Drug Channels News Roundup, September 2019: Amazon + 340B, UnitedHealthcare vs. Hospitals, A Naughty 340B Hospital, Generic Drug Prices, and Hotels

Autumn is here! Curl up with your favorite pumpkin-spiced blog and savor these stories plucked from the Drug Channels patch:

• Amazon targets 340B

• UnitedHealthcare shows how providers increase drug prices

• Another 340B hospital behaves badly

• The downsides of deflating generic drug prices

Plus, upscale hotel or hospital: Can you tell the difference? (I couldn’t.)

P.S. Join the nearly 8,200 people who follow @DrugChannels on Twitter. My recent tweets have highlighted Amazon’s formulary, Walmart Health, PBM regulation, uninsured, drug price forecasts, CBO scoring, and more.

CBI’s Strategic Medicare Contracting Forum

CBI’s Strategic Medicare Contracting Forum
November 20-21, 2019 | Alexandria, VA
www.cbinet.com/Medicare

CBI’s Strategic Medicare Contracting Forum, taking place November 20-21 in Alexandria, VA, provides bio/pharmaceutical manufacturers with an update on the seismic changes occurring within Medicare. The expert faculty provides insight into the current state of new and proposed regulations, explores what lies ahead and breaks down how these changes will impact your organization. Join colleagues and expert speakers to stay ahead of the curve on Medicare.

Exclusive Offer for Drug Channels Readers:
Register Now to SAVE $400* using promo code TZJ345

You and your team members will benefit from this opportunity by gaining insights from industry experts on the complex changes occurring within Medicare, walking away with critical perspectives and robust knowledge on key topics.

In-Depth Discussions on High-Impact Issues Include:

• Political and Legislative Trends Impacting Healthcare Coverage and Access – Goldwater Institute
• Discuss State Efforts on Drug Pricing Transparency for 2020 – Mallinckrodt Pharmaceuticals and Bristol-Myers Squibb
• Navigate Legislative Proposals to Lower Drug Pricing – U.S. House of Representatives
• Update on the International Price Index (IPI) Model and the Favored-Nations Clause – Bristol-Myers Squibb and PhRMA
• Strengthening Medicare Part D for Patients – Pfizer Inc.
• Assess the Future of Medicare Part D 2.0 – American Action Forum
• And much more!
  

Visit cbinet.com/Medicare to view the complete speaker and in-depth session lineup, then register using promo code TZJ345 for this exclusive savings of $400 off!

 *Discount expires 11/19/19; cannot be combined or applied to existing registration. 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.

Employers Slowly Warm to Point-of-Sale Rebates—But Must Move Faster for Insulin

Third-party payers' benefit designs remain a significant barrier to addressing drug costs. Many continue to use the ever-growing rebate dollars of the gross-to-net bubble to offset overall plan costs rather than reducing patient’s out-of-pocket spending.

Point-of-sale (POS) rebates are one possible benefit design solution. POS rebates directly share with patients the discounts that PBMs negotiate with manufacturers.

A recent survey of large employers by the National Business Group on Health (NBGH) suggests this change may be coming. The survey found that about one in five large employers is using point-of-sale (POS) rebates in their pharmacy benefit plans. The survey found that a further 40% of employers are considering POS rebates for 2021 and 2022.

Pharmaceuticals are the only part of the U.S. healthcare system where the difference between list and net prices is monetized as rebates and redistributed by intermediaries to payers. But we’ve seen that moving to a world without rebates may not be possible, given the drug channel’s entrenched interests and payers’ established economics.

POS rebates may therefore be our most realistic chance for addressing the drug costs of patients trapped in the gross-to-net bubble. Commercial payers and Congress (for Medicare Part D) should get started ASAP with POS rebates for insulin—a highly rebated and massively distorted therapeutic category.

Half-Off Sale! Five Major Drugmakers Reveal Vast Gross-to-Net Price Gaps—and Why Rebate Reform Is Still Needed

Five of the largest pharmaceutical manufacturers—Eli Lilly, Janssen, Merck, Novartis, and Sanofi—have now publicly reported the 2018 gross and net price changes for their U.S. product portfolios, along with average discounts from list price. You can find links to the reports below.

These reports shed light on the heated political rhetoric and policy proposals that focus on drugs’ list prices. The reality: brand-name drug makers sold their products at half of those list prices. As you will see, the five companies discounted their average list prices by 44% to 55%.

Four of the five companies experienced a year-over-year decrease in average net prices.

This disparity continues to inflate the gross-to-net bubble. More than half of insured patients’ out-of-pocket prescription costs are tied to the list price, not the post-rebate net cost. That’s why rebate reform is needed. I’ll address the state of point-of-sales rebates in my next post.

