Quantifying Generic Buying Power for ABC-Walgreens-Alliance Boots

Tom Gallucci and his team at Lazard Capital Markets (LCM) have estimated “oral solid generic purchasing power” for the biggest U.S. drug buyers. Unsurprisingly, the new ABC-Walgreens-Alliance Boots combination tops the list. See the full list below. (Sorry, I can’t share the full report).

Key questions: Can the mega-combination truly achieve mega-savings? And if so, how much of those synergies will be shared with downstream customers?

A few years ago, Express Scripts, Kroger, and Supervalu formed Econdisc Contracting Solutions, a group purchasing organization for generics. Expect more cross-company buying deals as drug channels participants position for our generic future.

Drug Channels News Roundup: March 2013

Despite the cold weather, spring has finally arrived! Let’s get ready for outside fun by staying inside and reading this bespoke selection of noteworthy Drug Channels news stories.

In this issue:

• More on WAG/ABC—Other viewpoints on the supply chain impact
• Which Way for Specialty? A valuable interview on buy-and-bill vs. white bagging
• Generic Shenanigans—How consumers see the retail pharmacy’s price war
• How Much Do You Weigh? CVS asks some personal questions

Plus, The Onion provides the patient’s perspective on weight management programs.

15th Annual Medicaid and Government Pricing Congress

Drug Channels is pleased to welcome CBI’s 15th Annual Medicaid and Government Pricing Congress as a new sponsor. This mega-event is being held at the Hilton Orlando Lake Buena Vista, Florida on May 14-16, 2013.

If you are involved with Medicaid or government pricing, this looks like a must-attend event. There are 50+ industry experts and 30+ sessions at this year’s conference. Check out the agenda, which features a diverse line-up of speakers from throughout the pharma industry.

You'll also hear from such government agencies as Congressional Budget Office, Department of Health & Human Services, Office of Inspector General, Office of Pharmacy Affairs, Office of the Attorney General (California), Office of the Attorney General (Texas), Oklahoma Health Care Authority, State of Florida Medicaid, Sunovian Pharmaceuticals, U.S. Department of Justice, and U.S. Public Health Service (PHS).

CBI is offering a special discount to Drug Channels readers. Register with promo code MDGPDC by Friday, March 29 and save $400 off of the standard rate. Thanks, CBI!

My FOX Business Interview about ABC-Walgreens-Alliance Boots

Yesterday afternoon, I was interviewed live on FOX Business about the AmerisourceBergen / Walgreens / Alliance Boots deal. The video is embedded below.

I was at the Philadelphia Fox affiliate, while Melissa Francis was in New York. This was my first live TV interview, which was fun and a bit scary. The actual interview was five minutes long, but it felt like 30 seconds.

My 16-year old daughter tagged along. When you see me randomly smile at 2:37, it's because she was standing behind the camera, reminding me to smile! (She's a sweetie.) Plus, she got to think her dad was (a tiny bit) cool.

Enjoy!

Making Sense of ABC-Walgreens-Alliance Boots

Before the dust settles on the AmerisourceBergen / Walgreens / Alliance Boots news, let’s take a deeper look at the implications for drug channels. The Wall Street Journal’s Tim Martin and Jon Kamp did a very nice job of summarizing the basics in Deal Transforms Global Pill Pipeline.

In this longer-than-usual Drug Channels article, I probe:

• How does Walgreen benefit?
• What does ABC get?
• What does this mean for drug procurement?
• What should Cardinal do?
• How will the companies balance competing priorities?
• Will this become one mega-company?

Please add your own questions (and any answers!) in the comments below.

NOTE: I don’t address here how brand-name manufacturers should respond. If you are a brand-name manufacturer, email me to learn more.

BREAKING NEWS: Walgreens and ABC Sign a Big Deal

3/21/13 UPDATE: For more detailed analysis, please see Making Sense of ABC-Walgreens-Alliance Boots

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Remember all of those rumors and noise about Walgreens bypassing wholesalers and buying directly?

Never mind.

This morning, Walgreens (NYSE: WAG) announced a surprise 10-year supply deal with AmerisourceBergen (NYSE: ABC).

And in a move that should make everyone nervous: “Walgreens and Alliance Boots together have been granted rights to purchase an equity position in AmerisourceBergen.”

Highlights below. I’ll follow-up later this week as details become known.

Channel consolidation, thy name is Walgreens!

Predictive Acquisition Cost and MAC Optimization

Here's an update on Predictive Acquisition Cost (PAC), the drug pricing measure developed by Glass Box Analytics and distributed by Elsevier/Gold Standard. Elsevier/Gold Standard is a Drug Channels sponsor.

Elsevier/Gold Standard has just released a new PAC Proof of Concept Analysis for Payers and PBMs. It shows how PAC can be used to adjust the maximum allowable cost (MAC) paid to pharmacies. Elsevier is offering payers the opportunity to have their MAC list evaluated against PAC. See below for more details.

For background PAC vs. other drug pricing metrics, download Elsevier's white paper: Drug Price Types and Options For A Future Standard. (Free with registration.)

