A System Without Rebates: The Drug Channels Negotiated Discounts Model (rerun)

This week, I’m rerunning some popular posts before the holidays. Click here to see the original post and comments from August 2018.

This has been the most impactful article that I have ever published on Drug Channels. Review it and get ready for 2019.

P.S. You can also find this material at www.WorldWithoutRebates.com. (Yes, we bought that domain!)

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Are you ready for a world without rebates?

In June, Alex Azar, Secretary of the U.S. Department of Health & Human Services (HHS), summarized his long-range vision for a new drug channel system:

“[W]e may need to move toward a system without rebates, where PBMs and drug companies just negotiate fixed-price contracts. Such a system’s incentives, detached from artificial list prices, would likely serve patients far better.” (emphasis added)

No one has yet explained what a system without rebates would look like.

To facilitate the discussion, I have sketched out a possible new drug channel system that would:

• Respond to the HHS vision for a “system without rebates”

• Remove/decrease the reliance on list price as a component of intermediary compensation

• Use negotiated discounts as an alternative to the current system of retrospective rebates

• Require manufacturers to negotiate for desirable market access

You can download The Drug Channels Negotiated Discounts Model below.

Please note that I am not advocating for this approach. I am merely exploring one way that a system without rebates could be implemented. I hope you find it helpful for your strategic planning.

As always, I welcome feedback on how to improve and refine this model. Either leave comments below or email me. Enjoy!

New Disclosures Show CVS and Express Scripts Can Survive in a World Without Rebates. Are Plan Sponsors Now the Real Barrier to Disruption? (rerun)

This week, I’m rerunning some popular posts before the holidays. Click here to see the original post and comments from August 2018.

This rerun explains how and why PBMs are shifting responsibility and blame toward third-party payers. In 2019, we'll hear much more about how payers' use of rebates affect patients' out-of-pocket costs and distort the drug channel. Addressing the problems will require a major rethink of commercial and Medicare Part D pharmacy benefit designs. For my related $0.02 on the politics of "drug prices," see also Drug Prices After the Midterms: Five Crucial Implications of Pharmacy Benefit Design.

P.S. Drug Channels was sad to hear about the passing of Stephen Hillenburg, creator of SpongeBob Squarepants.

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Last week, the two largest pharmacy benefit managers (PBMs)—CVS Health and Express Scripts—both stated that rebates now account for a small part of their profits. The companies therefore strongly implied that they could survive in a world in which PBMs did not participate in the flow of funds from a brand-name manufacturer to a plan sponsor. Below, I unpack the new disclosures, which move us materially closer to a new model.

Hmm. The two biggest PBMs and at least one major manufacturer (Pfizer) have now implied a willingness to change. So what’s to stop massive drug channel disruption?

CVS Health perhaps inadvertently identified the real barrier to a system without rebates: employers and health plans. As you will see below, CVS Health disclosed for the first time the massive gross-to-net bubble within its commercial book of business. The new information confirms that plan sponsors are hoarding rebates rather than sharing the savings with the employees whose prescriptions generated the rebate funds.

If we really do migrate to a system without rebates, PBMs’ reportedly minimal profits from rebates mean they could escape drug channel disruption unscathed. The focus will now turn to the plan sponsors that are absorbing rebate dollars. Whether plan sponsors realize it or not, they are the next target.

Building a New Drug Wholesaler Compensation Model: What Happens as Brand Inflation Slows? (rerun)

This week, I’m rerunning some popular posts before the holidays. Click here to see the original post and comments from July 2018.

The challenges facing wholesalers have intensified since this article was originally published, in July. Brand-name drug inflation will likely reach historical lows in 2019, and the prospects for a gross-to-net bubble reset are greater than ever. Have executives at the Big Three companies fully grasped the changes coming to the drug wholesaling business model?

For more on the industry, see our 2018–19 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors.

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Today, drug wholesalers make money from distribution in a straightforward manner: Buy low, sell high, collect early, and pay late. They also profit as brand-name list prices increase. Like other drug channel intermediaries, wholesalers have warped incentives to prefer ever-higher list prices.

But what happens to their business model if list prices don’t rise—or even if they decrease?

This question is no longer theoretical. Many drug makers—Pfizer, Roche, Novartis, Novo Nordisk, Sanofi, and others—have announced an intention not to raise list prices for 2018 or have rescinded planned increases. Merck has gone further and become the first major manufacturer to reduce the list price of a brand-name, patent protected product, albeit for a product with minimal sales. And for the first time, there is a serious attempt to pop the gross-to-net bubble and build a system without rebates.

Below, I analyze what this could mean for the Big Three drug wholesalers—AmerisourceBergen, Cardinal Health, and McKesson. I explain some of the problems that arise when wholesalers are compensated based on a brand-name drug’s list price. I then suggest an alternative approach that would reshape wholesalers’ economics. It appears that even the wholesalers’ trade association supports some sort of new model.

Given what’s happening, it’s clearly time for some ch-ch-ch-ch-changes.

GAO Confirms It: 340B Hospitals and Contract Pharmacies Profit from Low-Income, Uninsured Patients (rerun)

This week, I’m rerunning some popular posts before the holidays. Click here to see the original post and comments from July 2018.

Expect 340B to stay in the news during 2019. Unfortunately, a sensible, bipartisan legislative fix still seems unlikely.

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The United States Government Accountability Office (GAO) has just issued a must-read report on the 340B Drug Pricing Program: Federal Oversight of Compliance at 340B Contract Pharmacies Needs Improvement.

Some of the report’s most startling revelations confirm our worst fears about how hospitals and pharmacies are abusing the 340B program.

Here are two especially dispiriting findings from the GAO’s analysis:

• 16 out of 28 hospitals (57%!) did not provide discounted drug prices to low-income, uninsured patients who filled prescriptions at the hospital’s 340B contract pharmacy. Seriously?!?

• Many 340B contract pharmacies can earn excessive profit margins of 15% to 20% from brand-name 340B prescriptions. As I have long suspected, large, publicly-traded pharmacies are sharing in the 340B discounts generated for covered entities.

Bottom line: Hospitals and pharmacies are making money from poor people. Are you kidding me?!? For shame!

The 340B program’s apologists will have a hard time rebutting the uncomfortable facts from this GAO report. Calling something a “drug discount program” apparently doesn’t mean that the neediest patients get access to those discounts. Read on, and prepare to be outraged.

P.S. In two upcoming articles about 340B, I’ll review the pharmacies participating in the program and then examine the role of specialty pharmacies and pharmacy benefit managers.

