Drug Channels News Roundup, October 2017: FTC Workshop on PBMs, HDHPs, OOP Spending, Hospital Profits, and FDA Biosimilar Cartoons

Eeek! Time for my Halloween roundup of Drug Channels news stories. In this issue:

• Spooktakular! An FTC competition workshop will include a terrifying panel on pharmacy benefit managers (PBMs)

• Scary! The pros and cons of frightful high-deductible health plans

• Creepy! JPMorgan Chase conjures up surprising new data on consumer out-pocket costs

• Spooky! Ghastly hospital markups on outpatient drugs

Plus, the FDA treats us to a new educational campaign on biosimilar drugs—complete with groovy shareable GIFs for millennials.

P.S. For a daily haunting, join the zombie horde who shamble after me here: @DrugChannels on Twitter. (ICYMI: Over the past week, I have sent multiple tweets with my $0.02 on Amazon and CVS-Aetna.)

CBI’s Drug Pricing Transparency Congress

CBI’s Drug Pricing Transparency Congress
December 5, 2017 | Philadelphia, PA
www.cbinet.com/drugpricing

With numerous states across the country ramping up on introducing and passing laws aimed at drug pricing transparency and reporting, is your organization prepared to act? And fast? The recent passage of California’s drug pricing bill and a number of other states passing laws earlier in 2017 leaves many unanswered questions and the opportunity to steer the course is now.

Exclusive Offer for Drug Channels Readers: Save $300 when you use discount code DCP125 and register by November 17, 2017.

CBI’s one-day Drug Pricing Transparency Congress, taking place December 5th in Philadelphia, convenes stakeholders across the healthcare ecosystem, including state and federal government regulators, manufacturers, health plans, PBMs, associations and other industry experts to learn how the future of drug pricing transparency regulation impacts commercialization, reimbursement and drug pricing models with a focus on state pricing and transparency regulation.

This monumental shift will undoubtedly impact so many functions across the healthcare system. If your responsibilities touch any facet of your organization's pricing, transparency or commercialization efforts, you'll need to be on the pulse of the rapid developments and this conference will serve as an unparalleled uniting place for the industry to assess the future landscape and gain clarity on the many unanswered questions from industry experts and regulators.

Don't be left out of the critical conversation.

Exclusive Offer for Drug Channels Readers: Save $300 when you use discount code DCP125 and register by November 17, 2017.

*Offer expires November 17, 2017; applies to standard rates only and may not be combined with other offers, category rates, and promotions or applied to an existing registration.

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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.

How Independent Pharmacies Will Participate (Or Not) in 2018's Part D Preferred Pharmacy Networks

In a previous analysis (CVS Bets Big: Our Exclusive Analysis of Pharmacy Chain Participation in 2018's Part D Preferred Pharmacy Networks), I highlighted how the largest pharmacy chains will participate in next year’s Medicare Part D prescription drug plans (PDP).

Today, I examine independent pharmacies’ participation in 22 major 2018 Part D preferred networks. Our analysis focuses on the pharmacy services administration organizations (PSAOs) that represent these pharmacies in negotiations with plans.

As you will see below, the profit pressures from narrow networks have made smaller pharmacies much choosier about contracting for preferred status. For three of the four largest PSAOs, smaller pharmacies will have preferred status in fewer than half of the major plans. By contrast, members of AmerisourceBergen’s Elevate PSAO will not have preferred status in the largest plans, although they will be preferred in some smaller plans.

I wonder: Will 2018’s surprising pharmacy participation patterns trigger a rethink of preferred networks in Medicare Part D?

Reality Check: New Prime Therapeutics Data Show Very Low Drug Spending Growth in 2017

Prime Therapeutics, the fifth largest pharmacy benefit manager (PBM), has just released its first look at drug spending data for 2017. The results strongly contradict the public rhetoric about excessive growth in drug spending and prices.

Prime analyzed three groups of third-party payers: commercial (employers and health plans), Medicare Part D, and Medicaid.

• For all payers, overall drug spending growth was negligible—below 1% or negative.  
• Post-rebate costs for traditional drugs declined compared with 2016. Specialty drug costs grew by only 3.7% for commercial payers and declined for Medicaid. 
• Utilization—more people taking more prescriptions—was more important than pricing for drug spending growth.

