Drug Channels News Roundup, September 2014: WAG, Generics, NADAC, and Alliance Boots

Autumn has arrived! Time to gather your acorns, make fantasy football trades, and read my thoughts on these Drug Channels stories:

• Walgreens wants to sell its infusion business?!?

• New evidence that generic drug inflation is creating multiple generic tiers

• Texas Medicaid will base pharmacy reimbursement on acquisition costs

• Alliance Boots’ Stefano Pessina is not a fan of tobacco in pharmacies

Plus, the American Medical Association announces an innovative new cost-saving program: placebo doctors!

Government Pricing and Reporting Compliance

Government Pricing and Reporting Compliance
December 8-9, 2014
Philadelphia, PA
www.cbinet.com/GPCompliance

As bio/pharmaceutical manufacturers struggle with a rapidly evolving healthcare landscape and heavy government scrutiny on price reporting, the Government Pricing and Reporting Compliance Summit provides the first opportunity to assess the impact of the Final AMP Rule on operations and pricing methodologies. Key stakeholders come together to discuss strategies and best practices to comply with the increasing demands of government price reporting, while mitigating compliance risk.

Reasons to attend:

• Understand the role and importance of the NCPDP and the billing unit standard
• Assess AMP Rule changes and the impact on past, present, and future calculations
• Hear about current OIG oversight involving prescription drug enforcement
• Learn about strategies and procedures you can implement to mitigate risk and ensure contract compliance
• Ensure readiness and compatibility of current GP systems in light of DDR enhancements

Speakers come from such organizations as Arnold & Porter,Bristol-Myers Squibb, Celgene, Chiesi USA, Genentech, IMS Health, Jazz Pharmaceuticals, King & Spalding, OIG’s Office of Evaluation and Inspections, Pfizer, Ranbaxy, Skadden, Arps, Slate, Meagher & Flom, Taft Stettinius & Hollister, and West-Ward Pharmaceuticals.

Plus, extend your stay and benefit from the VA * DoD * PHS * Federal Pricing and Contracts conference. For special group rates, contact Christian.Alongi@cbinet.com.

Drug Channels readers who register before October 31st will save $400 off of the standard registration rate when they use code GTY563.*

Register today!

*Cannot be combined with other offers or used towards a current registration or applied to special category rates. Other restrictions may apply.

Buy-and-Bill’s Still Alive: The Surprising Uptick in Part B Spending

The Medicare Payment Advisory Commission (MedPAC), an independent agency that advises Congress on the Medicare program, recently released Health Care Spending and the Medicare Program, its latest, 200+ page wonktastic data dump. Chapter 10 focuses on prescription drugs.

The latest MedPAC Part B spending data show a surprising increase in Medicare buy-and-bill spending for provider-administered drugs. (See chart below.) After a post-2005 slowdown, spending growth accelerated from 2009 through 2012.

Do these data of prove buy-and-bill’s resilience, or are they a pre-sequestration fluke driven by new therapies and a growing Medicare population? My speculations are below. If you feel brave, make a yummy sound with a comment of your own.

NEW: 2014-15 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors

I am pleased to announce the availability of our latest report: The 2014–15 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. We’re offering special discounts if you order before October 10, 2014.

This completely updated, revised, and expanded report gives you the most comprehensive overview and analysis of the latest financial and industry data. You can see the breadth and depth of content by downloading the Free Overview of the Report. (Fair warning: the report has no jokes and zero pop culture references.)

The 2014-15 edition’s significant new content includes:

• New analysis of generic purchasing organizations
• New content on global drug distribution markets
• New assessments of wholesalers’ opportunities and risks from specialty drugs, including the prospects for biosimilars
• New market share estimates for the specialty distribution segment
• Expanded analysis of wholesaler margins
• Comparison of full-line vs. specialty distribution service agreements
• New analysis of wholesalers’ changing relationships with their large customers
• Updated company analysis of the Big Three public wholesalers: AmerisourceBergen, McKesson, and Cardinal Health
• Updated analysis of underlying business profitability, based upon our proprietary economic models
• And much more!

If you like Drug Channels, then you'll love this report. You'll also enjoy 83 data-packed charts and more than 200 endnotes, most of which have hyperlinks to original source materials. I included many more internal hyperlinks, making it easy for you to navigate and customize the material.

Click here to download the report today. If you have any questions (before or after reading the report), please email me. Enjoy!

Real-World Data/Late Phase Summit

Real-World Data/Late Phase Summit
November 5-6 | Philadelphia, PA
www.cbinet.com/RWD

Real-World Data/Late Phase Summit – A forum for navigating the latest updates and challenges with real-world data utilization, reimbursement, product value, market access late phase study design and much more – is being held November 5-6 in Philadelphia. Join CBI to convene with peers and discover practical business strategies for real-world data utilization to advance late stage research.

