Drug Channels News Roundup, March 2018: Copay Accumulators, Cancer Drug Costs, Physician Employment, and Insurer Profits

It’s technically spring here at Drug Channels' worldwide headquarters in lovely downtown Philadelphia. While the last snowdrifts melt into memory, please enjoy this month’s selection of noteworthy news stories. You’ll learn:

• Why copay accumulators are making national news

• How hospitals are doubling cancer drug costs

• Fun facts about the massive shift to hospital-employed physicians

Plus, a joke (I think) about how a major health insurer makes money.

P.S. Join the nearly 5,400 people who follow me at @DrugChannels on Twitter. I share links to crucial news and reports that you should know about.

Five Takeaways About Cigna's Strategy for Express Scripts

Almost three weeks ago, the health insurer Cigna announced that it would acquire the pharmacy benefit manager (PBM) Express Scripts. Click here to read my initial analysis of the deal.

Wall Street remains unimpressed. Ever since the transaction was announced, Cigna’s stock price has dropped by 16%. Meanwhile, Express Scripts’ stock is trading more than 20% below Cigna’s offer price, suggesting that many believe the deal won’t be completed.

To soothe rattled investors, Cigna last week filed an intriguing SEC Form 425. It contains 31 questions that you may or may not have been asking yourself about its acquisition of Express Scripts, along with Cigna’s answers.

Below, I highlight my five key insights from Cigna’s responses to its own questions. I support each of these five takeaways by quoting relevant material from the company’s answers to the questions it poses in the document. Riddle me this: When is it easier to interview yourself instead of dealing with skeptical investors?

CBI’s 5th Annual e-Rx and EHR Summit

CBI’s 5th Annual e-Rx and EHR Summit
May 15-16, 2018 | Philadelphia, PA
www.cbinet.com/erx

Whether new to the eRx and EHR space or a seasoned expert, CBI’s Bio/Pharma Forum on e-Rx and EHR provides tangible takeaways and tailored sessions to ensure effective partnerships with EHR and EMR providers to maximize these critical technologies. Join CBI in May to gain tactical strategies to streamline HCP workflow drive patient education and engagement and facilitate access. Download the agenda here.

Visit www.cbinet.com/erx for further details and to register. Drug Channels readers will save $500 off the standard rate when they use discount code BJA629 and register prior to April 13th.*

Hot Topics on the Agenda Include:

• Spotlight Panel Session: Physician Perspectives on EHR systems
• Table Talks: Physician Perspectives
• Perspectives on the Use and Sustainability of HIEs
• Learn the Effects of EHR Documentation on Physician-Patient Communication
• Key Approaches to Enhance Patient Adherence
• Distinguished Speaking Faculty Includes: AstraZeneca, Allergan, Boehringer Ingelheim, Bayer, NCPDP, Geisinger Health System, Geisinger Medical Center, and more.

Visit www.cbinet.com/erx for further details and to register. Drug Channels readers will save $500 off the standard rate when they use discount code BJA629 and register prior to April 13th.*

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.

Leveraging Technology for Specialty Patient Engagement

Leveraging Technology for Specialty Patient Engagement
A free webinar hosted by Therigy
Tuesday, April 24, 1-2pm EDT
Click here to register

Therigy is pleased to announce a free webinar on the influence and leverage of technology for specialty patient engagement, Tuesday, April 24, 1-2pm EDT.

Interested in learning the most effective way to communicate with your patients? Attend this FREE Webinar: Leveraging Technology for Specialty Patient Engagement. Receive insider tips on how to leverage technology to improve overall patient engagement and satisfaction leading to higher rates of adherence and better outcomes.

Speakers will present research and insights on the topic of developing the right treatment and communication plan for patients that matches their lifestyle needs and improves their quality of life.

Featured speakers include:

• Russel Allinson, RPh, MS, Chief Executive Officer, Therigy
• David Medvedeff, PharmD, MBA, Chief Executive Officer, VUCA Health
• Jon Hamrick, MBA, Chief Operating Officer, Therigy

Featured topics include:

• How do patients and caregivers prefer to communicate with their HCP (pharmacist)?
• Technology platforms leveraged in different ways to increase communication
• Most effective communication approach to encourage adherence
• Potential beneficial impact on pharmacy labor and patient adherence

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.

Janssen’s New Transparency Report: A Peek Behind the Drug Pricing Curtain Raises Troubling Questions About Rebates

Johnson & Johnson’s Janssen business unit just released its 2017 Janssen U.S. Transparency Report. (Free download.) This is the second annual edition of the report, which provides a comprehensive look at Janssen’s commercial activities.

Most notably, Janssen reveals that the list price for its pharmaceutical products grew by 8.1% in 2017. Its average net prices, however, declined in 2017 by 4.6%. Janssen paid $15 billion in rebates and discounts, which subtracted 42% from its list prices. Kudos to Janssen for providing so much disclosure.