Copay Accumulator Update: Widespread Adoption As Manufacturers and Maximizers Limit Patient Impact (rerun)

This week, I’m rerunning some popular posts before the holidays. Click here to see the original post and comments from September 2018.

BTW, my personal Independence Blue Cross “platinum” health plan just added copay accumulator adjustment! Click here to see the evidence.

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In January, I alerted you to an important new benefit design trend in Copay Accumulators: Costly Consequences of a New Cost-Shifting Pharmacy Benefit. It is by far the most widely read article ever published on Drug Channels.

New data from Zitter Health insights (ZHI) suggest that these programs are widely used. Nearly one-third of commercially-insured lives are enrolled in plans that have implemented copay accumulator adjustment or closely-related copay maximizers. (We explain the benefit design math behind maximizers below.)

ZHI also found that a surprising number of plans are already set up to use these programs, but have not done so yet. And many more are planning implementation for 2019 and beyond. Check out the full data below.

Manufacturers have stepped up with more financial support to shield patients from the worst aspects of these benefit designs. This support further inflates the gross-to-net bubble. Plan sponsors’ use of maximizers instead of accumulators has also blunted the impact on patients.

Accumulators, maximizers, and large copay support programs are inefficient solutions to flaws in the U.S. drug channel system. Alas, it looks like they are all now a common—but possibly not even fully utilized—feature of the benefit design landscape.

Three Reasons to Join the Industry-Wide Effort to Speed Time-to-Therapy for Specialty Pharmacy

Today’s guest post comes from Lee Ann Stember, President and CEO of the National Council for Prescription Drug Programs (NCPDP).

Lee Ann discusses the crucial importance of getting patients timely access to specialty therapies. She invites Drug Channels readers to participate in NCPDP’s specialty pharmacy work group and its four task groups. Your participation will help establish and refine standards that will benefit patients and all industry participants.

It's simple. Create an account at www.dms.ncpdp.org and then select your preferred task groups. You can also click here to register for upcoming NCPDP meetings.

Read on for Lee Ann’s insights and to get more information about NCPDP’s specialty pharmacy task groups.

Drug Channels Outlook: What to Watch in 2019

Whew. I can’t recall a year with as much drug channel tumult as we experienced in 2018.

Hot topics included the ever-inflating gross-to-net bubble, the prospect for a world without rebates, the boom in copay accumulators, the specialty pharmacy industry’s slowdown, the completion of vertical integration mega deals, an aggressive federal government attempt to reform the entire industry, the still-looming challenge from Amazon, and much more.

I’m exhausted just thinking about it all!

I’m happy to say that Drug Channels was there to help you figure it out. Our site had another record year of readership. Drug Channels now has more than 24,000 subscribers, including more than 6,600 @DrugChannels Twitter followers. (Follow me there for daily updates.)

Thank you, dear readers, for welcoming me into your inboxes and browsers each week. I’ve had a blast writing Drug Channels and hope that you had fun reading it. I’m grateful to our many sponsors and guest writers. Special thanks to the brave souls who posted comments and joined in the spirited discussions below the articles.

Below, you'll find our annual bonus stocking stuffer: The Drug Channels Outlook: Things to Watch in 2019. These slides capture ideas I shared in my recent keynote presentation at CBI's Trade and Channel Strategies conference. It’s a sneak peek at some of next year's likely hot topics.

You'll also find our annual holiday tradition—a video greeting below from me and Paula, my wife and business partner in Drug Channels Institute.

Wishing you and your family health and happiness,
Adam

CMS Confirms It (Again): Minimal Drug Spending Growth, While Hospital and Physician Spending Keep Going

Last week, the econowonks at the Centers for Medicare & Medicaid Services (CMS) released the 2017 National Health Expenditure (NHE) data. Links below.

For 2017, drug spending grew by a mere 0.4%—significantly below the growth of spending on hospitals, physician services, and overall national healthcare costs. These latest CMS data confirm the drug spending slowdown that I have highlighted in previous Drug Channels articles.

Too many people—including politicians, journalists, and a certain billionaire—have committed to a false narrative of “skyrocketing” drug spending. Hmm, I don’t recall any of them ranting about “hospital prices” or “physician salaries”—two categories that together account for six times as much healthcare spending as outpatient drugs. Perhaps that's because despite the aggregate spending disparity, consumers (voters) spend a lot more out-of-pocket on pharmaceuticals than what they spend out-of-pocket on hospital care.

Alas, I must again note that demonizing pharmaceuticals as the prime driver of U.S. healthcare spending is simply false. See what you think.

sPCMA Business Forum

sPCMA Business Forum
March 11 & 12, 2019
Hilton Bonnet Creek | Orlando, FL
Register Today!

The sPCMA Business Forum will return to the Hilton Bonnet Creek in Orlando, FL on March 11 & 12.

Senior executives and decision makers from PBMs, health plans and their affiliate specialty pharmacies will come together at the 2019 Business Forum to collaborate with drug makers and their other important business partners. The event offers invaluable networking and education for individuals and companies involved in the specialty drug supply chain. Registration for the conference is now open online.

Contact PCMA

Please contact Jenny Bradham (jbradham@pcmanet.org) with questions or to request further information.

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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.

Delivering Care Beyond Prescriptions: A Marketplace Opportunity for Independent Pharmacies

Today’s guest post comes from Brian Nightengale, President, Good Neighbor Pharmacy at AmerisourceBergen.

Brian discusses the challenges facing independent pharmacies. He outlines an intriguing growth vision for pharmacies that provide medication therapy management and other patient care services.

For more on how pharmacies can enhance care and lower medical expenses, see Delivering Care Beyond Prescriptions: A Marketplace Opportunity for Independent Pharmacies.

Read on for Brian’s insights.

Five Industry Trends for U.S. Drug Wholesalers in 2019

Modern Distribution Management recently published my article 2018 MDM Market Leaders | Top Pharmaceuticals Distributors. It is an excerpt from our 2018–19 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors.

Below, I republish the section of the article highlighting five significant industry trends affecting the U.S. drug wholesaling industry. I think Drug Channels readers will enjoy this summary as we look toward 2019. Click here to download a free overview of the full 2018-19 report.

P.S. I’ll be discussing these and other topics next week in my keynote address at CBI's 14th Life Sciences Trade and Channel Strategies. Hope to see you there!

CMS Considers Point-of-Sale Pharmacy DIR: Another Prelude to a World Without Rebates?

Last week, the Centers for Medicare & Medicaid Services (CMS) released a new rule for Medicare Parts B and D. It proposes changes to protected classes, e-prescribing, and other issues. Links and background below.

