The Walgreens-Rite Aid Deal: Ten Things You Should Know

Wow. Walgreens Boots Alliance is acquiring Rite Aid. As I told The New York Times: “The pharmacy consolidation endgame has begun.”

Read on for my analysis of the deal and what it means.

Feel free to add your own thoughts in the comments below. (Yes, you can comment anonymously.)

Valeant, Philidor RX, and the Uninformed Attack on Specialty Pharmacy

Yesterday, Valeant Pharmaceuticals finally explained its complex interactions with Philidor RX Services, a so-called “specialty pharmacy” that has a previously-undisclosed financial relationship with Valeant. Click here to see the full 89-slide webcast deck. Valeant has been labeled the “Enron of the pharmaceutical industry,” although I don’t know if any of the alleged shenanigans are true.

Unfortunately, the controversy has tarred the entire specialty pharmacy industry along with manufacturers’ legitimate specialty pharmacy relationships. Below, I explain why Philidor RX is not a specialty pharmacy. I also suggest what the Valeant-Philidor relationship could mean for payer surveillance of manufacturers’ copay offset programs.

I believe (hope?) that over time, everyone will recognize the differences between a true specialty pharmacy and a company such as Philidor. Meanwhile, expect greater scrutiny of manufacturers’ specialty channel strategies. Smaller independent specialty pharmacies should also expect greater oversight, as manufacturers and payers work to validate the business operations of their trading partners.

eyeforpharma Customer Engagement USA Summit 2015

eyeforpharma Customer Engagement USA Summit 2015
November 19-20, 2015 | Philadelphia, PA
www.eyeforpharma.com/customer-engagement/

At eyeforpharma’s 3rd annual Customer Engagement Summit, attendees will learn how to engage their key customers through a wide range of channels - from digital to F2F. The speaker faculty selected from both inside and outside the industry will focus on truly intelligent engagement strategies that start with the customer and end with the channel.

Drug Channels readers will save $300 off the standard registration rate when they register with discount code 2772DC300.

Speakers include:

• Jim De Lash, Director Multi-Channel Marketing Execution, GlaxoSmithKline
• Tom Wagner, Leader, Global Digital Governance, AstraZeneca
• Jorge Herrera, LatAm Head of Digital, Pfizer
• Sandra Velez, Content Strategy Leader, Customer Engagement COE, Merck
• John Kane, Director of Commercial Training & Leadership Development, Eisai
• Laurent Flouret, Director Digital Launch Readiness, Sanofi
• Andrew Schwartz, Director NA IT Strategy & Ops, Ipsen
• Greg Cohen, Global Associate Director, Multichannel Marketing, UCB
• Rachel Sosalski, Director, Pharmacy Marketing, GlaxoSmithKline

Download the brochure now to find out who else is on the agenda.

Use discount code 2772DC300 to save $300. Register today!

The Customer Engagement USA 2015 Summit is designed for those who:

• Want to develop global capabilities and have the vision of creating streamlined marketing processes as well as channel integration
• Appreciate marketing innovation and understand or desire to understand how data can help achieve multichannel marketing efficiency
• Believe we can do better at understanding and engaging with our customers to provide the information they need
• Are inspired to think outside the box, work across job functions and look to achieve beyond just ROI

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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.

Three Ways The C-Suite Can Prepare for the Cadillac Tax

Today’s guest post comes from Leon Greene, Cofounder and Executive Vice President at Truveris. Leon discusses “the Cadillac tax,” a federal tax employers will pay on higher priced employee health benefit plans. The tax is scheduled to go into effect in 2018.

Leon offers three concrete actions that could lessen the effect of the Cadillac tax:

• Use available technologies to research your vendors’ economics
• Offer your employees digital tools such as OneRx to help them identify the potential cost savings of coupons or paying cash for their prescriptions
• Educate your employees on their health insurance options and promote wellness programs to workers

Read on and see if you agree.

How Wholesalers Profit from Brand-Name Drug Inflation (But Perhaps Not As Much As You Think)

Since pharmaceutical pricing is in the news, let’s take a look at how pharmaceutical wholesalers benefit from inflation in brand-name drugs.

Growing drug prices are boosting wholesalers’ top-line revenues. We estimate that in the twelve months ending June 30, 2015, U.S. drug distribution revenues at the Big Three public wholesalers—AmerisourceBergen, Cardinal Health, and McKesson—reached a record $353 billion.

And as I explain in the excerpt below from our new 2015-16 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors, wholesalers also generate substantial gross profits as prices increase. Their agreements with manufacturer and negotiations with customers, however, reduce wholesalers’ ability to retain the full benefit.

P.S. Friendly reminder: Special discount pricing on our new report ends this Saturday!

