Medicaid and Government Pricing Congress

Medicaid and Government Pricing Congress
December 14-17, 2020 | Virtual
www.informaconnect/medicaidgov

Register Today and be sure to use promo code MDCDCBG to save $300*

With drug pricing and benefit coverage top of mind for many Americans, coupled with a volatile election and overall healthcare landscape, the stakes are incredibly high for bio/pharma manufacturers. Staying on the pulse of industry trends, policies and changing regulations has never been more crucial. 

The 22nd Annual Medicaid and GP Congress delivers critical updates and industry best practices to effectively contract, report and comply with state and federal healthcare programs. Gain timely, up-to-the-minute insights on:

• CMS’ Proposed Rule
• 340B Program
• State Price Transparency
• Value-Based Contracts
• Dispute Resolution
• Bona Fide Service Fees
• Class of Trade
• FSS Contracts
• State Invoicing
• Policy Initiatives
• Election Implications
• And many other critical topics. Download the complete agenda

The robust, fully virtual agenda features 30+ CPE and CLE-accredited sessions and 50+ speakers representing leading bio/pharma companies, government organizations and law firms from Aimmune, Alvogen, AMAG, Apexus, Arent Fox, Arnold & Porter, Astellas, AstraZeneca, BMS, CMS, Covington & Burling, CSL Behring, Daiichi Sankyo, Eisai, Exelixis, Gilead, Granard, Hogan Lovells, Indivior, J&J, King & Spalding, Louisiana Department of Health, Maryland Department of Health, OIG, Oklahoma Health Care Authority, Pfizer, Regeneron, Sandoz, Sidley Austin, UCB and many more.

Register Today and be sure to use promo code MDCDCBG to save $300*

*Discount applies to standard rates only and may not be combined with other offers, categories, promotions or applied to an existing registration. Offer not valid on non-profit/government registrations.

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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, November 2020: Rebate Rule Redux, MFN (maybe), Amazon’s Pharmacy Customers, Drug Spending, GPO M&A, and RxTrace

Happy Thanksgiving, everyone! Before you stretch your stomach, stretch your mind with this extra-stuffed helping of food for thought. In this issue:

• Rebate rule redux

• Most Favored Nation and healthcare benchmarking

• Amazon’s pharmacy customer opportunity

• Drug spending realities updated

• GPO consolidation

Plus, I congratulate Dirk Rodgers of RxTrace on his retirement.

P.S. Join the more than 10,600 followers of my curated links published on @DrugChannels on Twitter. My recent tweets have highlighted: doctors against step therapy, distribution of COVID-19 therapies, biosimilar savings, copay accumulator data, prospects for smaller PBMs, the new transparency rule, specialty pharmacy profit metrics, the future of oncology practices, and an update on Diplomat founder Phil Hagerman. You can also join my more than 13,500 followers on LinkedIn.

Informa Connect’s 16th Annual Commercial Contracts & Chargebacks

Informa Connect’s 16th Annual Commercial Contracts & Chargebacks
December 17-18, 2020 | Virtual Event
informaconnect.com/contracts-chargebacks

Excusive Offer for Drug Channels Readers

Register Now

To SAVE $300* using promo code CHR300

Informa Connect’s 16th Annual Commercial Contracts & Chargebacks, taking place virtually December 17-18, arms the industry with strategic approaches to improve contract operations, navigate class of trade complexities, streamline membership management and reduce revenue leakage to improve chargeback efficiency and the bottom line. Dynamic conference features include:

• Two Days of Live Content, Audience Polling, Speaker Q&As and Interactive Discussions
• View Our Library of On-Demand Content at Your Leisure, Available for 30 Days After the End of the Conference
• High Impact Topics Transforming the Market Include:
• Membership Eligibility and Classification — Tolmar Pharmaceuticals
• Strategic Contracting Playbook — Pfizer Inc.
• Expert Manufacturer/Trading Partner Exchange — McKesson
• Class of Trade Navigation — Health Industry Business Communications Council (HIBCC)
• EDI Think Tank — FFF Enterprises
• Scorecarding and Metrics — Zydus Pharmaceuticals USA
• Next-Gen Technology — Chronicled

Drug Channels readers are eligible for an exclusive savings of $300 off* the standard rate by using promo code CHR300, so download the complete conference agenda and reserve your seat today!

*Expires 12/16/2020; applies to standard rate only and may not be combined or applied to existing registrations; 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.

Disruption Delayed: Making Sense of Amazon’s Latest Pharmacy Moves

Amazon is getting more serious about pharmacy. ICYMI: Introducing Amazon Pharmacy: Prescription Medications Delivered.

This announcement is much less disruptive than it appears to be. Amazon is copying the GoodRx discount card model—including GoodRx’s partnership with Express Scripts. At the same time, Amazon is launching a mail pharmacy that will accept insurance and be in PBM pharmacy networks.

