How GoodRx Profits from Our Broken Pharmacy Pricing System

On Friday, GoodRx filed its Form S-1 in preparation for going public. Link below.

The company is insanely profitable. Its adjusted net income—earnings before interest, taxes, depreciation, and amortization (EBITDA)—is an astonishing 40%.

Below, I provide my overview of how our crazy drug channel system enables GoodRx’s good fortune. You will admire the GoodRx management team’s business savvy in building a company that lowers out-of-pocket costs for consumers. But you will also wonder whether this business perpetuates a broken pharmacy drug pricing model.

P.S. This article updates and expands on the comments I posted to @DrugChannels on Friday evening.

The ConnectiveRx Non-Commercial Pharmacy: Maximize Your Patient Access Strategy

Today’s guest post comes from Frank Dana, Chief Commercial Officer at ConnectiveRx.

Frank discusses the access challenges that patients face at the point of prescribing. He then describes how ConnectiveRx’s non-commercial pharmacy solution streamlines workflow for healthcare providers and captures useful data for brands.

Click here to download a free information sheet about the ConnectiveRx Careform non-commercial pharmacy.

Read on for Frank’s insights.

Five Surprising Facts About COVID-19 Prescription Trends for Retail and Mail Pharmacies

Somehow, we are nearly two-thirds of the way through 2020. It’s time to explore what’s been happening within the U.S. prescription market and its dispensing channels.

Below, I highlight five data-based observations about the prescription trends we’ve seen so far this year. Our findings span the unexpected resilience of retail pharmacies and a troubling drop in new prescription activity.

I also offer a fresh perspective on recent mail controversies and the abundance of nonsensical statistics in recent news stories. Links to sources appear at the bottom of this article.

While reviewing the data below, please recall our Drug Channels philosophy, courtesy of the late senator Daniel Patrick Moynihan: "Everyone is entitled to his own opinion, but not his own facts."

Improve Compliance and Create Transparency with 340B Rebates (Free webinar)

As regular readers know, I believe the 340B Drug Pricing Program needs to evolve into a more transparent, properly regulated program.

That’s why I’m especially glad to share today’s guest post from Jeremy Docken, Founder and CEO at Kalderos. Jeremy explains the 340B program's use of rebates instead of the more common upfront discounts. He argues that greater adoption of the established 340B rebate process will benefit all stakeholders: covered entities, manufacturers, state Medicaid programs, and others.

To help the industry learn more about 340B rebates, Kalderos is sponsoring a live video webinar: Evolving 340B: Moving from Discounts to Rebates.

I’ll be joining Jeremy during this webinar for an interactive presentation, discussion, and Q&A. This webinar will take place on September 11, 2020 (12:00 p.m. to 1:00 p.m. ET). Registration is free and open to all.

Read on for Jeremy’s insights—and be sure to join us in three weeks!

Regards,
Adam

Hospitals Continue Their Startling Expansion into Specialty Pharmacy

Hospitals and health systems are building a major presence in the specialty pharmacy industry.

As we demonstrate below, nine out of ten large hospitals now operate a specialty pharmacy. Hospitals and other healthcare providers account for one-third of all U.S. accredited specialty pharmacies.

Clinical and general financial motivations are driving hospitals’ DIY specialty pharmacy growth. The enormous profit opportunities from the 340B Drug Pricing Program offer further encouragement for hospitals. In-house specialty pharmacies are also a valuable hedge against the potential loss of contract pharmacies.

Manufacturers would be wise to incorporate hospitals into channel strategy planning for their specialty drugs. At the same time, antitrust regulators should weigh the impact of hospitals’ growing clout over prescribers of specialty drugs and attempts to steer patients to in-house pharmacies.

Using Technology to Improve Medication Access and Impact More Patients

Today’s guest post comes from Julia Phillips, VP of Pharma Accounts and Enablement at CoverMyMeds.

Julia discusses the challenges of both access to therapy and patient adherence, specifically during the COVID-19 pandemic. CoverMyMeds’ technology solutions mitigate these issues and ultimately improve patient outcomes.

To learn more, download the CoverMyMeds case study, Overcoming Medication Access Barriers Caused by Prior Authorization.

Read on for Julia's insights.

Five Top Drugmakers Reveal List vs. Net Price Gaps (Plus: The Trouble With Insulin Prices)

Time for our annual update on pricing at five of the largest pharmaceutical manufacturers—Eli Lilly, Janssen, Merck, Novartis, and Sanofi. You can find links to each company’s data below.

