Drug Channels News Roundup, June 2021: Amazon's Latest, Patients vs. Accumulators, Generics & Biosimilars, 340B Games, and a Hospital Road trip

Happy 245th birthday, America! As you declare your vaccinated independence, celebrate with these Drug Channels fireworks:

• Amazon’s teeny step toward pharmacy disruption

• How patients view copay accumulators

• My $0.02 on generic and biosimilar trends

• Some hospitals seem to be gaming their 340B eligibility

Plus, tips on effective hospital marketing.

P.S. Please join the nearly 12,000 consumers of my daily commentary and links to neat stuff at @DrugChannels on Twitter. You can also find me on LinkedIn, where I am approaching 19,000 followers.

Gross-to-Net Bubble Update: Net Prices Drop (Again) at Six Top Drugmakers (rerun)

This week, I’m rerunning some popular posts while I prepare for today’s live video webinar at 12:00 p.m. ET: Drug Channels Update: 340B Controversies and Outlook. More than 2,000 people have already registered for the webinar. Will you be there, too?

Click here to see the original post and comments from April 2021.

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

When rebates and discounts were factored in, brand-name drug prices declined—or grew slowly—in 2020. Consistent with our previous analyses, rebates and discounts reduced the selling prices of brand-name drugs to less than half of their list prices. What’s more, net drug prices have declined for the past four years.

Alas, many pharma industry perma-critics refuse to accept that brand-name drug prices are falling—or that they remain the only part of U.S. healthcare where prices have been declining. That’s why they are drug pricing flat earthers (DPFE.) Consider today’s data deluge as my small contribution to making the world a slightly smarter and more fact-based place.

The Top 15 U.S. Pharmacies of 2020: Market Shares and Revenues at the Biggest Companies (rerun)

This week, I’m rerunning some popular posts while I prepare for this Friday’s live video webinar: Drug Channels Update: 340B Controversies and Outlook.

Click here to see the original post and comments from March 2021.

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Next week, Drug Channels Institute will release our 2021 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. It’s the 12th edition of our popular and comprehensive examination of the entire drug pricing, reimbursement, and dispensing system. (You can preorder at special discounted prices.)

The exhibit below—one of 211 in our new report—provides a first look at the 15 largest organizations, ranked by total U.S. prescription dispensing revenues for calendar year 2020.

U.S. prescription dispensing revenues reached a record $465 billion in 2020. The largest players all had bigger slices of the revenue pie, due to the growth at specialty pharmacies and multiple transactions that shifted market share among the vertically integrated companies.

For a sneak peek at the complete report, click here to download a free pre-publication draft overview (including the table of contents and a list of exhibits).

How GoodRx’s Rapid Growth Creates Conflict between PBMs and Payers (rerun)

This week, I’m rerunning some popular posts while I prepare for this Friday’s live video webinar: Drug Channels Update: 340B Controversies and Outlook.

Click here to see the original post and comments from March 2021.

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Pharmacy pricing and benefit design are fundamentally broken.

For proof, look at GoodRx’s 2020 financial results for its discount card business. The company accounted for an estimated $3.4 billion in U.S. prescription revenues—and earned nearly $500 million in fees from PBMs.

Incredibly, three out of four consumers who used GoodRx already had commercial, Medicare, or Medicaid insurance. This means that someone—the consumer, their employer, and/or the government—paid insurance premiums for a pharmacy benefit managed by a PBM. Yet it was still worthwhile for people to bypass their plan’s out-of-pocket costs and PBM network rates in favor of a different PBM’s rates. As I explain below, such arbitrage creates potent conflicts between PBMs and their plan sponsor clients.

Don’t blame GoodRx for this mess. I give it credit for helping consumers navigate a crazy system that incentivizes people to bypass their own insurance plans. But it’s hard not to dislike a system that enables these games. Read on and let me know what you think.

The Top Pharmacy Benefit Managers of 2020: Vertical Integration Drives Consolidation (rerun)

This week, I’m rerunning some popular posts while I prepare for this Friday’s live video webinar: Drug Channels Update: 340B Controversies and Outlook.

Click here to see the original post and comments from April 2021.

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The drug channel is consolidating, both vertically and horizontally.

For evidence, look no further than Drug Channels Institute's estimates of pharmacy benefit manager (PBM) market share, which are shown in the chart below. For 2020, DCI estimates that the three biggest PBMs accounted for more than three-quarters of total equivalent prescription claims.

To help you make sense of recent market changes, I also include a brief video explaining how various transactions and partnerships have concentrated and shifted PBM share among the vertically integrated companies. The video is excerpted from my recent Patients, Payers, and PBMs webinar.

Depending on your role in the drug channel, you may or may not find these data terrifying.