The data demonstrate that public perception of outrageous drug spending growth has not caught up with 2017’s realities. Sorry to be the bearer of non-fake news.

Alas, I am probably naive to believe that these facts will cause our politicians to transform their thinking before complaining, tweeting, or bloviating.

CBI’s Patient Journey Mapping 2017 Conference

CBI’s Patient Journey Mapping 2017 Conference
December 12-13, 2017
Wyndham Historic District | Philadelphia, PA
www.cbinet.com/patientjourney

CBI is pleased to announce the agenda for the Patient Journey Mapping 2017 Conference.

This conference will begin with Keynote Speaker, Rolf Benirschke, a former placekicker in the NFL before he was struck down with a major illness that nearly cost him his life. He emerged from his experience with a unique patient perspective, which he will share in his presentation.

Patient Journey Mapping attendees will save $300
off the standard rate when you register by October 27th.*

Here’s a quick glance at what’s to come with CBI’s dynamic, distinguished speaking faculty:

• Alan Balch, CEO, Patient Advocacy Foundation
• Maria Kirsch, Executive Director, Head Patient & Specialty Services Strategy, Operations and Finance, Novartis
• Maria Pandolfo MS., Field Director, Patient Services, Shire
• Kristina Sullivan, Senior Manager Patient Access & Nurse Engagement, Actelion
• Catherine Blansfield, MA, BS, RN, Vice President of Patient Services, National Organization for Rare Disorders (NORD)
• Cheryl Allen, Vice President, Industry Relations, Diplomat Specialty Pharmacy
• Melanie Powell, Field Logistics Manager, Relypsa, Inc.
• Brittany Mani, Global Medical External Relations, Eli Lilly and Company (invited)

Follow the product from diagnosis to treatment and discuss critical issues:

• Determine the important factors for specialty agents in decreasing or maintaining optimal time to fill
• Transform the patient experience into data drive insights with actionable improvement
• Foster prescriber and patient loyalty
• Identify and prevent missteps in patient journey mapping

Visit www.cbinet.com/patientjourney for further details and to register. Patient Journey Mapping attendees will save $300 off the standard rate when you register by October 27th.*

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rate or non-profit 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.

CVS Bets Big: Our Exclusive Analysis of Pharmacy Chain Participation in 2018's Part D Preferred Pharmacy Networks

In a previous analysis (Preferred Pharmacy Networks Will Dominate 2018 Medicare Part D Plans), I highlighted how preferred pharmacy networks will dominate next year’s Medicare Part D prescription drug plans (PDP).

Today, I examine chain pharmacies’ participation in 22 major 2018 Part D preferred networks. Our analysis shows significant changes from last year:

• CVS has changed strategy and will go all in as a preferred pharmacy in many 2018 networks. It's also the exclusive chain in some plans. 

• Walgreens remains an active participant, but CVS has displaced it in some plans.

• Kroger has raised its bet on being a preferred pharmacy. Walmart has held steady, maintaining a position similar to that of 2017.

• Rite Aid continues to play a losing hand. It will be a preferred pharmacy only in the single plan offered by its EnvisionRx subsidiary.

Our 2018 Part D analysis demonstrates the pharmacy industry’s new period of hypercompetition. Seniors are willing to switch pharmacies to reduce out-of-pocket expenses. Chains must therefore reduce their prescription profit margins to compete for a spot in narrow networks. Expect the dominance of preferred networks to the wild card for pharmacies’ 2018 profits.

EXCLUSIVE: Preferred Pharmacy Networks Will Dominate 2018 Medicare Part D Plans (Plus: We Review the Top Plan Sponsors)

The Centers for Medicare & Medicaid Services (CMS) has just released the initial raw data on the 2018 Medicare Part D plans.

Our exclusive analysis of these data reveals that preferred cost sharing pharmacy networks have officially won. For 2018, 99% of Medicare Part D regional prescription drug plans (PDP) will have a preferred network. This figure exceeds those of the past four years. The three largest open network plans from 2017—CVS Health’s SilverScript Choice and WellCare’s Classic and Extra plans—have given up and will have preferred networks.

