connect’s Copay, Reimbursement and Access Congress
Hybrid Event | October 2-4 at the Bellevue Hotel in Philadelphia, PA
www.informaconnect.com/copayreimbursement

Exclusive Offer: Be sure to use your exclusive promo code
USAVE10 to save 10% off* of your registration.

Copay, Reimbursement and Access Congress is back and we have a lot to talk about! With drug pricing legislation growing more complex, ongoing enforcement actions, accumulator and maximizer programs affecting patients and the rise of PBM cost-shifting strategies, there has never been a more important time for industry to unite. A program driven by marketplace insights and led by industry trailblazers, now is the time to join to drive adherence, access and commercialization forward–It's all happening October 2-4.

Exclusive Offer: View the agenda and register today! Be sure to use your exclusive promo code USAVE10 to save 10% off* of your registration.

Why should you attend this pivotal event?

The challenges of keeping up with shifting market dynamics in the midst of maximizing access while also meeting business objectives remains a deep concern and brings about many questions for access professionals.

How are you managing out-of-pocket costs for patients? Do you have clarity on the future of health policy? What is the impact of alternative funding programs on your organization?

In just two-and-a-half days, walk away with answers to these questions and more from experts from across the industry. Do not miss your chance to join seasoned leaders, your peers and leading solution providers as they navigate marketplace trends and dive into the impact coupons, benefit design, accumulators, maximizers, alternative funding programs and drug pricing legislation have on patient affordability and out-of-pocket costs. This is your chance to gain critical insights on industry standards, forward-thinking strategies to optimize your copay and cost sharing programs and so much more.

Can’t miss content highlights:

• Two Conference Workshops
• Copay and Reimbursement Basics
• Advanced Copay and Reimbursement Strategies
• State of the Industry Keynote: Patient Affordability Challenges
• Luminary Address–Reimbursement and Rebate Marketplace Challenges
• Stakeholder Perspectives: Copay and Reimbursement Marketplace Trends
• Enforcement Update: Exploring Regulatory Actions and Trends
• Build Sustainable Copay Programs While Balancing GTN
• Leveraging Data to Understand the Impacts of Copay Adjustment Programs on Historically Marginalized Communities
• Exploring Formulary Challenges
• And more!

HOW COULD IT GET BETTER?

Enhance Your Conference Experience with Optional Add-On Workshop: Understand the Nuances and Impact of Alternative Funding Programs:

Disrupting the industry, join Dawn Holcombe, MBA FACMPE ACHE, President at DGH Consulting as she leads this workshop, exploring the nuances and complexities of alternative funding programs, the evolution of AFPs and future industry impact these programs will have and what you need to know to fortify your cost-sharing program against AFPs. It may be optional, but with an expert like this, you won’t want to miss it.

Walk away with an understanding of these three main themes:

• The Basics of Alternative Funding Programs
• Industry Impact
• How to Prepare

Exclusive Offer: View the agenda and register today! Be sure to use your exclusive promo code USAVE10 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.

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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).

Digital as a Disguise: Beware the Illusion of an Automated Hub Experience

Today’s guest post comes from Rebecca Cotton, Executive Director of Strategy & Product Innovation at Cardinal Health™ Sonexus™ Access and Patient Support

Rebecca discusses the essential features biopharmaceutical manufacturers should seek in a digital hub that will help patients get their therapies faster. She argues that the most effective hub balances automation with the still-relevant value of human interactions.

Download the Cardinal Health™ Sonexus™ Access and Patient Support case study for more details about how ePA technology can accelerate time to therapy for patients. .

Read on for Rebecca’s insights.

What I (and Others) Told the Senate about the 340B Drug Pricing Program

Recently, a bipartisan group of six U.S. senators issued a request for information (RFI) for “input on bipartisan policy solutions that would provide stability and appropriate transparency to ensure the 340B program can continue to achieve its original intent of supporting entities serving eligible patients.” Click here to read the full letter.

I submitted a 14-page letter, which you can read below. I shared my $0.02 on the overall market, explained channel distortions from 340B contract pharmacies, and offered some policy recommendations. How could I not?

Click here to read the Drug Channels Institute letter to
Senators Thune, Stabenow, Moore Capito, Baldwin, Moran, and Cardin.