Informa Connect’s IDN & Bio/Pharma Partnering Summit

Informa Connect’s IDN & Bio/Pharma Partnering Summit
August 17-19, 2021 | Virtual Event
www.informaconnect.com/IDN

As part of an evolving healthcare environment, the life science industry is continually challenged to be effective in how it engages health system partners. It is critical that discussions evolve to meet the needs of today and also where healthcare is headed tomorrow.

Visit www.informaconnect.com/IDN for more information. Drug Channels subscribers will save 10% off the current registration rate when they use promo code 21IDNDC10*

To address the challenges and opportunities ahead, join a distinguished group of industry pioneers at Informa Connect’s IDN & Bio/Pharma Partnering Summit—an important event for learning how to best meet the needs of these evolving networks for better patient outcomes.

Diverse Perspectives from Industry Pioneers:

• Timothy Paine, Vice President, Pharma Strategy & Relations, Fairview Pharmacy Services
• Kim Coppom, Executive Director, Managed Markets, Relypsa
• Gerard Taglianetti, Market Access Strategy & Analytics, Pfizer Inc
• Chip Kurt, Senior Director, Corporate Accounts; Specialty Pharmacy IDNs and GPOs, CSL Behring
• Richard Stefanacci, DO, MGH, MBA, AGSF, CMD, Medical Director, Population Health, Jefferson College of Population Health
• Matthew Malchowski, PharmD, BCPS, System Director, Population Health & Ambulatory Care, Ochsner Health Pharmacy
• Elizabeth Cherry, Program Director, Trade Relations, Vanderbilt Specialty Pharmacy
• Michael Gannon, PharmD, CSP, Assistant Director, Specialty Pharmacy Services, Ambulatory Pharmacy Services, University of Illinois Health
• Ryan Haumschild, PharmD., MS, MBA, Director of Pharmacy Services, Emory Healthcare and Winship Cancer Institute
• Sophia Humphreys, PharmD., MHA, Director, System Pharmacy Clinical Services, Providence St. Joseph Health
• Ameet Wattamwar, PharmD., Director of Pharmacy, Specialty Pharmacy Program, NYU Langone Health System
• And more!

High-Impact Topics Driving the Content:

• State of the Healthcare Industry—Impactful Policy Changes and COVID-19 Implications
• Best Practices in Working with Payers and PBMs
• Insights from Leaders in Population Health
• IDN CEO Fireside Chat: Lessons from Leadership – Priorities and New Directions to Adapt, Align and Advance the Business Forward
• [Case Study] Innovative Ways to Pay for High Cost Drugs
• The Next Frontier for IDNs: True Integration of Accountability
• The Role and Utility of Data and Predictive Analytics to Identify and Service Patient Populations
• And More!

Visit www.informaconnect.com/IDN for more information. Drug Channels subscribers will save 10% off the current registration rate when they use promo code 21IDNDC10*

*Applies to current rates only and may not be combined with other offers, category rates, promotions or applied to an existing registration. Offer not valid on workshop only or academic/non-profit 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.

EXCLUSIVE: The 340B Program Soared to $38 Billion in 2020—Up 27% vs. 2019

Despite what you may have heard, the 340B Drug Pricing Program continues to thrive.

Discounted purchases under the program reached at least $38 billion in 2020. That figure is an astonishing 27% higher than its 2019 counterpart—and more than quadruple the value of discounted purchases in 2014.

Drug Channels has exclusively obtained the 2020 amount from the Health Resources and Services Administration (HRSA). We received it by filing a Freedom of Information Act (FOIA) request that was just answered yesterday. You can read our FOIA letter below, along with more details on the program's growth.

The 340B program’s size now exceeds the Medicaid program’s outpatient drug sales—and accounts for nearly 20% of the total rebates and discounts that manufacturers provide for brand-name drugs. Alas, many elements of the 340B program—including its controversial contract pharmacy component—lack a comprehensive regulatory infrastructure.

I’ll help you understand what these new figures mean during DCI’s upcoming live video webinar, Drug Channels Update: 340B Controversies and Outlook, on June 25, 2021. Click here to learn more and sign up.

Exclusive: 340B Continues Its Unbridled Takeover of Pharmacies and PBMs

Drug Channels Institute’s latest review of contract pharmacies in the 340B Drug Pricing Program reveals that an astonishing 30,000 pharmacy locations—half of the entire U.S. pharmacy industry—now act as contract pharmacies for the hospitals and other healthcare providers that participate in the 340B program.

Over the past 12 months, the number of pharmacies in the program has grown by more than 2,000 locations.

As you will see below, multi-billion-dollar, for-profit, publicly traded pharmacy chains and PBMs—Walgreens, CVS Health, Express Scripts, OptumRx, and Walmart—dominate 340B contract pharmacy relationships with covered entities. 