Below, I review some key takeaways from this valuable report. We’re left with some key unanswered questions, however: Did patients’ out-of-pocket costs for Janssen’s drugs also decline in 2017? Which entities in the drug channel benefited most from the $15 billion in payments?

I suspect that patients didn’t share fully in the benefit of Janssen’s ever-growing payments. That’s precisely the problem with the gross-to-net bubble.

CBI’s Real-Time Benefit Check & ePrior Authorization Summit

CBI’s Real-Time Benefit Check & ePrior Authorization Summit
May 15-16, 2018 | Philadelphia, PA
www.cbinet.com/eprior

Join industry pioneers from bio/pharma, PBMs, payers, health systems, prescribers and system solutions providers at the Real-Time Benefit Check & ePrior Authorization Summit, where you’ll discuss the latest in standards, adoption and best practices to ensure streamlined prescriber workflow and faster access to medication for patients. Download the agenda here.

Visit www.cbinet.com/eprior for further details and to register. Drug Channels readers will save $500 off the standard rate when they use discount code EJT243 and register prior to April 13th.

Navigate Evolving Trends and Cutting-Edge Strategies for Adoption and Implementation:

• Advancement Panel: Next-Generation Strategies for Improving Workflow Efficiency while Satisfying ePA Requirements
• NCPDP Update: Working Group Advancements in Real-Time Prescription Benefit and ePrior Authorization
• Discover and Utilize: Leading Portals from Manufacturers to Increase Patient Access
• Cutting-Edge Case Study: Internal Model of Centralized ePA Team and Next Steps for Timelier Collaboration
• AMA Address: Prescriber Perspective on Reducing PA Burden in the Physician Practice – Update on Advocacy, Automation and Workflow Improvements
• Uncover: The Real-Time Benefit Check – Key to Closing the Gaps in Eligibility Driven Formulary
• Leverage: Healthcare Technology Applications to Improve Medical Adherence

Visit www.cbinet.com/eprior for further details and to register. Drug Channels readers will save $500 off the standard rate when they use discount code EJT243 and register prior to April 13th.

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.

Plan Sponsors Prefer Specialty Pharmacies Over Retail Drugstores

Top 'o the morning to you! Let’s take a wee look at the Pharmacy Benefit Management Institute’s (PBMI) new 2018 Trends in Specialty Drug Benefits. (Free download with registration.) It’s a great resource for understanding how plan sponsors manage specialty drugs.

The new report contains fascinating data showing how sponsors of employer-based health plans view dispensing channels for specialty drugs. As you will see below, employers believe that the capabilities of specialty pharmacies are superior to those of retail pharmacies. They also think that over the past few years, specialty pharmacies’ performance gap has widened for crucial clinical and patient services.

Being a specialty pharmacy has become as fashionable as a #unicornmarshmallow. The PBMI’s data partly explain specialty pharmacies’ market position is more than just the luck of the Irish.

The Top 15 Specialty Pharmacies of 2017: PBMs and Payers Still Dominate

Below is our exclusive Drug Channels Institute list of the 15 largest pharmacies, ranked by estimated 2017 revenues from dispensing specialty pharmaceuticals.

The battle for control of the specialty market accelerated in 2017, though pharmacies owned by pharmacy benefit managers (PBMs) continued to capture most of the market share. The top four specialty pharmacies are all owned or co-owned by a PBM. They accounted for about two-thirds of prescription revenues from pharmacy-dispensed specialty drugs.

Vertical integration M&A has been in the news. But as our data shows, the integration of PBMs and specialty pharmacies has already happened.

2nd Annual MSL Management & Development Summit

2nd Annual MSL Management & Development Summit
May 21-22, 2018 | Philadelphia, PA
www.worldcongress.com/msl

Join senior medical affairs, medical science liaisons (MSLs), regulatory and communication professionals from life sciences organizations at World Congress’ 2nd Annual MSL Management & Development Summit, May 21-22, in Philadelphia for two days of communication, training and compliance best practices to ensure you and your team excel at an operational level as well as a strategic one.

Register with discount code DC200 and save an additional $200 on current early bird rates.

Summit Chairperson, Robert J. Schott, MD, MPH, FACC, Chief Medical Officer, Eli Lilly, believes this event is a MUST ATTEND because it will be “…an opportunity for Medical Affairs professionals to examine and discuss the Medical Affairs value proposition: enhancing patient access to optimal value-based medical treatment in a healthcare system where treatment options are proliferating but resources are more constrained. “

2018 Key Takeaways include:

• Gain insight into re-defined KPIs and metrics and measurements to put in place in order to showcase the value MSLs provide to your organization and the critical role they play in achieving overall business objectives
• Hear regulatory guidance direct from the DOJ about how the False Claims Act affects the work of MSLs
• Develop a playbook on using RWD & RWE to gain a competitive advantage
• Review Merck’s framework and re-defined benchmarks put in place to embrace the changing Medical Affairs role and achieve success
• Learn key factors and challenges to consider when working with an IIT
• Discover strategies to map and segment the right KOLs, foster an in-depth strategic engagement with the MSL force, and leverage digital technologies to reshape the KOL engagement framework

Our expert speaker faculty includes representatives from: AstraZeneca, Pfizer, Novartis, Teva, Abbvie, Bristol-Myers Squibb, Astellas, Merck, GlaxoSmithKline, Eli Lilly and Company, EMD Serono, Bayer, Sanofi Genzyme and many more!