Below, I include links to publicly available comments from a diverse range of stakeholders, including 340B Health, the American Hospital Association, Biotechnology Innovation Organization, Community Oncology Alliance, National Association of Community Health Centers, and Pharmaceutical Research and Manufacturers of America. Enjoy!

Delivering a Modern Patient Access Experience

Today’s guest post comes from Jonas Boli, Chief Product Officer at Phil, Inc.

Jonas describes the challenges patients face when accessing specialty therapies and explains how patient abandonment affects manufacturers over time. He argues that an effective telemedicine program can help patients via an end-to-end digital experience.

To learn more, register for Phil’s free webinar on August 29th at 2 p.m. ET: Your Guide to Building an Exceptional Telemedicine Program.

Read on for Jonas’ insights.

The Economics of Copay Accumulators, Maximizers, and Alternative Funding Programs (Video)

In my most recent video webinar, I explored how plans and PBMs are turning to novel—and highly controversial—benefit design tools that access manufacturers’ patient support spending: copay accumulators, maximizers, and alternative funding programs.

In the video excerpt below, I describe these new approaches that plans offset specialty drug expenses. I then follow the dollar to show how they impact plan, patient, and manufacturer costs when compared with traditional approaches to copay support.

During the full 90-minute webinar, I discussed seven crucial risks that could disrupt this market along with many other aspects of this emerging market. If this clip whets your appetite for more, you can purchase the 90-minute webinar replay and full slide deck here: PBMs and the Battle Over Patient Support Funds: Accumulators, Maximizers, and Alternative Funding.

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

Two recent Drug Channels article on these topics:

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

• Employers Expand Use of Alternative Funding Programs—But Sustainability in Doubt as Loopholes Close

Errata: The formulary rebate in the mathematical example that begins at 4:40 should be shown as 16.7%, not 20%. We apologize for the error.

Drug Channels News Roundup, July 2023: GoodRx + CVS Caremark, Accumulators vs. Patients, Hospitals vs. Taxes, and UnitedHealthcare Prior Auth Humor

Let’s cut through the steamy summer haze with Drug Channels’ refreshing breeze of questions for you to ponder while on your favorite pink beach:

• Why does the biggest PBM need a discount card partner?

• How do copay accumulators affect prescription adherence?

• Do nonprofit hospitals deserve their tax exemption?

Plus, Dr. Glaucomflecken asks: What would happen if UnitedHealthcare hired physicians who practiced evidence-based medicine?

P.S. Join my more than 43,000 LinkedIn followers for daily links to neat stuff. You can also find my daily posts at @DrugChannels on Twitter, where I have more than 16,600 followers. (I recommend that you follow me on LinkedIn, because the quality of comments and engagement is much higher than they are on Twitter. I’m not posting to Threads yet.)

How Prior Auth Solutions Can Empower Patients, Providers and Pharma Field Teams

Today’s guest post comes from Brent Clifton, Vice President of Product Management at CoverMyMeds.

Brent discusses the challenges that patients, caregivers, and providers face when seeking access to medications requiring prior authorization. He explains how an electronic prior authorization solution can reduce delays and help patients start their therapies sooner—especially when patients and brands can play an active role in the process.

Click here to learn about CoverMyMeds’ electronic prior authorization solutions.

Read on for Brent’s insights.

Four Crucial Questions about the Humira Biosimilar Price War

The Humira biosimilar market has arrived!

This month, nine biosimilar versions of adalimumab launched in the U.S. market. As I predicted in 2021, some products launched with list prices that are only slightly lower than Humira’s list price, while others are trying to tempt payers and pharmacy benefit managers (PBMs) with deep list price discounts.

Surprisingly, two PBMs—Express Scripts and OptumRx—will each offer at least one low-list-price biosimilar option on their main national formularies.

Below, I help you understand the current and future market dynamics by posing four questions about drug pricing, rebate walls, patient behavior, the gross-to-net bubble, pharmacy/wholesaler economics, and more.

No biosimilar has the trifecta of being high-concentration, citrate-free, and fully interchangeable. These shortcomings, combined with physician hesitancy, will limit the ability of price to drive adoption. But as I see it, the Humira price war signals that rebate walls will crumble and the gross-to-net bubble will pop. Will payers let Humira go?