You can keep your dogecoin and your stonks. The real money lies in the still-booming 340B contract pharmacy business.

I’ll provide more details and crucial context during DCI’s upcoming June 25 live video webinar, Drug Channels Update: 340B Controversies and Outlook. Click here to learn more and sign up.

Informa Connect’s 18th Life Sciences Accounting & Reporting Congress

Informa Connect’s 18th Life Sciences Accounting & Reporting Congress
August 10-12, 2021| Virtual Event
www.informaconnect.com/accounting

The Life Sciences Accounting & Reporting Congress Mid-Year Critical Update provides three comprehensive days of CPE accredited content, showcasing insights and expertise from top finance, accounting, and business leaders from across the life sciences sector. And, attendees are invited to local/regional in-person events for valuable networking and peer-to-peer reconnecting.

Visit www.informaconnect.com/accounting-reporting-congress for further details and to register. Drug Channels readers will save 10% off the current rate when they use promo code 21DRCH10 and register prior to July 9th.*

Join us on August 10-12, 2021 as we delve into complex technical accounting hot topics, high-impact industry trends, deal-making, capital markets forecasts, global risks, technology innovations and more. Expert Keynotes, In-Depth Workshops, Small Group Roundtables and Live Q&A Opportunities position attendees to advance career and company success.

Here’s a snapshot of what to expect:

• CFO Industry Insights Panel on Forces of Change: R&D, Supply Chain, Digital Transformation and Positioning for Future Success
• Technical Accounting Deep-Dive, with Benchmarking and Financial Reporting Best Practices
• SEC and Regulatory Corporate Finance Update
• Governance Considerations, Audit Committee Hot Topics and Board Composition
• Leadership Panel on Controllership Innovation
• Wall Street Discussion on Impactful Deals, Investment Trends and Breakthroughs Impacting the Sector
• Workshops on:
• IPO and SPAC Roadmaps
• Product Launch
• Corporate Tax and Transfer Pricing
• ESG Metrics and Disclosures
• Biotech Acceleration Strategies and Gross-to-Net
• Valuation Models
• AI and RPA Applied in Finance

Visit www.informaconnect.com/accounting-reporting-congress for further details and to register. Drug Channels readers will save 10% off the current rate when they use promo code 21DRCH10 and register prior to July 9th.*

*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.

The Top Five Considerations When Choosing a Patient Solutions Provider

Today’s guest post comes from Jan Nielsen, Division President of AssistRx Patient Solutions.

Jan provides five criteria that manufacturers can use when evaluating the capabilities of a Patient Solutions Provider (PSP), a.k.a. a hub vendor.

To learn more, register for AssistRx's new, four-part webinar series: “Leading the Market in a Rapidly Changing Patient Solutions Landscape.”

Read on for Jan’s insights.

Pharmacist Job Market in 2020: Hospital Employment Up, Retail Salaries Down

The Bureau of Labor Statistics (BLS) has recently released its employment and salary data for 2020. That means it’s time to update Drug Channels Institute’s (DCI) annual analysis of pharmacist salaries and employment.

We have found that the share of pharmacists who work at hospitals reached a new high. What’s more, average base salaries for retail pharmacists have dropped, while salaries have risen for pharmacists employed by hospitals, physician offices, and other non-retail settings. 

A word of caution: These data were collected during the peak of last year’s pandemic shutdowns. I suspect that 2020 will turn out to have been a much more challenging year for retail-employed pharmacists.

The 340B Drug pricing Program is a crucial topic for pharmacists. For a deep dive, join me for DCI’s upcoming live video webinar, Drug Channels Update: 340B Controversies and Outlook , on June 25, 2021, from 12:00 p.m. to 1:30 p.m. ET. CLICK HERE TO LEARN MORE AND SIGN UP.

National Association of Specialty Pharmacy (NASP) 2021 Annual Meeting & Expo

National Association of Specialty Pharmacy (NASP) 2021 Annual Meeting & Expo
September 27-30, 2021 | Marriott Marquis, Washington, D.C.
www.nasp.com/annualmeeting
Early Bird Registration Discount Ends June 30.

The National Association of Specialty Pharmacy (NASP) returns to Washington, D.C. on September 27-30 for the National Association of Specialty Pharmacy (NASP) 2021 Annual Meeting & Expo. The 2021 event will welcome attendees to a new conference venue—the beautiful and modern Marriott Marquis, located in the heart of downtown Washington, D.C.

Register today for this premier industry event! Discounted registration rates are available through June 30.

The NASP 2021 Annual Meeting & Expo will challenge and inspire attendees, sponsors, and exhibitors to Reimagine What’s Possible. We will focus on looking at our world differently—reimagining our teams, families, patients, business, the patient journey and ourselves. We will appreciate who we are at our best and understand the power of our presence. Join us to engage in interactive learning, share best practices, explore potential partnerships and synergies, and foster connectivity in a personalized, intimate setting.

