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.

---

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.

---

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.

---

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

---

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.

---

The content of Sponsored Posts does not necessarily reflect the views of Pembroke Consulting, Inc., Drug Channels, or any of its employees.