Notably for the Drug Channels audience, CMS also announced that it is considering—but not yet formally proposing—changes to how pharmacy price concessions are handled within Medicare Part D. These payments currently function like pharmacy rebates to Part D plans. They are therefore considered to be direct and indirect remuneration (DIR) and often called “DIR fees.”

Thanks to new CMS disclosures, we can now see why pharmacy owners hate these payments. Pharmacy DIR was $4 billion in 2017—about 1.5% of the retail pharmacy industry’s prescription revenues.

As I explain below, pharmacy DIR negatively affects the Medicare program and its beneficiaries in a manner similar to the impact of the rebates that manufacturers pay to plans. CMS wants the pharmacy DIR passed through to beneficiaries at the point of sale, i.e., when a prescription is dispensed.

Below, I explain this proposal, provide DCI's new analysis of DIR, and review the financial impact on drug channel participants. Keep in mind that the CMS proposal would *not* eliminate DIR fees or alter the financial impact of these payments on pharmacy profits. However, it’s clear that CMS wants plans and PBMs to change how these fees are computed and levied.

Pharmacy DIR is an important issue, because CMS is sharing some its views for a world without Part D rebates. The tough political question: Should taxpayers spend more to fix this problem?

PBMI 2019 Annual National Conference

PBMI 2019 Annual National Conference
March 4-6, 2019 │Palm Springs, CA

PBMI invites you to join more than 400 healthcare stakeholders in sunny Palm Springs, California at The Westin Mission Hills Golf Resort & Spa Hotel, March 4-6, 2019 for its 24th Annual Conference.

As a special offer to Drug Channels readers, PBMI is offering a $200 savings discount on conference registration fees. Enter discount code PEM19 when you register online – code expires February 15, 2019.

The conference will open with a keynote presentation from Thomas E. Price, MD, an orthopedic surgeon. Dr. Price most recently served as the 23rd Secretary of Health and Human Services (HHS). During his presentation, Dr. Price will talk about the ever-evolving and transforming role innovation has on healthcare and how Artificial Intelligence (AI) will change our system.

Attendees will also hear from thought leaders at the forefront of what's happening in the industry and the patient perspective. See a list of confirmed speakers here.

As a special offer to Drug Channel subscribers, PBMI is offering a $200 savings discount on conference registration fees. Enter discount code PEM19 when you register online – code expires February 15, 2019.

For more conference information, visit the conference website.

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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 NDC Shortage: What the FDA Could (and Should) Do to Address It

Today’s guest post comes from Patricia Milazzo, Senior Director, Embedded Content with Clinical Effectiveness at Wolters Kluwer, Health.

As Patty explains, the U.S. Food & Drug Administration (FDA) will run out of 5-digit National Drug Code (NDC) codes within the next ten to fifteen years. She describes how the FDA can minimize the negative effects of the inevitable change in NDC format.

To learn more about the debates and best practice recommendations, download the complete paper, The NDC Shortage: What the FDA Could (and Should) Do to Address It.

Read on for Patty’s insights.

Drug Channels News Roundup, November 2018: Amazon/PillPack Update, Fake News from BCBSA, Drug List Prices in Ads, Part D Plans, and Dan Best

Hope you enjoyed the Thanksgiving holiday! I remain ever-thankful for your support and readership.

Now that you’ve stretched your stomach, stretch your mind with some food for thought. In this issue:

• Amazon starts to expand PillPack's dispensing capabilities

• Blue Cross Blue Shield misrepresents drug spending data

• An excellent analysis of the CMS proposal for advertising drug list prices

• The patient’s perspective on choosing a Medicare Part D plan

Plus, please consider making a donation to the Dan Best Memorial Fund. Details below.

P.S. For daily updates on stuff that I am reading, join the more than 6,500 people who follow @DrugChannels on Twitter.

P.S.2 Today, I’m at the Forbes Healthcare Summit in New York. I’ll be participating in a panel discussion about drug pricing with Steve Miller from Express Scripts. Please say hello if you’re attending!

Pharmacist Salaries Keep Rising: Hospitals Continue to Lead in Wage and Employment Growth

Time to update our exclusive annual analysis of pharmacist salaries. We again rely on the latest Occupational Employment Statistics (OES) data from the Bureau of Labor Statistics (BLS).

For 2017, the average gross base salary for a pharmacist at a retail, mail, long-term care, and specialty pharmacy reached nearly $122,000—up slightly from the 2016 figure. Meanwhile, the share of pharmacists who work at hospitals reached a new high. Pharmacists who work at hospitals also had higher salaries and greater salary increases than those of pharmacists in outpatient dispensing formats.

Some people have predicted doom and gloom for pharmacists. These latest data show otherwise, though the ongoing shift to specialty drugs is altering long-standing employment patterns. Below, I profile pharmacist employment and salaries. I also offer a few controversial thoughts on U.S. healthcare spending and the industry’s salaries.

CBI’s 12th Hub and SPP Model Optimization

CBI’s 12th Hub and SPP Model Optimization
February 26-27, 2019 | Philadelphia, PA
www.cbinet.com/hubs

As the industry’s acclaimed event for hub and SPP model optimization, CBI’s 12th Hub and SPP Model Optimization conference brings together perspectives from manufacturers, payers, specialty pharmacies, hubs, PBMs, technology providers and more. You can't miss this timely meeting as you prepare to launch, transition or reboot your corporate or product approach to hub services!

Visit www.cbinet.com/hubs for further details and to register. Drug Channels readers will save $400 off the standard rate when they use promo code TJR752 and register prior to December 21st.*

CBI’s 12th Hub and SPP Model Optimization provides next-generation insights and strategies for service model design and enhancement to improve access and outcomes. By way of case studies, master classes and panels on stakeholder collaboration, compliance risks, technology advancements, auditing third-parties, nurse educator programs, contracting, data reporting, hub enrollment and more, you’ll return to the office ready to advance your organization to stay ahead in 2019.

You can sign up to see the agenda here.