The program features five case studies, an extended payer Q&A, and a diverse group of 18+ industry experts representing Aetna, Astellas, AstraZeneca, Biogen Idec, Bristol Myers Squibb, Johnson & Johnson, Medivation, NICE, Quintiles, Sanofi U.S. and more, will discuss tried and true solutions to the most significant challenges affecting industry today:

• Evaluate the role of medical affairs, clinical development and HEOR in the post-approval process and examine how and when phase 4 studies should be conducted
• Review the current climate of converging payer and regulator real-world evidence needs and some associated key challenges
• Examine what acceptable standards are for real-world data through examining what is required from a payer point-of-view
• Develop better treatment pathways and optimize patient outcomes in comparative effectiveness research
• And much, much more!

As a valued reader of Drug Channels, CBI is offering an exclusive $300 discount when you register by Friday, October 3. (Be sure to mention promo code DCN275).

*Offer valid through October 3, 2014, applies to standard rates only and may not be combined with other offers, category rates, promotions or applied to a current registration.

Walgreens and Alliance Boots Explain Their AmerisourceBergen Relationship

This week, Walgreens and Alliance Boots filed a “Registration Statement on Form S-4” that describes how the companies will transform into Walgreens Boots Alliance, Inc., a new Delaware corporation. (Link below.) The hefty 471-page filing, which will be the basis for a shareholder vote, has loads of interesting details on how the combined business will look.

Below, I highlight a few nuggets about the companies’ relationship with AmerisourceBergen, including equity ownership, Walgreens' distribution agreement, and the WBAD generic sourcing arrangement. This info had been previously disclosed, but only as part of a dense legal document. The S-4 summarizes the important points into a (somewhat) less cryptic format.

Read on for highlights. I’ll have more details on changing relationships between wholesalers and retail chains in our new 2014-15 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors, available next week.

How Employers Are Managing Pharmacy Benefits in 2014

The just-released Kaiser/HRET 2014 Employer Health Benefits Survey (free download) delves into employer-sponsored health coverage at more than 2,000 companies.

Today, I profile the pharmacy benefit highlights from this excellent survey. The charts below summarize (1) cost-sharing tier structures, (2), average copayments, by formulary tier, and (3) type of cost-sharing (coinsurance and copayment).

Bottom line: employers didn't make many major changes in the past year. Fourth-tier plans with substantial co-insurance remain a significant part of the market.

As a bonus, I also include a video with an intriguing forecast for the future of benefit tiers.

Elsevier Healthcare & Pharmaceutical Economics Conference- 2014

Elsevier Healthcare & Pharmaceutical Economics Conference- 2014
October 29-30, 2014 / Clearwater Beach, Florida

Join Elsevier as they bring together industry experts to share insight on issues and trends in the ever-evolving healthcare and pharmaceutical marketplace. Discover the new direction for healthcare and the obstacles and opportunities created for health plans, retail pharmacy chains and convenient care clinics, drug manufacturers, wholesalers and PBMs, and healthcare technology companies. Explore regulatory and compliance issues, cost savings measures, consumer-driven healthcare initiatives, alternative healthcare delivery models, and the impact these all have on the drug supply chain.

Featured sessions include:

• Healthcare Regulation: Current Status and What’s Next in State & Federal Legislation, Adam Huftalen, Government Affairs, Reed Elsevier

• Specialty Pharmacy and Reimbursement for Drugs under ACA and Outcome-Based Payments, Dean Erhardt, D2 Pharma Consulting

• Alternative Healthcare Delivery and the Rise of Convenient Care Clinics, Tine Hansen-Turton, Executive Director, Convenient Care Association

• The Next Big Thing: Genomics and Personalized Medicine, Scott Megill, President, Coriell Life Sciences

• Current and Future Trends in Pharmaceuticals and Drug Supply Chain, Doug Long, IMS

• The Empowered Patient: A New Paradigm for Healthcare and Pharmaceutical Marketing, Dorothy Wetzel, extrovetic

• Taking the Mystery Out of Maximum Allowable Cost: Addressing the Transparency Trend, Anu Pathria and Todd Grover, Glassbox Analytics

• Going Mobile: How Far and How Fast Will Healthcare Technology Go?, David Lee Scher,MD,FACC,FHRS, Penn State University College of Medicine and Digital Health Consultants

• Coming Soon? Update on the Promise of Biosimilars, Ruey Tu, Abbott Laboratories

Plus: panel discussions with industry leaders about the big issues, updates on product innovations, and a sunset dinner reception overlooking the beautiful Gulf of Mexico.

Space is limited. Don’t forget to save the date!