Below, I provide historical data on preferred networks’ growth and then discuss the top eight companies behind the 2018 plans. As I predicted many years ago, narrow pharmacy networks—whether preferred or limited models—have become an unstoppable force in benefit design.

CBI’s Specialty Product Data Strategies Summit

CBI’s Specialty Product Data Strategies Summit
December 12, 2017 | Philadelphia, PA
www.cbinet.com/specialtydata

CBI is pleased to announce the agenda for the Specialty Product Data Strategies Summit. CBI hopes you can join them on December 12th in Philadelphia for cutting-edge case studies and forward-thinking presentations. Take a look at the sessions and speakers CBI has lined up!

Highlights include:

• Assess the different data sources and look at the associated strengths and weaknesses
• Discuss incentive compensation implications for buy-and-bill products
• Implement a feedback loop between trade and data teams to enhance value, including ownership of data agreements
• Discover key data insights that support product placement on formulary and enhance strategic contracting with stakeholders
• Share strategies for a differentiated specialty patient experience
• Gain key concepts for commercial strategies and operational improvements
• Investigate the utilization, effectiveness and clinical outcomes of specialty drugs in real-world settings to foster evidence-based discussions
• Utilize data to drive specialty therapy revenue
• Hear innovative insights on the path forward toward interoperability
• Discuss forward-thinking approaches for leveraging data across sales, marketing and managed care to drive business performance
• Enhance compliance and ensure patient privacy
• Hear best practices to enhance pharmacy network design and SP data utilization

Plus! Takeda Pharmaceuticals leads a session on Building a Specialty Data Culture to Optimize Operations.

Visit www.cbinet.com/specialtydata for further details and to register. Drug Channels readers will save $200 off of the standard rate when they use discount code DSU834.*

If you would like to upgrade your registration to include attendance at the Trade and Channel Strategies Summit, please contact Juliet Nelson at Juliet.Nelson@cbinet.com. You can download that particular agenda here.

CBI will see you there!

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rate or non-profit 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.

Thanks, California! SB17 Will Trigger Massive Speculative Buying, Windfall Pharmacy Profits, and Supply Chain Disruption

California governor Jerry Brown has just signed SB-17 – Drug Price Transparency into state law. Click here for the official summary.

This law is truly nutty. It won’t accomplish much of what it purports to do.

Below, I focus on the provision that requires manufacturers to provide 60 days’ advance notice of increases in a prescription drug’s Wholesale Acquisition Cost (WAC) list price.

As I explain, this requirement ignores crucial drug channel and supply chain economics. Consequently, mandating advance notice of price increases will benefit pharmacies and hospitals, not third-party payers. The new law also ignores what we’ve learned from the wholesale channel’s evolution more than a decade ago.

To mitigate some of the disruption, manufacturers should pay special attention to trade agreements with wholesalers and pharmacies. Everyone else should shake their head in wonder and despair for healthcare policy making in our country.

CBI’s 3rd Annual Patient Registries Summit

CBI’s 3rd Annual Patient Registries Summit
December 5-6, 2017 | Philadelphia, PA
cbinet.com/patientregistries

Exclusive Offer for Drug Channels Readers:
Register Now to SAVE $400* using discount code JXT535

CBI’s 3rd Annual Patient Registries Summit convenes registry experts representing bio/pharmaceutical, medical device and non-profit organizations in a multi-stakeholder forum, uniting all facets of the healthcare ecosystem. Discover critical methodologies to design new patient registry models and explore the future of these essential platforms.

Join us for Solutions-Oriented Sessions, Powerful Industry Insights and Illuminating Panels:

• Global Regulatory Perspectives on Registries for Clinical Development and Post-Approval Assessment – Alexion Pharmaceuticals
• Panel: Promoting and Executing Sustainable Registry Models through Collaborations between Public, Private and Industry Partners – Amicus Therapeutics, Immune Deficiency Foundation, AHRQ, PMSIR
• Evolving Rare Disease Registries – One Company’s Experience – Actelion Pharmaceuticals
• Paving the Way for Meaningful Outcomes and Better Treatment – Designing Patient-Centric Registry Models – The Life Raft Group
• Fireside Chat: Getting It Right from the Get-Go – Best Practices for Starting a Registry – Merck, Actelion Pharmaceuticals, Sanofi Genzyme
• Best Practices in Designing Sustainable Registry Models – Agios Pharmaceuticals
• And more!