How Pharmacy Benefit Deductibles Stimulate Manufacturer Copay Program Spending

With little fanfare, the IMS Institute has just snuck out an interesting report: Emergence and Impact of Pharmacy Deductibles: Implications for Patients in Commercial Health Plans. (free download) The report’s overarching theme is unsurprising: Higher out-of-pocket costs reduce patients’ adherence to drug therapy and increase prescription abandonment rates.

The report’s major contribution, however, links the growth in pharmacy deductibles to manufacturers’ copayment offset programs, which cover a beneficiary’s out-of-pocket costs for a brand-name drug. High deductible plans are shifting costs from payers to consumers and—in many cases—back to manufacturers.

And as the charts below show, pharmaceutical manufacturers end up (perhaps inadvertently) paying full-price for an increasing number of prescriptions for their own products. Ouch.

Read on and then consider whether these results affect your company’s strategy.

Real World Evidence & Market Access Summit 2015

eyeforpharma Real World Evidence & Market Access Summit 2015
December 3-4, 2015 | Philadelphia, PA
www.eyeforpharma.com/rwe/

The 4th annual eyeforpharma Real World Evidence & Market Access Summit 2015 is the meeting place 250+ industry leaders in data, HEOR and market access come together to finalize the 2016 evidence strategy.

Drug Channels readers will save $300 off the standard registration rate when they register with discount code 4318DC300.

Latest additions include:

• Geisinger Health System on specialty analytics: Hear from Eric Newman, Vice-Chair of Clinical Innovations, on how Geisinger established a specialty care delivery model through the use of data analytics
• Is there an industrial complex around evidence? Sanofi’s policy leader Joseph Devaney speaks on the risks of dependencies and reveals differences between cost containment-driven quality measures and patient and outcomes-driven quality indicators – one that matters…
• How to engineer the (r)evolution in the evidence hierarchy: Optum Lab’s Paul Wallace, Chief Medical Officer, reveals how alternative models and methods can be applied to support your evidence generation and documentation.
• GSK’s innovative strategies to making all phase III studies pragmatic: Bridge the gap between the evidence being produced by pharma and the type of information that decisions makers want with Rafael Alfonso, Director, Value Evidence Analytics
• Cedars-Sinai on medication adherence: Hear from Pharmacy Director Rita Shane how to assess high risk Medicaid populations with multiple medications
• North Shore on improving clinical outcomes: Frederick Muench, Director, Health Interventions, presents insights on developing streamlined digital assessment and intervention tools to increase engagement

These are just a few of the exciting updates taking place during the program. See all of the latest developments, download the event brochure, and gain front-line insights from AMGA, Novartis, AstraZeneca, Pfizer, Mount Sinai, J&J, Actavis and 50+ others.

Use discount code 4318DC300 to save $300. Register today!

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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.

Employers Get Tougher About Pharmacy Benefits and Specialty Drug Management

It’s time for our annual review of the Kaiser/HRET 2015 Employer Health Benefits Survey, which you can read online for free. The survey delves into employer-sponsored health coverage at 2,000 companies.

Today, I profile the 2015 pharmacy benefit highlights from this well-executed survey. The charts below summarize (1) cost-sharing tier structures, (2), average copayments, by formulary tier, (3) type of cost-sharing (coinsurance and copayment), and (4) new data on specialty drug management strategies.

Bottom line: Employers didn’t make major changes this year, but they continue to shift prescription drug costs to beneficiaries and are focusing on specialty drug management. As I explain below, the plan details won’t give employees a glad expression.

Data-Driven Strategies for Specialty Product Optimization

Data-Driven Strategies for Specialty Product Optimization
December 9, 2015 | Philadelphia, PA
www.cbinet.com/specialtydata

CBI’s December 9th Summit on Data-Driven Strategies for Specialty Product Optimization is the first and only event for the biopharmaceutical industry that is laser-focused on strategies for leveraging third-party data to drive your specialty drug access, uptake, adherence and outcomes.

Benefit from compelling case studies, expert panels and interactive discussions:

• Discover key data insights that support product placement on formulary
• Enhance strategic contracting with key stakeholders
• Gain insight into channel partners ability and willingness to share data sets
• Address performance management and metrics management
• Assess the emergence of specialty pharmacy data within Integrated Healthcare Systems
• Utilize specialty data to enhance care coordination across the patient journey
• Apply data to maximize the impact of business decisions and activities
• Address privacy concerns and risks associated with specialty data

Visit www.cbinet.com/specialtydata for more information. Drug Channels readers will save $200 off of the standard registration rate when they use discount code QMS268.*

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rates. 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.

The Power of Formulary Non-Exclusion: Express Scripts Adds PCSK9 drugs

This week, pharmacy benefit manager (PBM) Express Scripts announced that both of the new PCSK9 inhibitors—Repatha (from Amgen) and Praluent (from Sanofi/Regeneron)—will be on its National Preferred Formulary. Both products will be subject to extensive prior authorization and step therapy. Read the press release.