Inside Express Scripts’ Narrow Network Strategy—and How It Beat Walgreens

Last month, AIS Health held a fascinating webinar: Health Plan/Employer Strategies for Implementing Narrow Pharmacy Networks. (A CD and on-demand recording are available for purchase.)

The webinar featured a Milliman consultant, a Medicaid managed care health plan director, and the director of Network Solutions at Express Scripts, Andy Becker.

Becker explained Express Scripts' pharmacy network strategy, noting that 15% to 20% of the PBM’s claim volume now goes through a narrow network. He also revealed some previously-undisclosed insights into how Express Scripts outfoxed Walgreens during their 2012 imbroglio.

I highly recommend this webinar to anyone interested in the PBM/pharmacy/patient dynamics behind narrow networks. Excerpts below.

CMS Forecast: Big Drug Spending Growth, But Hospitals and Doctors Will Still Capture Most Healthcare Spending

Last week, the Centers for Medicare & Medicaid Services (CMS) released its latest forecasts for national health expenditures. The forecast is summarized in a new Health Affairs article: National Health Expenditure Projections, 2013−23: Faster Growth Expected With Expanded Coverage And Improving Economy (free download).

I crunch the prescription drug forecasts below. In 2013, prescription drug spending growth was again slower than the growth in total U.S. spending. Growth will accelerate as insurance coverage expands, the generic wave ends, and newer specialty drugs launch. By 2023, the U.S. will spend nearly $500 billion on drugs.

Despite this impressive growth, outpatient prescription drugs will account for less than one of every 10 U.S. healthcare dollars. Hospitals and physicians will remain at almost 60% of U.S. healthcare spending—or about six times as much as spending on pharmaceuticals.

NORD’s Rare Diseases and Orphan Products Breakthrough Summit

NORD’s Rare Diseases and Orphan Products Breakthrough Summit
October 21-22, 2014 | Alexandria, VA
Brought to you by NORD; Powered by CBI
www.cbinet.com/NORD

NORD’s Rare Diseases and Orphan Products Breakthrough Summit is the largest and most meaningful multistakeholder event of its kind – Featuring over 20 speakers from the FDA, over 80 patient organizations and the Pharma/Biotech industry’s foremost experts in orphan product innovation, investment and commercialization. The 2014 Breakthrough Summit is concentrated with innovative content and convenes the top leaders from the FDA, NIH, Industry, Patient Groups, Payers and Research Institutions to address the progress of rare disease diagnosis, genomics, drug development, patient engagement, product approvals, FDA oversight and market accessibility to orphan products.

Tracking for an unprecedented turnout, with hundreds of executives already registered to attend, the NORD 2014 Breakthrough Summit is crafted with multiple workshops and focused tracks of content to ensure high quality learning, networking and accessibility to thought leaders in the rare disease community.

• Network, learn and benchmark from hundreds of industry counterparts, patient advocacy stakeholders, investors and FDA leadership to better align their thinking on complex issues

• Gain insight into the strategic models for commercializing an orphan product

• Learn strategies to stay ahead of the curve on the newest R&D advancements in rare diagnostics and treatment regimens

Drug Channels readers will save $200 off of the standard registration rate when they use code XRZ293.* Register today!

*Cannot be combined with other offers or used towards a current registration. Discount valid towards final, standard rate. Other restrictions may apply.

2013’s Fastest-Growing, Private Specialty Pharmacies

Time for our annual review of the Inc. 5000 list, Inc. magazine’s ranking of the fastest-growing private U.S. companies. Once again, the Inc. 5000 list highlights the boom in specialty drug dispensing.

The 2014 list, which is based upon revenue growth through 2013, includes 13 specialty pharmacies. The pharmacies and key stats are listed below. Total revenues for the group were $3.1 billion. Diplomat, with $1.5 billion in revenues, accounted for half of the total.

If you want to buy a specialty pharmacy, here’s your shopping list!

Specialty Brand Building and Sales Strategy

Specialty Brand Building and Sales Strategy
October 27-28, 2014 | Philadelphia, PA
www.cbinet.com/specialtybrand

CBI’s Specialty Brand Building and Sales Strategy conference is designed to help you optimize sales and marketing strategies to advance patient engagement and increase market share. Specialty products present a unique set of challenges compared to traditional pharmaceutical products and services. Coupled with increased scrutiny on product value as a result of the ACA, specialty drug manufacturers must develop go-to-market strategies unique to each product.

This conference provides manufacturers with comprehensive strategies to optimize sales and marketing tactics to grow specialty brands and ensure patient adherence. Speakers come from such organizations as Allergan, Avella Specialty Pharmacy, Boehringer Ingelheim, Merck, Novartis, and Occam Health Services.

Drug Channels subscribers will save $400 off of the standard registration rate when they use code FBH478.* Register today!

*Cannot be combined with other offers or used towards a current registration. Other restrictions may apply.