View the complete agenda then register today using discount code JXT535 for this exclusive savings of $400* off.

*Discount offer valid through 12/5/17; applies to standard rates only and may not be combined with other offers, category rates, promotions or applied to existing registration. Offer not valid on workshops only or academic/non-profit registration.

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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.

NEW: The 2017–18 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors

I am pleased to announce our new 2017–18 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors, available for purchase and immediate download.

• Click here to download a free report overview (including the Table of Contents and a List of Exhibits) 

• Click here to read the press release (which highlights some key findings about revenues, profits, and trends)

We’re offering special discounted pricing if you order before October 15, 2017!

The 2017–18 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors—our eighth edition—remains the most comprehensive tool for analyzing the economic and business realities of U.S. pharmaceutical distribution.

This year's edition has been thoroughly updated, revised, and expanded. It contains the most current market and industry and data. The report is the only resource of its kind available anywhere.

See below for more info and some behind-the-scenes tidbits. Happy reading!

Join Me At CBI’s Trade and Channel Strategies 2017 Conference

CBI’s 13^th Trade and Channel Strategies
December 11-12, 2017 | Philadelphia, PA
www.cbinet.com/trade

Are you ready for some channel strategy? Then join me at CBI’s 13^th Trade and Channel Strategies Conference, being held this December in Philadelphia. CBI’s annual event has become our industry’s premier event focused on bio/pharma trade management.

I’ll be kicking things off with a keynote address titled Drug Channels Update – Things to Watch in 2018. I'll highlight the key trends for the year ahead.

Drug Channels readers can save $500 when you
register with discount code GDB273 by October 13^th*

I hope you’ll join me in Philadelphia this December.

Regards,
Adam

A MESSAGE FROM CBI

CBI is thrilled to announce the agenda for the Life Sciences Trade and Channel Strategies Conference! The theme for 2017 is "rewriting the playbook on product-specific network design, contracting and specialty distribution strategy." You can read all about it here.

Led by chairman Jeff Henderson, VP, Managed Markets, Intarcia Therapeutics, Inc., the 13^th annual meeting features a broad range of perspectives:

• Drug Channels Update – Things to Watch in 2018: Adam J. Fein, Ph.D., President, Pembroke Consulting, Inc.; Author, Drug Channels
• Fragmentation and Customization Comes to Pharmaceutical Channels: William Roth, Founding Partner, Blue Fin Group
• Payer Dynamics and Drug Utilization Management: Tracey McGuire, Specialty Services Directors, MedImpact Healthcare Systems, Inc.
• Word on Wall Street Exchange: Goldman Sachs, Marathon Asset Management and RBC Capital Markets
• IDN Partnerships Affecting Patient Journey and Outcomes: Jerry Buller, Director, Specialty Pharmacy Services, Vanderbilt University Medical Center

You’ll also benefit from three tailored content tracks:

• Specialty Distribution and Channel Optimization
• Serialization and Traceability
• Specialty Product Data Strategies

Plus! Develop a playbook during the first-ever product specific strategic showcase. Navigate and optimize distribution strategy based on product type, reimbursement and site of care.

You’ll hear from such companies as Acorda • Apobiologix • Aralez Pharmaceuticals • Axendia • Blue Fin Group • BTG plc • Cardinal Health Specialty Solutions • CoverMyMeds • Eli Lilly • Ferring Pharmaceuticals • Goldman Sachs • Intarcia Therapeutics • IntegriChain • Mallinckrodt • Marathon Asset Management • MedImpact Healthcare Systems, Inc. • Pharma Logic Solutions, LLC • Prometrics • RBC Capital Markets • Takeda Pharmaceuticals • Therigy • ValueCentric • Vanderbilt University Medical Center and more!

Visit www.cbinet.com/trade for further details and to register. Drug Channels readers will save $500 off of the standard rate when you register with discount code GDB273 by October 13^th.*

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rate or non-profit 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.