Amazon’s actions are another negative headwind for retail pharmacies, but not a fatal blow to the system. Perhaps Amazon will one day become a true disrupter. For now, Amazon is choosing to join the drug channel, not fundamentally change it.

Copay Accumulator and Maximizer Update: Adoption Accelerating As Pushback Grows

Almost three years ago, I warned about the emerging trend of copay accumulators and outlined the costly consequences for patients.

I’m sad to report that the latest data show a startling acceleration in the adoption of copay accumulator adjustment and the closely related copay maximizer. 

Within the next year, more than 80% of commercially insured beneficiaries will be in plans with these benefit designs—although not all plan sponsors will have fully implemented them.

Accumulators, maximizers, and copay support programs are inefficient solutions to flaws in the U.S. drug channel system. That’s why patient groups and provider organizations are pushing back against them. 

Alas, our divided Congress seems unlikely to provide any relief. Read on for the full details.

SaveonSP's Copay Maximizer Failed Me: A Patient's Perspective

Today’s guest post comes from Anndi McAfee, a successful voice over artist. Check out her impressive IMDB credits. Your kids have definitely heard her voice.

Anndi also suffers from a rare disease and requires treatment with an orphan drug. Below, she shares her troubling experiences with SaveonSP, the mysterious company behind Express Scripts’ copay maximizer program. (ICYMI, I profiled SaveonSP in May.)

Anndi’s story illustrates how a patient taking a specialty drug can lose out, even as others—her health plan, its PBM, and a sketchy intermediary—profit from a manufacturer’s patient support funds. I suspect that very few patients with similarly complex diseases are as savvy and persistent as Anndi has been.

Read on for her disturbing story. You can reach Anndi via her professional page or on LinkedIn.

Employer Pharmacy Benefits 2020: Some Good Coinsurance News, But Many Still Face Prescription List Prices

It’s time for our annual deep dive into employer-sponsored coverage for prescription drugs.

Consistent with our previous analyses, coinsurance and deductibles remain common for specialty and fourth-tier drugs, leaving patients exposed to the undiscounted list price of their prescriptions. 

However, there is also some good news: The use of copayments—instead of coinsurance—grew for people with both traditional and high-deductible plans. Perhaps nothing ever lasts forever.

Read on for my overview of cost sharing tier structure, copayment vs. coinsurance, and average copayments and coinsurance rates—along with our annual Drug Channels tiers/tears puns. 

In a follow-up post, I’ll examine how today’s benefit designs continue to challenge—and confuse—patients.

16th Annual Life Sciences Trade and Channel Strategies

16th Annual Life Sciences Trade and Channel Strategies
December 1-3, 2020 | Virtual Event
www.informaconnect.com/trade-channel

Navigating the distribution and contracting landscape is a complex endeavor. That’s why the life science industry’s top experts will come together virtually on December 1-3 at Trade and Channel 2020. They’ll guide you through new and innovative ways to optimize channel strategies to reach patients in need and provide the necessary services based on product type, site of care and reimbursement. You’ll benefit from 3 days of live content, as well as a robust library of on-demand content – with all live and on-demand sessions available for viewing for 30 days after the event concludes.

Visit www.informaconnect.com/trade-channel for further details and to register. Drug Channels readers will save $200 off the standard rate when they use code KTP933 and register prior to November 20th.*

You can download the complete agenda here.

Gain Critical Insight from Industry Trailblazers During a Time of Transformative Change – Speakers will include:

• Bill Roth, Founding Partner, Blue Fin Group
• Rob Osborne, Vice President Pharma Trade Relations, Express Scripts, Accredo, CuraScript SD
• Ray Tancredi, RPh, MBA, CSP, Divisional Vice President, Specialty Pharmacy Development & Brand Rx/Vaccine Purchasing, Walgreens
• Eric D. Hargan, Deputy Secretary, Department of Health and Human Services (HHS)
• Natalie Bedford, Executive Director, National Channel Account Team, AstraZeneca
• Timothy Paine, Vice President, Pharma Strategy & Relations, Fairview Pharmacy Services
• Dave MacLeod, Head of Patient Services and Specialty Pharmacy Operations, Amylyx Pharmaceuticals
• Brent Warner, Vice President, Gene Therapy, Novartis Pharmaceuticals
• Liz Minko, US Distribution and Channel Strategy, argenx US, Inc.
• Stuart Parker, Senior Director, Trade Relations, Mayne Pharma
• And more!

Live Keynotes Delivering Timely Updates and Insights on High-Impact Topics, Including:

• Critical Update – Market Dynamics Drastically Impacting the Channel
• Navigate the Evolving State of Regulatory Reform Driving Innovation and Access
• Emerging and Future Trends in Channel Strategy, Distribution and 3PL
• Pharmacy Spotlight – Innovative Models Redesigning Care in 2020 and Beyond

Download the agenda to plan your sessions and wrap up your week armed with critical updates and valuable takeaways.