CBI’s Gross-to-Net Summit – GTN 2019

CBI’s Gross-to-Net Summit – GTN 2019
November 12-14, 2019 | Philadelphia, PA
www.cbinet.com/GTN

With drug pricing reforms looming and discounts/rebates under tremendous scrutiny, it is pivotal that pharmaceutical and biotech manufacturers stay on the forefront of gross-to-net management. The materiality of GTN deductions has increased in today’s competitive marketplace, and the forecasting, analytics, reporting and oversight of the related processes are paramount.

CBI’s GTN Summit, now in the 9th year, is designed to position your organization for success in the end-to-end management of GTN. You can download the complete agenda here.

Visit www.cbinet.com/GTN for further details and to register. Drug Channels readers will save $400 off the standard rate when they use discount code RZT477 and register prior to October 11th.*

The meeting is coming up on November 12-14 at the Hilton Philadelphia at Penn’s Landing and features expert perspectives from companies such as Adamas, Almirall, Amneal, Astellas, Daiichi Sankyo, Deloitte & Touche LLP, GSK, Impax, Incyte, Kala Pharmaceuticals, Lifestar Pharma, Paratek, Sandoz, Sunovion, Teva and more, all ready to share their insights into strategic forecasting, accounting estimates, analytics and finance reporting strategies, specifically for life science companies.

Whether you are a smaller/emerging company entering the market with a new launch or a company with existing products and more GTN experience, we will arm you with the strategies needed to advance in 2020.

Hot Topics on the Agenda Include:

• GTN and Strategic Finance in a Revolutionary Marketplace
• Product Pricing Pressures and Trends within the Payer Marketplace
• Leading Practices in GTN Management that Drive Success and Add Value
• End-to-End GTN Excellence – A Blueprint for Organizational Processes, GTN Estimation, Contracting, Transaction Processing and Reporting
• Right-Fitting a GTN Solution to Effectively and Efficiently Optimize GTN
• Robotics and Automation Realized
• Implementing Salesforce Initiatives to Maximize GTN
• GTN and Revenue Analytics Toolkit – Key Metrics, Standards of Practice and Solutions for Success

Customize Your Experience:

• Choose from Two Pre-Summit Breakout Seminars:
1. Industry 101 Boot Camp
2. Senior Executive Master Class
• Choose from In-Conference Summits:
1. Value-Based Contracting Summit
2. Patient Access Summit
3. Medical Summit and Industry Updates from HHS
4. Inventory Summit
5. Solution Summit
• Choose from Content Tracks:
1. Large Pharma
2. Small/Emerging Biotech
3. Generic Manufacturers

Download the agenda to plan your sessions and prepare to return to the office armed with critical updates and valuable takeaways.

Visit www.cbinet.com/GTN for further details and to register. Drug Channels readers will save $400 off the standard rate when they use code RZT477 and register prior to October 11th.*

CBI will see you there!

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rates, clinic/hospital rates, non-profit rates other offers. 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.

We Shouldn’t Give Up on Biosimilars—And Here Are the Data to Prove it

An interesting spat about biosimilars has emerged between two prominent policy-oriented physicians.

Dr. Peter Bach of Memorial Sloan Kettering and Mark Trusheim of MIT argues that we should “throw in the towel” on biosimilars and begin regulating drug prices.

On the other side, Dr. Scott Gottlieb, a former FDA commissioner, argues that we shouldn’t give up on biosimilars, but instead make structural and legislative changes that would increase competition.

To inform the debate, I share below the latest data on biosimilar adoption. As you will see, adoption rates for the most recently launched products—biosimilars of Neulasta and Epogen—are growing quickly, and prices are declining. These products are penetrating the market much faster than the biosimilars of Remicade did. Substitution rates for the upcoming wave of oncology biosimilars will likely penetrate even faster.

That’s why I concur with Dr. Gottlieb: Regulating prices at this stage of the market’s development is premature. This strategy may save some money in the short run, but it risks destroying a market that is finally beginning to fulfill its promise.

CBI’s Federal Pricing and Reporting

CBI’s Federal Pricing and Reporting
October 22-23, 2019 | Philadelphia, PA
www.cbinet.com/fedpricing

With legislation and regulation changes on the horizon, CBI’s Federal Pricing and Reporting Summit is a must-attend for bio/pharma manufacturers! You'll learn about best practices and future opportunities directly from government officials, including keynotes from the VA, DoD and PHS, and industry experts on pricing models and processes for complying with complicated rules and regulations.

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 GDK898 and register prior to October 4th.

Take a deep dive into the latest innovations and challenges in federal reporting and contracting, especially as issues surrounding transparency and compliance evolve and offer opportunities for growth. The conference agenda covers the below and more:

• Review Federal Supply Schedule (FSS) compliance rules post-Acetris Health case with updated knowledge on transparency expectations
• Examine the possibilities around outcomes-based contracts and other strategies for better compliance and negotiations with the Big Four Federal Programs
• Managing Refunds of 340B Overcharges and Mitigating Compliance Risk
• Hear directly from the VA OIG regarding FSS contract compliance and audit expectations
• Review leading strategies and best practices for coordination with the Department of Defense with new budgeting changes
• Discuss the impact of drug shortages and limited distribution with an eye towards opportunities for growth and collaboration

Download the agenda here and prepare to return to the office armed with critical updates and valuable takeaways.