Here’s an inside look at what you can expect:

• Navigate the Complexities of Reimbursement and Access to Propel Adherence and Outcomes
• Down Wall Street — Examine Revolutionary Deals, Breakthroughs and E-Commerce Players Impacting the Life Science Marketplace
• Uncover Emerging Enforcement Trends and Top Risk Areas for 2019 and Beyond
• Collaborate with Compliance—From Program Development to Monitoring and Auditing Third-Party Providers
• Assess Powerful Partnership for Clinics and Patients—Aligning Manufactures, Hubs and SPPs to Minimize Duplication and Streamline Access
• Discuss How Patient Support Is Driving Meaningful Outcomes for Value-Based Reimbursement
• Evaluate Industry’s Leading Hub and SPP Models
• Hear What’s on the Horizon for Hubs—A Look into the Continued Evolution and Advancement of Services Accelerating Access
• Enhance Electronic Benefit Verification and Prior Authorizations to Decrease Time to Fill and Optimize HCP Workflow

PLUS! New this year – benefit from the Master Class Series:

• Copay Accumulator Download—Forecast and Manage the Impact on Patients and Manufacturers
• Elevate Efficiency and Value of the Hub while Reducing Costs
• Nurse Educator Programs—Compliant Program Design and
• Align Distribution Channel Strategies with Hub and SPP Model Design
• Optimize Compliant Quick Start and Bridge Programs
• Revamp and Restructure Contracting Agreements for Specialty Data to Create Operational Efficiencies

Visit www.cbinet.com/hubs for further details and to register. Drug Channels readers will save $400 off the standard rate when they use code TJR752 and register prior to December 21st.*

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.

CBI’s 14th Life Sciences Trade and Channel Strategies

CBI’s 14th Life Sciences Trade and Channel Strategies
December 11-12, 2018 | Philadelphia, PA
www.cbinet.com/trade

Don’t miss the life science industry’s favorite event where the experts will share how to expand the playbook on product-specific network design, contracting and specialty distribution strategy.

Visit www.cbinet.com/trade for further details and to register. Drug Channels readers will save $200 off the standard rate when they use promo code FPH346 and register prior to November 30th.*

Gain critical insights on industry trends, political impact, market dynamics and product-specific channel strategies. Key stakeholders come together to navigate the complex distribution and contracting landscape and discuss ways to optimize channel strategies in order to reach patients in need and provide the necessary services based on product type, site of care and reimbursement.

You can read all about it here.

• Hear from Adam J. Fein, Ph.D., Chief Executive Officer, Drug Channels Institute as he provides a Drug Channels Update—Things to Watch in 2019
• Gain insight from William Roth, Founding Partner Blue Fin Group as he addresses the Fragmentation and Customization Coming to Pharmaceutical Channels
• Walk down Wall Street as industry analysts sound off on the Cigna-Express Scripts deal and the CVS-Aetna deal as well as Amazon’s entrance into the marketplace
• Navigate the evolving managed care landscape and identify emerging models in utilization management to enhance product access and network design
• Discover leading distribution models based on product type (specialty pharmacy benefit, specialty medical benefit, orphan/rare, gene therapies, complex generics)
• Measure the impact of Copay Accumulator Programs on patients and manufacturers
• Customize your experience through a master class series:
• Integrating pharmacy and medical benefits
• Specialty pharmacy strategy design for biosimiliars and on-market brands
• Navigate limited and closed pharmacy network models
• Patient support programs and hub services
• Advanced SP contracting
• Managed markets compliance

Visit www.cbinet.com/trade for further details and to register. Drug Channels readers will save $200 off the standard rate when they use promo code FPH346 and register prior to November 30th.*

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.

Commercializing Cell and Gene Therapies with High-Touch Services

Today’s guest post comes from Layne Martin, VP/GM, Specialty Distribution and Third-Party Logistics at McKesson Life Sciences.

Companies commercializing cell and gene therapies face many novel challenges, including: supply chain logistics, patient access, adherence, outcomes collection, and data analysis. Layne reviews the crucial issues and explains the services needed for success.

McKesson Life Sciences has developed a portfolio of patient-centric solutions to help cell and gene therapy companies. To learn more, download their new white paper: The Key to Commercializing Revolutionary Gene Therapies and Other Orphan Drugs.

Read on for Layne’s insights.

Express Scripts Launches a New Formulary for a World Without Rebates. Will Plan Sponsors and Drug Makers Play Along?

Express Scripts has just announced its National Preferred Flex Formulary, a new option that favors drugs with lower list prices over the high-list/high-rebate versions of these products. Click here to read the press release.

This new formulary signals that Express Scripts is trying to prepare its plan sponsor clients for a world without rebates. The formulary also provides a way for Express Scripts to prepare itself for such a world.

As I explain below, many plan sponsors embrace the warped incentives of the gross-to-net bubble—the ever-growing pile of money between a manufacturer’s list price for a drug and the net price after rebates and other reductions. I outline two crucial payer and PBM factors that make it difficult for manufacturers to cut list prices and pop the gross-to-net bubble.

Express Scripts’ new formulary challenges plan sponsors that are addicted to rebate dollars. Let’s see how many plan sponsors will prefer a low list-price over a high-list/high-rebate product—and how many more manufacturers will respond with lower list prices.

13th Annual Health Care Supply Chain Summit

13th Annual Health Care Supply Chain Summit
January 28-29, 2019 | New Orleans, LA

Join senior supply chain executives from top hospitals as they share strategies to improve patient outcomes by optimizing and benchmarking supply chain operations.

Key Themes in World Congress’ 13th Annual Health Care Supply Chain Summit 2019 include:

• Cost, quality and outcomes
• Clinical integration and physician alignment
  
• Supplier relationships
  
• Sustainability and standardization
  
• Strategic planning
  
• Value analysis and strategic sourcing
  
• Data, analytics, and technology
  
• Talent acquisition, supply chain leaderships, and professional development
  
• Logistics and distribution
  

Engage in strategic discussions regarding next frontier supply chain operations with leaders from: Ochsner Health System | Mayo Clinic | AHRMM | Stanford Health Care | UPS | Mount Sinai Health System | Boston Children’s Hospital | and more!

Download the 2019 brochure.

Ready to register? Use promo code DC200 and save $200 off of current rates.

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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.

Enhancing Care For and Management of Hepatitis C Patients

Today’s guest post comes from Lily Duong, Chief Clinical Officer at Therigy.

Lily discusses challenges treating Hepatitis C patients and explains how a specialty patient management platform can improve outcomes.

She introduces Therigy’s latest publication series: Specialty Pharmacy Standards of Care. Download the first volume in this series here: Specialty Pharmacy Standards of Care: Hepatitis C.

Read on for Lily’s insights.

Drug Prices After the Midterms: Five Crucial Implications of Pharmacy Benefit Design

After Tuesday's election, House minority leader Nancy Pelosi pointed to "reducing the cost of prescription drugs" as a legislative priority. But addressing patient affordability issues will require more than decrying “high drug prices.”