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:

• Up to 15 hours of unique CE accredited educational sessions and panel discussions, organized into four dynamic tracks to help you focus on what is most important to you
• Encore presentations of the most popular sessions
• THREE KEYNOTE PRESENTATIONS
• Justin Patton, executive coach, will lead the conference in challenging attendees to Reimagine What’s Possible.
• Monica Pearson, distinguished journalist and humanitarian, and the first woman and first minority to anchor the daily evening news in Atlanta, Georgia.
• Montel Williams, an Emmy Award winner, decorated former naval officer, inspirational speaker, author, entrepreneur, multiple sclerosis patient, and advocate for patients worldwide.
• Four pre-conference workshops: the CSP Exam Preparation Course, Legal Day, Technology Day and Hospital/Health Systems Workshop (additional fee required for workshops)
• Dynamic Exhibit Hall featuring exhibitors representing stakeholders from across the specialty pharmacy industry
• The ever-popular Women in Specialty Pharmacy Luncheon, featuring motivational keynote speaker Amelia Rose Earhart
• CE satellite symposia
• Poster presentations and author discussions
• NASP Annual Meeting Awards presentations—including three new awards—the Caregiver of the Year award, the Pharmacist of the Year award, and the Pharmacy Technician of the Year award
• The NASP Ron Bookman Scholarship Awards
• Direct interaction with industry thought leaders and experts
• Ample networking opportunities
• Odyssey Dinner Cruise, an upscale dining and network experience along the Potomac River (additional fee required)

The safety of our guests is NASP’s top priority. We continue to work with federal, state, and local health officials to strictly adhere to current rules and requirements and do everything possible to protect the health and safety of all attendees.

Register today for this important industry event! Discounted registration rates are available through June 30.

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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.

Technology and Human Care Combine to Support the Medication Access Journey

Today’s guest post comes from Nathan Mott, President of CoverMyMeds.

Nathan discusses how technology can augment human expertise to help people access, afford, and adhere to their medications.

To learn more, download CoverMyMeds’ new solutions overview: Technology Helps Drive Medication Access, Adherence and Affordability.

Read on for Nathan’s insights.

How CVS Health Drives McKesson’s Distribution Financials

McKesson recently released the annual report for its 2021 fiscal year, which ended on March 31.

The report provides fresh insights about the company’s business with CVS Health, its largest customer. As you will see, CVS purchased $50 billion in pharmaceuticals from McKesson—more than triple the figure from 10 years ago.

The report also reveals that CVS Health paid McKesson in about 24 days, providing the wholesaler with an often-overlooked cash flow benefit. In fact, McKesson’s overall business had a negative cash conversion cycle. That’s essential for a low margin distribution business.

Below, I delve into the financials behind these two elements of the McKesson-CVS relationship. You’ll understand why CVS is McKesson’s worst best friend.

Join me for DCI’s upcoming live video webinar, Drug Channels Update: 340B Controversies and Outlook , on June 25, 2021, from 12:00 p.m. to 1:30 p.m. ET. CLICK HERE TO LEARN MORE AND SIGN UP.

NEW: Drug Channels Update: 340B Controversies and Outlook (live video webinar)

Dr. Adam J. Fein, CEO of Drug Channels Institute (DCI) and the author of Drug Channels, invites you to join him for his latest live video webinar:

Drug Channels Update: 340B Controversies and Outlook.

Friday, June 25, 2021 (12:00 p.m. to 1:30 p.m. ET)

This event is part of The Drug Channels 2021 Quarterly Video Webinar Series. Anyone who registered for the entire series will receive an email with a link to access the June event.

WHAT YOU WILL LEARN

Dr. Fein will help you and your team stay on top of the current trends and market developments. During the June 25 event, Dr. Fein will focus on the latest developments regarding contract pharmacies in the 340B Drug Pricing Program, including:

• Evolution of the 340B program

• Our 2021 analysis of the 340B contract pharmacy market

• The flow of funds in a 340B contract pharmacy network

• How 340B impacts payers, plan sponsors, and PBMs

• How 340B disrupts manufacturer-PBM rebates

• Current program administration controversies

• The latest manufacturer actions and covered entity responses

• How to make sense of ongoing litigation

• Policy options and actions

• Possible resolutions to the contract pharmacy conflict

• And more!

PLUS: During the webinar, Dr. Fein will give participants an opportunity to unmute themselves and ask live questions. The webinar will be 90 minutes to accommodate audience questions.

The 340B Drug Pricing Program remains highly controversial. As always, Dr. Fein will clearly distinguish his opinions and interpretations from the objective facts and data.

Read on for full details on pricing and registration. You can also watch a brief video invitation.