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 GDK898 and register prior to October 4th.

CBI will see you there!

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rates, clinic/hospital rates, non-profit rates other offers. 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.

Preorder Now: Our 2019–20 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors

On October 8, 2019, Drug Channels Institute will release The 2019–20 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors.

This new tenth edition is the most comprehensive, fact-based tool for understanding and analyzing all aspects of the U.S. pharmaceutical distribution industry. It also contains detailed information about the largest companies: AmerisourceBergen, Cardinal Health, and McKesson.

For the 2019-20 edition, we have added 19 additional exhibits and interesting new material, such as a look at the factors that determine executive compensation at the public wholesalers. I’ll share more details when we release the full report.

CLICK HERE to download a free prepublication draft report overview
(including the Table of Contents and a List of Exhibits)

We are providing you with the opportunity to preorder this thoroughly updated and revised 2019-20 edition at special discounted prices. This means that you can be among the first to access our new report. Those who preorder will receive a download link before October 2.

CLICK HERE to preorder the 2019-20 edition.

You can pay online with all major credit cards (Visa, MasterCard, American Express, and Discover) or via PayPal. Click here to email us if you would like to pay by corporate purchase order or check.

Preorder and launch pricing discounts will be valid through October 18, 2019.

If you have any questions before purchasing a license to the report, please email me. As always, thank you for your support of our work.

P.S. The launch date has been updated from October 2,2019, to October 8, 2019.

The Shakeout Begins: The Fastest-Growing, Private Specialty Pharmacies of 2018

Time for our review of the Inc. 5000 list, the magazine’s annual ranking of the fastest-growing private companies in the United States. The list—based on revenue growth from 2015 to 2018—offers a valuable snapshot of the dynamic specialty pharmacy industry. Today’s article marks our eighth annual analysis of the list.

The specialty pharmacy industry slowdown meant that fewer specialty pharmacies than ever before were eligible for the Inc. 5000 list. We have identified eight specialty pharmacies in this year’s edition. Annual revenues range from $15.5 million to $726.1 million. For the four companies returning from last year’s list, 2018 sales-weighted average revenues grew by 48%.

This year’s Inc. roster signals that the shakeout is beginning. Fewer new specialty pharmacies are starting up, the bigger companies are getting acquired, and market share is concentrating further with the biggest players. Look for other dramatic changes in the coming year.

The specialty pharmacy industry outlook will be a hot topic at next week’s 2019 NASP Annual Meeting & Expo. I’ll be there, so please share your thoughts with me if you see me there.

CBI’s 4th Annual Outcomes-Based Agreements & Innovative Payer Contracting Summit

CBI’s 4th Annual Outcomes-Based Agreements & Innovative Payer Contracting Summit
October 2-3, 2019 | Sheraton University City | Philadelphia, PA
www.cbinet.com/OutcomesContracting

Exclusive Offer for Drug Channels Readers:

Register Now to SAVE $400* using promo code OUT400

The shift from volume to value-based care presents an opportunity for payers and bio/pharma and device manufacturers to explore innovative contracting methods, while demonstrating a commitment to improving clinical outcomes and patient access.

CBI’s 4th Annual Outcomes-Based Agreements and Innovative Payer Contracting Summit, taking place October 2-3 in Philadelphia, is the ideal platform for cross-industry stakeholders to discuss critical strategies on how to navigate the continuous changing policy and regulatory landscape, structure value-based agreements and measure outcomes with real world data. Featured speaking faculty include those representing Titan Spine, Highmark Inc., Sanofi, Avalere Health, Pfizer, Pernix Therapeutics, Curant Health, Ferring Pharmaceuticals and more!

Forward-Thinking Topics of Discussion Include:

• Evaluate how to target the best opportunities for an integrated delivery and financing system
• Understand which therapeutic areas payers are looking into and at what level of investment
• How do you define and derive value from real-world evidence?
• Identify how Real-World Evidence and Health Economics Outcomes Research coalesce into actionable data generation platforms for internal and external collaboration
• Examine how drug leasing models for curative cell and gene therapies [CAR-T] work
• Explore the drug subscription model for direct contracting between employers and life sciences

PLUS! Join us for the pre-conference workshop Change Management for Value-Based Contracting with workshop leaders Nick Merryfield, CEO, Verpora and Omar Ali, Visiting Lecturer, Value-Based Pricing and Innovative Contracting of New Medicines, University of Portsmouth; Former Adviser, NICE.

Download the conference agenda for the complete speaker and session lineup, then register using promo code OUT400 to take advantage of $400 off* the standard rate!

*Discount expires 10/1/19; cannot be combined or applied to existing registration. 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.