Today, I highlight five implications of these benefit designs on patient affordability, out-of-pocket costs, and perceptions of prescriptions prices. My observations are based on Employer Pharmacy Benefits in 2018: More Tiers, Greater Coinsurance, and Lots of High-Deductible Plans, in which I summarized companies’ 2018 prescription drug coverage for their employees.

As I explain below, many aspects of employers’ plans are unfriendly to patients with serious medical conditions and to those who face coinsurance and high-deductible plans. What’s more, most employees don’t understand their increasingly complex prescription insurance.

If politicians want to get serious about controlling how voters feel about their prescription costs, they should focus on understanding the structure of commercial and Medicare Part D benefit designs.

Employer Pharmacy Benefits in 2018: More Tiers, Greater Coinsurance, and Lots of High-Deductible Plans

It’s time for a deep dive into the 2018 Kaiser Family Foundation Employer Health Benefits Survey, which you can read online for free. The survey provides valuable national benchmarking for employer-sponsored health coverage in 2018.

If you’d rather not to wade through the entire report, please enjoy my highlights on prescription coverage below. I summarize employers’ 2018 pharmacy benefits by examining (1) cost sharing tier structures, (2) prevalence of copayment vs. coinsurance, and (3) average copayments and coinsurance rates, by formulary tier. I breakdown the 2018 results for plans with and without high deductibles.

For 2018, employers continue to increase cost-shifting for specialty drugs. Most plans have four or more tiers. Economically debilitating coinsurance—in some cases with no limit on out-of-pocket expenses—remains distressingly common. Many people with employer-sponsored insurance are being exposed to prescription list prices, regardless of the actual net, post-rebate costs.

In a follow-up article, I’ll provide thoughts on what employers’ benefit designs mean for patient affordability, out-of-pocket costs, and perceptions of prescriptions prices. Spoiler: Patients won’t be looking like they are having fun.

CBI’s Specialty Therapies 2019

CBI’s Specialty Therapies 2019
January 24-25, 2019 | Las Vegas, NV
www.cbinet.com/specialtytherapies

Kick off 2019 in Las Vegas at Specialty Therapies 2019! Don’t miss the chance to come together with colleagues from across the industry to examine disruptions in specialty drug distribution and the impact on access, quality and cost. You can read all about it here.

Visit www.cbinet.com/specialtytherapies for further details and to register. Drug Channels readers will save $400 off the standard rate when they use promo code BQH229 and register prior to November 30th.*

With the advent of innovative service delivery models, alternative payment models and an emphasis on data sharing and data standardization, the quest to drive better outcomes, ensure access and manage costs is more vital than ever.

Experts from Ochsner Health System, Ardon Health, Moda Health, Vanderbilt University Medical Center, Atrium Health, Indiana University Health, Fairview Specialty Pharmacy, MedImpact Health Systems, Boesen & Snow Law, Diplomat, VIVIO Health, University of Arizona Cancer Center and Blue Cross Blue Shield North Carolina lead robust discussions on topics such as:

• Investigate how distribution channels for specialty therapies are changing and the impact on cost, access and health outcomes
• Understand how in-house specialty pharmacies can enable health systems to accelerate a patient’s speed-to-therapy and improve quality of care through integrated clinical coordination
• Evaluate the potential impact of the removal of safe harbor for drug rebates
• Consider how distribution channels that accommodate 340B hospital pharmacies, PBM owned pharmacies, limited distribution drugs, any willing provider legislation and closed specialty networks affect clinical outcomes and costs
• Unravel the complexities within Copay Accumulator Programs and how they will affect specialty therapy utilization rates and long-term medical spend

Visit www.cbinet.com/specialtytherapies for further details and to register. Drug Channels readers will save $400 off the standard rate when they use promo code BQH229 and register prior to November 30th.*

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.

Surprise Deal: Cardinal Health Sells Its Specialty Pharmacy (Again)

The evolving specialty market has just claimed another victim. Cardinal Health is selling its specialty pharmacy to BioMatrix Specialty Pharmacy LLC, a private-equity-backed company. There was no public announcement, so today's article counts as another Drug Channels exclusive. Below, I provide background about BioMatrix and the specialty pharmacies that wholesalers operate.

Cardinal’s capitulation highlights the challenges for smaller specialty pharmacies. Cardinal operates a small, sub-scale specialty pharmacy that has had difficulty attracting patients. What’s more, Cardinal’s overall size as a $137 billion business couldn’t help its pharmacy gain sufficient access to manufacturers’ and payers’ limited networks.

Each of the Big Three wholesalers—AmerisourceBergen, Cardinal Health, and McKesson—is encountering challenges to its diversification efforts. Will Cardinal’s move prompt a rethinking of wholesalers’ broad business portfolios over the next 12 to 18 months?

Drug Channels News Roundup, October 2018: Amgen, Walgreens, Rite Aid’s PBM, Drug Price Ads, and Buy-and-Bill Murray

Boo! Time for my Halloween bag of Drug Channels news stories. This issue’s tricks and treats:

• Shocking! The gross-to-net bubble for Amgen’s PCSK9 product magically vanishes—and my $0.02 appears

• Creepy! Stefano Pessina of Walgreens Boots Alliance shares startling thoughts about Amazon, ABC, and more

• Scary! Shareholders vote today on whether Rite Aid should amputate its PBM

• Spooky! The Wall Street Journal conjures up a frightfully funny editorial about the drug channel

Plus, the Centers for Medicare & Medicaid Services summons Buy-and-Bill Murray for its latest foray into Part B reform.

P.S. Join the zombie horde who shamble after me at @DrugChannels on Twitter. It’s a great way to haunt me between Drug Channels articles.

CBI’s 6th Annual Reimbursement & Contracting Conference

CBI’s 6th Annual Reimbursement & Contracting Conference
January 23-24, 2019 | Philadelphia, PA
cbinet.com/Contracting

CBI’s 6th Annual Reimbursement & Contracting Conference is the ideal platform for bio/pharma manufacturers to unravel complexities associated with reimbursement, pricing strategies and commercial contracting. Join industry thought-leaders and colleagues in Philadelphia on January 23-24 at this CPE accredited event, and discover the necessary insights to navigate the evolving landscapes to develop innovative and competitive pricing strategies.