This formulary approach contrasts sharply with the approach used for the Hepatitis C products. As I explain below, perhaps Express Scripts has learned an important lesson about the business risks of formulary exclusion. AmerisourceBergen, however, may find that it was dealt a losing hand.

As Canadian philosopher Gary Lee Weinrib once opined: "If you choose not to decide, you still have made a choice." Read on and see if you agree.

NEW: 2015-16 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors

I am pleased to announce the availability of our new report: the 2015-16 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. We’re offering special discounts if you order before October 24, 2015.

This year’s report—our sixth edition—has been updated, revised, reorganized, and expanded. It contains the latest industry and financial data, along with detailed information about the strategies and market positions of the largest public companies: AmerisourceBergen, McKesson, and Cardinal Health. It also includes many new elements.

• Click here to download a free report overview

• Click here to review the Table of Contents.

• Click here to review the List of Exhibits

The 2015-16 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors is the most comprehensive, non-partisan tool for building deep business acumen about the economic and business realities of U.S. pharmaceutical distribution.

I've worked hard to make it an essential tool for pharmaceutical manufacturers, wholesalers, pharmacists, pharmacy owners, benefit managers, managed care executives, healthcare policy analysts, investors, consultants—anyone who wants to understand and benefit from this ever-changing industry.

Alas, the report has no corny jokes and 0.0% pop culture references. I recognize that some Drug Channels readers may consider these omissions to be value-enhancing features.

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

Life Sciences Trade and Channel Strategies 2015

CBI’s 11th Life Sciences Trade and Channel Strategies
December 9-10, 2015 | Philadelphia, PA

Are you ready for some drug channel strategy?

Then join me at CBI’s 11th Trade and Channel Strategies conference, being held this December in Philadelphia. CBI’s annual event is the life science industry’s premier event focused on bio/pharma trade, channel, and account management. Use discount code AKE367 to save $200.

Adam J. Fein, Ph.D., of Pembroke Consulting, will kick things off with a keynote address called Drug Channels Update—Things to Watch in 2016. Dr. Fein will update everyone on hot topics and identify key strategic issues for the year ahead.

Day one will end with the renowned Trade Throwdown: Battle of the Experts. This year, Dr. Fein will be joined by Bill Roth of Blue Fin Group and Allen Dunehew of Rx Sourcing Strategies. Come prepared with your most vexing questions and watch them compete in CBI’s XTreme Trade Battle Cage™. Three consultants will enter…but only three will leave!

Other new features for 2015 include:

• A Trailblazer Address from Kaiser Permanente Colorado on Optimizing Care and Quality in Our Health System.
• A Manufacturer Strategic Viewpoint Panel featuring industry speakers discussing network design and forward-thinking product-specific strategies for optimized distribution.
• A Wall Street Panel, where you'll learn how the drug channel is changing and what they are forecasting for the future.
• A Trade Think Tank, where you can identify trailblazing trends by benchmarking with your peers utilizing interactive and anonymous live polling.

Visit www.cbinet.com/trade for more information. Drug Channels readers will save $200 off of the standard registration rate when they use code AKE367.*

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rates. 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.

EXCLUSIVE: In 2016, 85% of Medicare Part D plans have a preferred pharmacy network

The Centers for Medicaid & Medicare Services (CMS) just released data on 2016's Medicare Part D plans. Our exclusive, warp speed analysis reveals that 85% of Medicare Part D regional prescription drug plans (PDP) will have a preferred cost sharing network in 2016. That’s comparable to the 2015 figures, and signals that these plans are here to stay.

Preferred network plans are controversial (and generally disliked) by pharmacy owners. That’s because reduced pharmacy profits are the biggest source of cost savings from these networks. Despite ongoing complaints, it's still full speed ahead for preferred networks.

Read on for a look at the top plans. I'll review pharmacy network participation in a future article.

It's Finally Time For ICD-10 Fun!

Rejoice, fans of medical billing codes. It’s ICD-10 Compliance Day!

As you may know, the International Classification of Diseases (ICD) will expand the number of medical service codes for doctors and hospitals, from 18,000 in the ICD-9 to more than 140,000 in the ICD-10. Click here for a good background article from The Wall Street Journal. The Centers for Medicare & Medicaid Services (CMS) has been counting down to today's launch.

So, today is a perfect time to revisit the Find-A-Code YouTube channel, where you can see a gaggle of semi-wacky video clips illustrating legitimate ICD-10 codes.

I picked out a few choice ones below, including my personal favorite V95.44 ("Spacecraft accident injuring occupant”). And that's only one of an astounding 21 spacecraft-related ICD-10 codes.

Click here to search the database and discover your own lucky code.