Visit www.informaconnect.com/trade-channel for further details and to register. Drug Channels readers will save $200 off the standard rate when they use code KTP933 and register prior to November 20th.*

Informa-Connect 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 or 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.

What I told Congress about the 340B Program

ICYMI, House Energy and Commerce Committee Republican Leader Greg Walden (R-OR) and Senate Health, Education, Labor and Pensions (HELP) Committee Chairman Lamar Alexander (R-TN) recently asked for input on how to improve the 340B Drug Pricing Program. Comments were due last Friday (October 30).

Your friendly neighborhood blogger submitted an 11-page letter, which you can read below. I shared my $0.02 on the overall market, explained channel distortions from 340B contract pharmacies, and offered some policy recommendations.

For your reference, I also include links to published comments from the American Hospital Association and the Pharmaceutical Research and Manufacturers of America.

The new Congress has an ambitious agenda. Let’s hope modernizing 340B gets on the do list.

Independent Pharmacies Learn to Live With (and Without) Preferred Networks for 2021

Last week, I highlighted the largest pharmacy chains that will participate in the 2021 Medicare Part D prescription drug plans (PDP).

Today, I examine how independent pharmacies will participate as preferred cost sharing pharmacies via the pharmacy services administrative organizations (PSAOs) that represent these pharmacies in negotiations with plans.

As you will see here, some PSAOs are rejecting preferred networks, while others are participating cautiously. There are notable differences in strategy between the PSAOs operated by AmerisourceBergen and McKesson. Details and a handy scorecard below.

The Centers for Medicare & Medicaid Services (CMS) continues to take a hands-off approach to pharmacy networks. One notable consequence: Independent pharmacies have formed their own Part D plan, in which only independents are preferred. We’ll know in January if the new plan is sitting pretty—or on a bed of nails.

Rare Disease Innovation and Partnering Summit 2020

Rare Disease Innovation and Partnering Summit 2020
December 1-4, 2020 | Virtual Event
www.raredisease-summit.com

This December, tackle challenges faced in ensuring patient access and furthering therapeutic and curative progress at the Rare Disease Innovation & Partnering Summit. Held in a 100% virtual format, this four-day meeting convenes diverse stakeholders to discuss opportunities for continued innovation, advancement of impactful patient advocacy and acceleration of commercial strategy success. Benefit from live sessions, keynotes and panels, plus a library of on-demand sessions ready to watch as your schedule allows. All sessions are available for viewing for 30 days post event.

Visit www.raredisease-summit.com for further details and to register. Drug Channels readers will save $200 off the standard rate when they use code ZZX688 and register prior to November 13th.*

You can download the complete agenda here.

Unparalleled Insights, Impactful Keynotes and Luminary Addresses from Industry Trailblazers, including:

• Patient Perspective - Chasing My Cure
  David Fajgenbaum, M.D., Co-founder and Executive Director, CASTLEMAN DISEASE COLLABORATIVE NETWORK

• Technology Spotlight - Using AI to Speed Discovery and New Treatments
  Tim Guilliams, Founder, CEO, HEALX LTD

• Scientific Luminary - Targeting the Morphological Impact of Disease
  Marzieh Haghighi, PH.D., Postdoctoral Associate, BROAD INSTITUTE OF HARVARD MIT

• Novel Funding - Accelerate Rare Disease Therapeutic Development
  Andrew Lo, Ph.D., Charles E. and Susan T. Harris Professor, MIT SLOAN SCHOOL OF MANAGEMENT

• FDA Address – Navigating Regulatory Pathways and Evidentiary Requirements
  Kerry Jo Lee, MD, Acting Associate Director for Rare Diseases, FDA/CDER/OND

PLUS! Hear from the most innovative industry organizations, including Acceleron, Alexion, Alkeus Pharmaceuticals, Argenx, Biogen, Castle Creek Biosciences, Centogene, Collaborations Pharmaceuticals, Foundation Medicine, Perseo Pharma, Relypsa, Sanofi Genzyme and more.

Customize Your Virtual Experience with Powerful Program Offerings:

• Two Strategic, One-Day Forums:
• Global Drug Development and Access
• Patient Engagement, Advocacy and Alliance Management

• Four Targeted Track Offerings:
• Patient-Driven Progress
• Reimbursement, Value and Access
• New Launch and Commercialization
• Partnering, Investment and Portfolio Strategy

Download the agenda to plan your sessions and wrap up your week armed with critical updates and valuable takeaways.

Visit www.raredisease-summit.com for further details and to register. Drug Channels readers will save $200 off the standard rate when they use code ZZX688 and register prior to November 13th.*

Informa Connect-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/advocacy rates or 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.