Exclusive Offer for Drug Channels Readers:

Register Now to SAVE $400* using promo code MGS852

Featured Sessions from Our Distinguished Faculty Include:

• Best Practices and Implications of Contracting with Digital Therapeutics – Pear Therapeutics
• Unmet Medical Need – Can the Stakeholder Align? – Chiesi USA, Inc.
• 340B Summit – Case Studies and Provider Perspective – Boone County Hospital and ProMedica
• HEOR and RWE Around the World – Roles in Reimbursement and Contracting – BeiGene, Ltd.
• And more!
• Plus, Choose Between Two In-Conference Summits:
1. Foundational Summit: Principles of Reimbursement and Contracting – The Robinson Research Group, Inc.
2. Strategic Summit: Network Contracting Strategies — The Janssen Pharmaceutical Companies of Johnson & Johnson and Johnson & Johnson Health Care Services

Visit cbinet.com/contracting to view the complete agenda and speaker lineup, then register using the Drug Channels promo code MGS852 to save $400 off* the standard rate.

 *Expires 1/22/18; applies to standard rate only and may not be combined with other offers or applied to 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.

PBM Pricing Overhaul: Express Scripts Prepares for a World Without Rebates—But Employers May Not Change

This week, Express Scripts announced an innovative pharmacy benefit contracting model for members of the National Drug Purchasing Coalition (NDPC), a group of 18 large employers. Click here to read the fully-titled press release.

You should pay close attention to this b.i.g. news. It is structured so that Express Scripts will not profit from the flow of funds from a brand-name manufacturer to a plan sponsor. What’s more, the PBM’s compensation will be fully delinked from drug list prices. Instead, Express Scripts will earn only fixed management fees plus additional at-risk compensation tied to clinical outcomes.

I spoke to Express Scripts and the NDPC’s consultant to clarify how the new model will differ from more conventional structures. As I see it, this PBM compensation approach could be an important step in our industry’s journey toward a world without rebates.

For now, it only applies to a sliver of Express Scripts’ revenues. But if the new pricing model is widely adopted, Express Scripts (Cigna) will be able to escape drug channel disruption unscathed.

The biggest unknown is how employers will behave as they select pharmacy benefits. Will the funds flowing transparently through the PBM be put toward solving the reverse insurance issue the gross-to-net bubble? Will this lower out-of-pocket costs for patients? As they say: Mo money, mo problems.

The Law of Holes: Some Independents Skip 2019 Part D Preferred Pharmacy Networks

Last week, I highlighted the largest pharmacy chains that will participate in next year’s Medicare Part D prescription drug plans (PDP).

Today, I examine independent pharmacies’ participation via the pharmacy services administrative organizations (PSAOs) that represent these pharmacies in negotiations with plans.

This year’s results show a major divergence in strategies. Three of the four biggest PSAOs will participate in a comparable number of Part D networks, as the big chains do. AmerisourceBergen’s Elevate network, however, continues to go its own way and will skip preferred status in the major Part D networks. You will find its reasoning below.

Are we at a turning point for preferred pharmacy networks? Remember that Humana will trigger a small pullback by switching two of its plans from preferred to open networks for 2019. Have pharmacies decided to stop digging holes in their income statements?

CBI’s Specialty Product Data Strategies Summit

CBI’s Specialty Product Data Strategies Summit
December 12, 2018 | Philadelphia, PA
www.cbinet.com/specialtydata

Specialty Product Data Strategies 2018 is your next step towards leveraging internal and third-party data to drive product access, uptake, adherence and outcomes. This unique and cutting-edge forum provides you with breakthrough data discussions and key industry perspectives on how to strategically contract, analyze and utilize specialty data to measure outcomes and illustrate value. You can read all about it here.

Drug Channels readers will save $200 off the standard rate when they use
discount code HXF785 and register prior to November 2nd.*

Innovative Discussions and Compelling Case Studies:

• Leverage Artificial Intelligence (AI) to Drive Specialty Channel Insights and Examine Emerging Pharmacy Models Driving New Data Sets for Specialty Drugs
• Transform Specialty Product Data Sets into Cutting-Edge Dashboards to Gain Actionable Insights
• Update on NCPDP’s New Specialty Pharmacy Work Group and Task Group Activities
• Partnership Pavilion— Collaborating with the Right Complex Patient Data Providers to Drive Value
• I Know What I Want, but How Do I Get There? Building an Effective, Innovative Commercial Operations Organization
• Value-Based Therapy Management Driven by Data Collection throughout the Patient and Product Journey
• Revamp and Restructure Contracting Agreements for Specialty Data to Create Operational Efficiencies
• Strategies to Foster High Quality Data for Advanced Analytics
• Opportunities for Data-Driven Patient Services

Visit www.cbinet.com/specialtydata for further details and to register. Drug Channels readers will save $200 off the standard rate when they use discount code HXF785 and register prior to November 2nd.*

CBI will see you there!

REMINDER: Upgrade your registration and come in a day early to attend CBI’s Trade and Channel Strategies meeting. To register for both events, please visit this site, sign up for the Trade and Channel event and chose the Specialty Data track.

*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.

McKesson: Biopharma Companies Need an Integrated, Customized and High-Touch Approach to Solve Critical Commercialization Challenges

Today’s guest post comes from Shawn Seamans, President of McKesson Life Sciences.

Shawn discusses the channel and commercialization complexities associated with launching and managing specialty medications. He then outlines McKesson Life Sciences, a business that brings together McKesson's multiple solutions for connecting biopharma companies, providers, pharmacies and payers. These solutions also help patients access their therapies.

To learn more, visit McKesson Life Sciences or email LifeSciences@mckesson.com.

Read on for Shawn’s insights.

Battle Royale: CVS and Kroger Gain, Walgreens Slips in 2019 Part D Preferred Pharmacy Networks

In Humana Triggers a Pullback for Preferred Pharmacy Networks in 2019 Medicare Part D , 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 24 major 2019 Part D preferred networks. Some highlights:

• CVS, for the second year, has strengthened its position as a preferred pharmacy in many 2019 networks.

• Walmart and Kroger have maintained the strong positions that they have established over the past few years. Walgreens, however, has slipped as the other chains grow.

• Poor ol’ Rite Aid will again be a preferred pharmacy only in the single plan offered by its EnvisionRx subsidiary.

Below, we provide you with a handy table for scoring each chain’s participation and all changes from 2018 to 2019. Get ready to do The Floss!

EXCLUSIVE: Humana Triggers a Small Pullback for Preferred Pharmacy Networks in 2019 Medicare Part D (Plus: Top Sponsors and CVS Health’s POS Plan)

The Centers for Medicare & Medicaid Services (CMS) has recently released the initial raw data on the 2019 Medicare Part D plans.

Our exclusive analysis of these data reveals that preferred cost sharing pharmacy networks will be slightly less popular next year. For 2019, 92% of Medicare Part D regional prescription drug plans (PDP) will have a preferred network. This figure compares with 99% of plans in 2018. The decline will occur primarily because two Humana plans will switch from preferred to open networks for 2019.