Informa Connect’s Medicaid Drug Rebate Program Summit (MDRP)

Informa Connect’s Medicaid Drug Rebate Program Summit (MDRP)
September 18-20, 2023 in Chicago, IL
www.informaconnect.com/MDRP

Drug Channels readers save 10% with code 23DRCH10*

Join Informa Connect and the life science industry on September 18-20, 2023 in Chicago, IL at the 2023 Medicaid Drug Rebate Program Summitto master complex MDRP regulatory guidelines to deliver compliant government pricing and reporting programs.

View the agenda for the 2023 MDRP Summit to see the complete picture – the program, speakers, and more, and visit for further details and to register. Drug Channels readers will save 10% off when they use code 23DRCH10 and register prior to August 11, 2023.*

This annual event provides you and your team unparalleled access to the government regulators creating the rules, policies and regulations, the industry leaders tasked with interpreting them and the manufacturer experts who will be implementing them.

Hear from more than 90 leading experts representing the Acadia Pharma, Ascendis, AstraZeneca, Bristol Myers Squibb, CSL Behring, Eisai, FTC, Genentech, Genmab, Gilead Sciences, GlaxoSmithKline, Helsinn Therapeutics, Kyowa Kirin, Lundbeck, Lupin Pharma, Novartis, OIG, Optum, Pfizer, PhRMA, Sandoz, Takeda, United Therapeutics, Vaitris and many more.

Sessions include coverage on multiple hot topics, including:

• CMS Stacking Rule
• Everything IRA and 304B
• FSS and Government Contracting
• GTN Best Practices
• State Drug Price Transparency and Reporting
• Value Based Agreements
• Bundling, Acquisitions and Divestitures
• AMP Cap Removal
• Rebates, Disputes and GP Calculations
• OIG Perspective on Prescription Drug Pricing and Payment
• And so much more!

View the agenda for the 2023 MDRP Summit to see the complete picture – the program, speakers, and more, and visit for further details and to register. Drug Channels readers will save 10% off when they use code 23DRCH10 and register prior to August 11, 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.

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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).

New SingleCare Pharma Solutions Help Drugmakers Reach Cash-Paying Patients

Today’s guest post comes from Josh Bliss, SVP of Customer Acquisition and Head of Pharma Solutions at SingleCare

Josh discusses the challenges that pharmaceutical manufacturers face connecting with consumers who could benefit from patient financial support programs. He describes SingleCare's new Pharma Solutions, which offers manufacturers the opportunity to market their copay assistance programs directly to SingleCare's millions of monthly prescription discount users.

To learn more about SingleCare's Pharma Solutions, please visit www.singlecare.com/pharmasolutions.

Read on for Josh’s insights.

EXCLUSIVE: For 2023, Five For-Profit Retailers and PBMs Dominate an Evolving 340B Contract Pharmacy Market

Looks like pharmacy and PBM profiteering within the 340B Drug Pricing Program will never go out of style.

Drug Channels Institute’s (DCI) latest analysis reveals that more than 33,000 pharmacy locations—more than half of the entire U.S. pharmacy industry—act as contract pharmacies for the hospitals and other healthcare providers that participate in the 340B program. Over the past 12 months, the number of pharmacies in the program has grown by more than 1,000 locations, which was the slowest growth rate since DCI started tracking this figure more than 10 years ago.

Consistent with our previous research, five multi-billion-dollar, for-profit, publicly traded pharmacy chains and PBMs—CVS Health, Walgreens, Cigna (via Express Scripts), UnitedHealth Group (via OptumRx), and Walmart—account for 75% of all 340B contract pharmacy relationships with covered entities. These contract pharmacy operators’ total estimated gross profits from the 340B program were nearly $3 billion in 2023.

Manufacturers’ contract pharmacy policy changes have slowed profits at pharmacies and PBMs, while triggering change in hospitals’ pharmacy strategies. Read on for my latest effort to pierce these little webs of 340B opacity.

Optimizing Access: Balancing Speed-to-Therapy and Gross-to-Net

Today’s guest post comes from Sahil Naik, Chief of Staff to the CEO at Phil, Inc.

Sahil discusses how manufacturers can balance patients’ access to therapy with gross-to-net (GTN) goals. Visit https://phil.us/ to learn more about how Phil helps improve the patient experience while managing GTN.

Read on for Sahil’s insights.