When rebates and discounts were factored in, drug prices declined—or grew slowly—in 2019. Consistent with our previous analyses, rebates and discounts reduced the selling price of brand-name drugs to about half of their list prices.

This growing disparity between list and net prices continues to inflate the gross-to-net bubble. As the companies’ insulin data illustrate below, the bubble raises costs for patients who are not always benefiting from lower net selling prices.

These data also highlight the lunacy of inflationary rebates that are based on a government pricing metric that approximates a brand-name drug's list price. This is what Senator Charles Grassley (R-IA) has proposed in the Prescription Drug Pricing Reduction Act of 2020. Legislation should shield patients from the excesses of the gross-to-net bubble while enhancing the competitive pressures that are reducing drug prices. Is that too much to ask?

Patient Assistance Programs–Weathering COVID-19 and the Unknown

Today’s guest post comes from Rob Brown, VP/GM of RxCrossroads by McKesson Program Pharmacy.

Rob reviews how COVID-19 is changing patient access and adherence to specialty therapies. He then describes specific RxCrossroads’ program changes that are helping patients and providers remain on therapy and navigate this challenging environment.

To learn more, visit www.McKesson.com/RxCrossroads.

Read on for Rob’s insights.

The Gross-to-Net Bubble Hit $175 Billion in 2019: Why Patients Need Rebate Reform

Last Friday’s Executive Orders revived the government’s effort to reform rebates in federal programs. Whether that effort succeeds, today's update reminds us what's still at stake in reforming rebates within the U.S. drug channel.

For 2019, Drug Channels Institute estimates that the gross-to-net bubble—the dollar gap between sales at brand-name drugs' list prices and their sales at net prices after rebates and other reductions—reached $175 billion.

The bubble reflects—and drives—many of patients’ problems and misunderstandings of U.S. drug prices.

However, the political and practical challenges to rebate reform remain daunting. Few people grasp the complex economic interplay of patient out-of-pocket spending, cost-shifting, premiums, and payer incentives.

Despite the pandemic, I remain hopeful that we can help this bubble pop.

NASP 2020 Annual Meeting & Expo Virtual Experience

NASP 2020 Annual Meeting & Expo Virtual Experience
September 14-18, 2020 | Virtual Experience
www.naspmeeting.com/registration

Utilizing innovation and cutting-edge technology, the National Association of Specialty Pharmacy (NASP) is hosting its 2020 Annual Meeting & Expo, September 14-18, as a full-scale virtual conference experience that includes all that attendees have come to expect and love from the live event. The NASP 2020 Annual Meeting & Expo Virtual Experience promises to be the next best thing to being there!

The conference agenda is jam packed and offers something for everyone, whether you are new to the industry or a seasoned expert. Conference highlights include:

• 26 unique educational sessions and panel discussions, organized into four dynamic CORE tracks – Clinical, Operational, Regulatory, and Patient Experience – to help you focus on what is most important to you
• Earn CPE and CLE credits through in-line programming, satellite symposia and pre-conference workshops
• Encore presentations of the popular sessions
• THREE KEYNOTE PRESENTATIONS
• Jim Kelly, former NFL quarterback and Pro Football Hall of Fame member, will share what it means to be “Kelly Tough”
• Former interim chair of the Democratic National Committee (DNC) Donna Brazile and former chairman of the Republican National Committee (RNC) Michael Steele will give a joint keynote presentation on the political landscape and the 2020 election
• Allan Lichtman, a distinguished professor at American University, scholar, and author will share his predictions for the 2020 election

• Five pre-conference workshops: the CSP Exam Preparation Course, Legal Day, Home Infusion Workshop (1/2 day) and our two newest workshops, Technology Day and Hospital/Health Systems Workshop (1/2 day) (additional fee required for workshops)
• The interactive Virtual Exhibit Hall will feature 50+ exhibitors, representing stakeholders from across the specialty pharmacy industry
• The ever-popular Women in Specialty Pharmacy event, featuring motivational keynote speaker Courtney Clark
• CE satellite symposia
• Poster presentations and author discussions
• NASP Annual Meeting Award presentations – including two new awards – the Specialty Pharmacy Service Excellence award and the Strategic Partner of the Year award
• The NASP Ron Bookman Scholarship Awards
• Direct interaction with industry thought leaders and experts through live Q&A and private chats
• Ample networking opportunities
• Virtual wellness initiatives on Tuesday and Wednesday mornings to help you get up and going
• Personalized avatars and MUCH More!

Register today for this must-see virtual experience!

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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.