Below, I provide historical context on preferred networks’ growth and then discuss the top nine companies behind the 2019 plans. As you will see, narrow pharmacy networks are now an essential and established component of Part D benefit design.

Especially notable will be CVS Health’s SilverScript Allure, the first Part D plan with point-of-sale (POS) rebates for brand drugs. Is Allure the next generation of Part D plan design, or an unattractive offer that helps CVS stop a mandated policy shift that it opposes?

Join me at CBI’s 14th Life Sciences Trade and Channel Strategies

CBI’s 14th Life Sciences Trade and Channel Strategies
December 11-12, 2018 | Philadelphia, PA
www.cbinet.com/trade

Are you ready for some channel strategy? Then join me at CBI’s 14th Life Sciences 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 kick things off with an interactive keynote address titled Drug Channels Update – Things to Watch in 2019. I'll highlight the key trends for the year ahead.

I'll also be moderating a panel with Wall Street experts. We'll delve further into industry trends and such other hot topics as stock market valuations, M&A, Amazon (of course), and more.

Drug Channels readers will save $300 off the standard rate
when you register with promo code HNB269 by October 26th.*

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

Regards,
Adam

A MESSAGE FROM CBI

Don’t miss the life science industry’s favorite event where the experts will share how to expand the playbook on product-specific network design, contracting and specialty distribution strategy.

Gain critical insights on industry trends, political impact, market dynamics and product-specific channel strategies. Key stakeholders come together to navigate the complex distribution and contracting landscape and discuss ways to optimize channel strategies in order to reach patients in need and provide the necessary services based on product type, site of care and reimbursement.

You can read all about it here.

The hottest topics addressed by the experts:

• Drug Channels Update – Things to Watch in 2019
Adam J. Fein, Ph.D., CEO, Drug Channels Institute
• Fragmentation and Customization Comes to Pharmaceutical Channels
William Roth, Founding Partner, Blue Fin Group
• Market Economics and Emerging E-Commerce Players
Lance Wilkes, Senior Equity Analyst, Healthcare Services, Sanford C. Bernstein
• Utilization Management and Copay Accumulator Impact
Jeff Henderson, Vice President, Head of Market Access and Government Affairs, US, Sobi, Inc.
• Seamless Distribution Models for Orphan Therapies
Dave MacLeod, Senior Director, Patient Services and Channel Operations, Intercept Pharmaceuticals
• Inaugural Specialty Pharmacy Working Group and Data Standard
John Klimek, R.Ph., Senior Vice President, Standards and Information Technology, NCPDP
• Specialty Pharmacy and Distribution Trends Reshaping the Industry
Erika Chiles, Director, Pricing, Contracting and Trade, Neurocrine Biosciences, Inc.
• Navigate the Biosimiliars Landscape for Market Access
Joseph P. Fur, Jr., Professor Emeritus of Economics, Widener University

PLUS! Customize your experience through a master class series:

• Integrating Pharmacy and Medical Benefits for Better Health and Cost Reduction
• Specialty Pharmacy Strategy Design for Biosimiliars and On-Market Brands
• Navigate Limited and Closed Pharmacy Network Models
• Accelerate Access through Patient Support Programs and Hub Services in an Increasingly Competitive Therapy Class
• Advanced SP Contracting Course - Industry Best Practices During an Evolving and Consolidating Era
• Managed Markets Compliance - Pharmaceutical Manufacturer Relationships with Specialty Pharmacies, Wholesalers, Distributors and GPOs

Visit www.cbinet.com/trade for further details and to register. Drug Channels readers will save $300 off the standard rate when they use code HNB269 and register prior to October 26th.*

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.

DIR Fees: A Prescription While You Wait

Today’s guest post is sponsored by Elsevier and written by Todd Grover, Co-Founder, Glass Box Analytics and President, PharmacyFocus.

Todd discusses some of the challenges associated with Direct and Indirect Remuneration (DIR) fees. He explains how Elsevier’s Predictive Acquisition Cost (PAC) pricing tool helps pharmacies better manage DIR fees and challenge insufficient reimbursements.

Learn more by downloading Elsevier’s infographic: Managing the Impact of DIR Fees.

Read on for Todd’s insights.

NEW: The 2018–19 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors

I am pleased to announce our new 2018–19 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 26, 2018.

The 2018–19 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors—our ninth 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. Enjoy!

P.S. If you would like to pay by corporate purchase order or check, please email Tamra Feldman. If you preordered the report, you should have already received an email with download instructions. Please contact us if you did not receive the email.

CBI’s Copay Accumulator Summit

CBI’s Copay Accumulator Summit
December 13, 2018 | Philadelphia, PA
www.cbinet.com/accumulators

Exclusive Offer for Drug Channels Readers:
Register Now to SAVE $300* using discount code PBQ239.

As the adoption of copay accumulators and maximizers becomes widespread, so does the need for pharmaceutical manufacturers to ensure a comprehensive understanding of the impact to the commercially insured patient population.

CBI’s Copay Accumulator Summit convenes stakeholders from across the life sciences community to discuss the growing trend of cost-shifting pharmacy benefits and strategies to enhance financial support.

Gain critical insights from a distinguished speaking faculty representing Amgen, Allergan, EMD Serono, Jazz Pharmaceuticals, ConnectiveRx, NASP, Pacific Pharmacy Group, Multiple Sclerosis Association of America, CSRO, FirstView, BIO, TrialCard and more!

Elevate Access Strategies with Expert Insights and Compelling Discussions:

• Evaluate cost-shifting trends in drug plan benefit design and cost management
• Measure the impact of copay accumulator programs on patients and manufacturers
• Hear stakeholder insights on managing patient access and adherence challenges
• Promote patient education and informed discussion to encourage adherence
• Discuss payment technologies to manage the impact of copay accumulator programs
• Forecast and anticipate what is to come with PBM restrictions, payer access and copay reform

Register using discount code PBQ239 to receive $300 off* the standard rate.

*Expires 12/12/18; applies to standard rate only and cannot be combined with other offers or applied to 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.

Does Rite Aid Have the Grit to Succeed With Its EnvisionRx PBM Business?

Let’s check in with poor ol’ Rite Aid, the little drugstore that couldn’t.

Over the past year and half, Rite Aid has sold off 2,000 stores to Walgreens Boots Alliance, scuttled a proposed merger with Albertsons, and watched its stock price drop from nearly $9 to about $1. Yikes.