Register with discount code DC200 and save an additional $200 on current early bird 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.

Cigna-Express Scripts: Vertical Integration and PBMs’ Medical-Pharmacy Future

Wow. Yesterday, Cigna announced that it would acquire Express Scripts. See the links below.

Though Cigna was an unexpected acquirer, the deal confirms the importance of pharmacy and medical benefit integration. It also reinforces the role that pharmacy benefit management (PBM) plays in the drug channel. PBMs are now linked closely to the expensive specialty drugs that treat smaller patient populations, not to the primary care blockbusters of yesteryear.

The strategic logic, however, is much more compelling for Express Scripts than it is for Cigna. Perhaps that’s why the stocks reacted so differently yesterday. Express Scripts’ stock closed up 9%, while Cigna’s stock closed down 12%. Better to sell a PBM than buy one?

Below, I provide data about the PBM market, highlight vertical integration between PBMs and insurers, and discuss other industry implications.

Please feel free to leave your own $0.02 below. If you’re shy, you can comment anonymously.

UnitedHealthcare’s Point-of-Sale Rebate Announcement: What’s Next?

Did I just hear the gross-to-net bubble deflate a little bit?

This week, UnitedHealthcare announced that it would provide point-of-sale (POS) rebates to 7 million people enrolled in its fully insured commercial group benefit plans. Click here to read the press release.

UnitedHealthcare’s action is a big win for patients, though not (yet) a black swan event for pharmacies and pharmacy benefit managers (PBMs). As I explain below, it’s a small but significant move that will trigger new questions about drug prices, patients’ out-of-pocket costs, and channel economics.

I’m sure that SpongeBob SquarePants, honorary mascot of the gross-to-net bubble, is ready for change.

As CVS-Aetna Looms, Retail Pharmacy Clinic Growth Stalls

Last week, the Senate Judiciary Committee held an uneventful hearing on the CVS-Aetna merger. The lack of fireworks suggests that the deal is on track for approval later this year. Click here to read the testimony.

Below, I review 2017 clinic developments for the largest retail chains: CVS, Walgreens, Kroger, Target, Walmart, and Rite Aid.

Despite the hype, there was little advancement in retail health at pharmacy locations. For the third consecutive year, the total number of retail clinics has remained essentially flat, at about 2,000 nationwide. CVS Health’s comments at last week’s hearing (highlighted below) would represent a major new direction.

P.S. Today’s post is adapted from Section 1.4.1. of our new 2018 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. Friendly reminder: Discounted pricing for the report ends on Friday!

2nd Annual Manufacturers’ 340B Summit

2nd Annual Manufacturers’ 340B Summit
May 15-16, 2018 | Philadelphia, PA
www.worldcongress.com/manufacturers340B

Join pharmaceutical manufacturers, legal experts, thought leaders, and leading regulatory strategists at World Congress’ 2nd Annual Manufacturers’ 340B Summit, May 16-17, in Philadelphia. This premier event is your first opportunity of 2018 to hear critical updates on finalized regulations and ensure you have the internal strategies in place to effectively execute 340B processes.

How will you benefit from attending?

• Hear directly from your peers on how they are navigating the regulatory and operational challenges including: AstraZeneca, Bristol-Myers Squibb, Eli Lilly, and many more
• The best and brightest legal minds will be here to aid you with navigating nuances associated with Government Programs, including: Alice Vander-Curran, John Shakow, Bill Sarraille, Kristin Hicks, and Donna Lee Yesner just to name a few
• This is your opportunity to meet with key states including Delaware and North Carolina, to discuss state plan amendments and healthcare reform around 340B
• Network with Covered Entities to foster collaboration and brainstorm on best practices

Executives from J&J, EMD Serono, Merck, Sagent Pharmaceuticals, Grifols, Luitpold, Pfizer, Lilly, Incyte are already signed up for this event. Shouldn’t you be there?

Register with discount code DC200 and save an additional $200 on current early bird rates - starting at $1125 for pharmaceutical manufacturers.

Can’t leave the office? Live stream this event from the convenience of your office.

This event, co-located with the 3rd Annual Covered Entities’ 340B Summit, provides comprehensive coverage of the 340B program.

CPE Credits and CLE Credits* are available.

*CLE Pending approval

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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.