What Free Generic Lipitor Says about Pharmacy's Future

Supermarket chain Wegmans just extended its discount program for atorvastatin, the generic version of Lipitor. Through the end of 2013, the total prescription price is … nothing. Yes, you read that right: $0.00. Click here to read the story from the Philadelphia Inquirer.

As I document below, a pharmacy's profits on a generic Lipitor prescription are still double the brand-name prescription's profits. At this stage in the generic life cycle, few other pharmacies are foolhardy (or desperate) enough to give up these superior generic profits. Wegmans' willingness to race to the bottom illustrates the inexorable downward economics facing retail pharmacy in coming years.

What’s the implied value of pharmacy counseling when the prescription is free? Hint: You don’t need to compute the circumference over the diameter to figure out the answer.

A Surprising Twist in the Walgreens-Cardinal Contract Renewal (maybe)

Here’s some unexpected news: Walgreens (NYSE: WAG) has apparently shifted controlled substances distribution from its own Perrysburg, OH, distribution center to Cardinal Health (NYSE: CAH). This morning, the always-insightful Tom Gallucci at Lazard Capital Markets broke the story publicly in a research note. UPDATE: Read the official comment from Walgreen in the comments below.

Regardless of Walgreen’s stated distribution strategy goals, shifting responsibility for controversial product shipments sure makes it looks like wholesalers still provide value in the channel.

Read on for more details and possible implications for the Walgreens-Cardinal contract renewal.

Oncology USA 2013: 4th Annual Oncology Market Access & Marketing Summit 2013

Drug Channels is pleased to welcome a new sponsor: eyeforpharma’s 4th Annual Oncology Market Access & Marketing Summit 2013 (Oncology USA 2013). The event is being held at the Hyatt Harborside in Boston, MA, on May 8 and 9, 2013.

The agenda looks very strong. Speakers come from such companies as Aetna, Amgen, Bayer, Bristol-Myers Squibb, Cardinal Health, D3 Oncology Solutions, DARA Bioscience, Eli Lilly, Foundation Medicine, Genentech, International Oncology Network Solutions, NCCN, New Century Health, Novartis-Genoptix, Oncology Business Review, Onyx Pharmaceuticals, Janssen, Sanofi Oncology, Sanofi US, Seattle Genetics, and more.

Check out the official description below or visit the Oncology USA 2013 site for complete details.

Drugstore Sales Drop Along with Drug Trend: Implications for Retail Pharmacy

In yesterday’s Insights from the 2012 Express Scripts Drug Trend Report, I highlight the fact that 2012 spending on traditional drugs dropped for the first time on record.

Last year marked a similar milestone for retail drugstores. For the first time, revenues at U.S pharmacies and drugstores declined on a year-over-year basis. See the chart below.

Given the superior profitability of new generics, retail pharmacies’ top-line pain is being offset with bottom-line joy. But when generic launches slow down in 2016, the pharmacy industry's traditional dispensing profits will be hit hard. Drugstores must either embrace the low-cost generic revolution or figure out how to penetrate the specialty market. Otherwise, they'll find it hard to climb out of the rabbit hole.

Insights from the 2012 Express Scripts Drug Trend Report

Express Scripts just released the latest iteration of its long-running Drug Trend Report. Instead of a convenient downloadable report, the report is now a confusing “interactive” web page. (3/20/13 UPDATE: Click here to download the full report.) You can also read the press release.

This year’s report includes both Express Scripts and legacy-Medco covered lives, so it’s the most comprehensive look at pricing and utilization. Once again, specialty drug trend of 18.4% dominated traditional drug trend of -1.5%.

Yes, you read that right. Spending on traditional drugs declined, for the first time ever. Below, I look at the factors behind these figures and provide some historical context.

Tune in tomorrow, when I look at these trends’ impact on the pharmacy industry.

Sequestration Mania Hits Physician-Administered Drugs

So, the federal government’s mandated spending cut took effect. The world didn’t end, consistent with the Wall Street Journal’s prescient February 6 editorial titled The Unscary Sequester.

Physician-administered drugs under in Medicare Part B will get a 1.6% payment cut, because of a reduction in the reimbursement rate from ASP+6% to ASP+4.3%. (Check the math. It’s a cut from 106% to 104.3% of ASP.)

While I view the sequester as incredibly poor public policy, let’s keep some perspective. As I explain below, total drug revenue per full-time equivalent hematology/oncology physician will drop by less than $27,000.

Even President Obama is busy walking back his administration’s comments of complete disaster. KCCO.

Alternative Pharma Distribution Strategies

I am pleased to welcome CBI’s Alternative Pharma Distribution Strategies conference as a Drug Channels sponsor. The event is being held at the Sonesta Hotel in Philadelphia, PA on May 22 and 23, 2013. Speakers come from such companies as Acorda Therapeutics, Pharmaceutical Commerce, Santarus, Sonexus Health, Therapeutics MD, Vertex Pharmaceuticals, and more.

Register by March 22nd and save $300.