Rite Aid’s EnvisionRx business, which includes two small PBMs and some related pharmacy services businesses, still has some value. But as you will see below, there appear to be few synergies between Rite Aid’s pharmacy business and the Envision PBMs. Investors are grumbling that Rite Aid should sell EnvisionRx before things get any worse.

Rite Aid is again trying to prove that hope will triumph over experience. I suspect that the industry’s dynamics will hip check the company onto the ice.

Therigy’s Free Webinar: Systems Interoperability and Its Impact on Coordinated Specialty Therapy Management

Therigy’s Free Webinar: Systems Interoperability and Its Impact on Coordinated Specialty Therapy Management
Tuesday, October 16, 2018, 2:00 to 3:00 pm ET
Register Here

One of the nation’s leading specialty pharmacy technology companies, Therigy is hosting a free webinar on Tuesday, October 16, 2:00 to 3:00 pm ET.

This webinar will explore current trends of interoperability within the industry.  It will provide actionable insights to help pharmacy leaders exchange and share data between their pharmacy operation/care management systems and their EMR.

Speakers will dive into analytics and tools that tap every aspect of the clinical experience. They will explore how to deploy insightful, immediate diagnostic suggestions to physicians on robust, multi-function care delivery systems, creating an exceptional patient experience.

Featured team of expert speakers from Therigy include:

• Russel Allinson, RPh, MS, Executive Chairman, Therigy
• Jon Hamrick, MBA, President and Chief Operating Officer, Therigy
• Kate Fontenau, Director, Product and Technology, Therigy

When it comes to the healthcare industry, interoperability has to do with the capability of disparate computer and software systems to exchange and share data from a range of vital sources, including laboratories, clinics, pharmacies, hospitals, and medical practices.

All attempts at interoperability must inherently begin by recognizing the starting point of what makes everything so tricky: EHRs consist of a series of disparate systems built in silos that are suddenly being asked to work together for the good of the patient. (Click here for background information.)

It’s only now, in an era of value-based care where every aspect of an organization is being scrutinized like never before, that administrators are starting to rethink whether the systems they have in place act as a hindrance to overall care.

Webinar topics to be discussed:

• Why specialty patient outcomes can be enhanced through coordination and integration of care and therapy management activities

• Current role and uses of various systems (dispensing systems, electronic medical records, electronic pharmacy records/care management systems), existing limitations, and the need for system interoperability

• Dispensing system/care management system interoperability case study

• Pathway to a meaningful pharmacy system integration with Health System EMRs and the benefits for specialty pharmacy management

Visit Therigy’s registration page for additional information and to register.

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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.

Drug Channels News Roundup, September 2018: Gilead’s Price Cuts, Out-of-Pocket Costs, Hospital-Physician Vertical Integration, and WXPN + Me

Autumn is here, and we’ve squirrelled away some great acorns that have fallen from the mighty Drug Channels oak trees:

• Gilead’s new pricing starts to pop the gross-to-net bubble

• New fact-based insights on patient out-of-pocket costs and prescription abandonment

• Cool new stats on hospital-physician vertical integration by specialty

• The U.S. healthcare crisis will probably never end (Sorry.)

Plus, your friendly neighborhood blogger joins the board of 88.5 WXPN, the country’s leading non-commercial Triple A (adult, album, alternative) radio station.

P.S. Follow my daily stream of links to neat stuff at @DrugChannels on Twitter.Recent tweets have highlighted rebates, step therapy, PSAOs, white bagging, PBM network spreads, lab-based microbreweries, and more.

The Cigna-Express Scripts Deal's Intriguing Connections With—And Implications For—AmerisourceBergen and Walgreens

Almost there! Last week, the U.S. Department of Justice (DOJ) Antitrust Division closed its investigation of Cigna’s proposed acquisition of Express Scripts. Click here to read the DOJ’s closing statement.

As with everything in the U.S. drug channel, there’s more to this transaction than meets the eye.

Below, I explain how the transaction will benefit AmerisourceBergen (ABC), which supplies the mail and specialty pharmacies of Express Scripts. But as you’ll see, Express Scripts has been relying less on ABC as a source of supply for its mail and specialty pharmacies.

Meanwhile, the new organization transaction will have few degrees of separation from Walgreens Boots Alliance (WBA). To add to the intrigue: WBA is both ABC’s largest customer and its largest shareholder. Below, I map how Cigna, Express Scripts, AmerisourceBergen, and Walgreens Boots Alliance connect with one another.

Drug channels are organizing and aligning themselves into multifaceted entities that cross traditional functional boundaries. Are you ready to compete, collaborate, and coexist with a complex arrangement that crosses many traditional boundaries?

CBI’s 10th Federal Pricing and Reporting – VA, DoD, PHS

CBI’s 10th Federal Pricing and Reporting – VA, DoD, PHS
November 7-8, 2018 | Baltimore, MD
www.cbinet.com/fedpricing

At CBI’s 10th Federal Pricing and Reporting Summit, elevate the conversation and take a deep dive into the complexity of contracting with the “Big 4” federal programs. In an era of political transformation and industry uncertainty, this highly acclaimed meeting is a must-attend, offering bio/pharma manufacturers best practices and timely updates from government officials and industry counterparts on pricing models and processes for complying with complicated rules and regulations.

With perspectives from Marci Anderson of the VA, Vincent Valinotti of the DoD, Captain Robert W. Hayes of PHS, and Captain Mike Crockett of the BoP, along with a Spotlight Session from J'Aime Conrod and Eric Escobar of UCB, this is a meeting you can't afford to miss!

Visit www.cbinet.com/fedpricing for further details and to register. Drug Channels readers will save $300 off the standard rate when they use discount code ATT954 and register prior to October 12th.*

You can read all about the Summit here.

Featured Sessions Include:

• Uncover leading strategies and best practices for coordination with the DoD
• Receive answers to critical questions related to TAA Non-Compliant Covered Drugs Policy and its specific role in the Acetris Health LLC v. United States court cases
• Navigate the recent and impending changes to 340B legislation and guidance and their impact on federal contracting and reporting
• Discuss the financial implications of government contracting strategies in the context of GTN
• Analyze and build your understanding of non-FAMP and Federal Ceiling Price with regard to the calculations and data from which they are derived
• Gain insight on key challenges surrounding the Federal Supply Schedule (FSS)
• Hear directly from the VA OIG regarding FSS contract compliance and audit expectations

Visit www.cbinet.com/fedpricing for further details and to register. Drug Channels readers will save $300 off the standard rate when they use code ATT954 and register prior to October 12th.*

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.