Drug Channels News Roundup, December 2021: CAR-T Profits, UM Boom, Health Plans vs. Experts, Confused Physicians, and Health Insurance Explained

Happy New Year, everyone! We made it through a challenging 2021. Ring in 2022 with these noisemakers from the Drug Channels party bag:

• Hospitals earn incredible markups on CAR-T therapies

• Utilization management booms

• Health plans often ignore clinical guidelines

• Benefit designs flummox physicians

Plus: an awesomely concise summary of U.S. health insurance.

P.S. Please join the more than 13,100 consumers of my daily commentary and links to neat stuff at @DrugChannels on Twitter. You can also find my daily posts on LinkedIn, where I have more than 22,000 followers.

How and Why I Was Overcharged by Penn Medicine and My Blue Cross Health Plan: A True Story (rerun)

This week, I’m rerunning some popular posts while I prepare for today's live video webinar: Drug Channels Outlook 2022. See you soon!

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

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Sometimes, a little knowledge can be a bad thing.

I want to share with you, dear reader, the strange but true tale of my recent foray into the wonderful world of hospital price transparency for routine lab services.

I discovered—with great effort—that the rates my health plan negotiated with the largest local health system in Philadelphia were greater than the self-pay, cash price. Ultimately, my baffling and unexpected out-of-network bill required me to pay more out-of-pocket than the total cash price.

This tale neatly summarizes why so many people hate our healthcare system—and why the average patient will have trouble benefiting from transparency regulations.

How CVS Health Drives Cardinal Health’s Distribution Financials (rerun)

This week, I’m rerunning some popular posts while I prepare for tomorrow's live video webinar: Drug Channels Outlook 2022. Hope you can join me!

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

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Cardinal Health recently released the annual report for its 2021 fiscal year, which ended on June 30. See the links below.

Today, I delve into the financials behind Cardinal’s relationship with its largest customer, CVS Health. In Cardinal’s 2021 fiscal year, CVS purchased more than $42 billion in pharmaceuticals from the wholesaler—about double the figure from 10 years ago. The new report also reveals that CVS Health’s payment terms with Cardinal give the wholesaler an often-overlooked cash flow benefit.

I also compare Cardinal’s relationship with CVS to McKesson’s relationship with CVS. The two wholesalers sell more than $90 billion in pharmaceuticals to CVS Health—making it the largest U.S. drug purchaser.

Like McKesson, however, Cardinal Health has discovered that CVS is its worst best friend.

A Video History of Pharmacies and Prescription Prices: From Soda Fountains to GoodRx (rerun)

This week, I’m rerunning some popular posts while I prepare for this Friday’s live video webinar: Drug Channels Outlook 2022.

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

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Charlotte Morabito at CNBC has put together “Why Pharmacies Overcharge,” an entertaining and provocative video on the pharmacy industry and its generic prescription pricing.

It’s definitely worth your time. I especially enjoyed the cool visualizations of Drug Channels Institute’s industry data. Links below.

The video covers the history of pharmacy, from the “Soda Fountain Era” to “Lick, Stick, and Pour” to the rise of PBMs and GoodRx. 

It also includes a wide variety of expert perspectives, including $0.02 from your friendly neighborhood blogger at Drug Channels. See the list below.

Grab some popcorn and enjoy the show!

PBMs and Drug Spending in 2020: Data from CVS Health (sort of), Express Scripts, Navitus, and WellDyne (rerun)

This week, I’m rerunning some popular posts while I prepare for this Friday’s live video webinar: Drug Channels Outlook 2022.

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

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Since 2012, Drug Channels has examined commercial drug spending using the annual trend reports published by the largest PBMs.

This year, we review 2020 data on commercial plan sponsor clients of CVS Health and Express Scripts along with two smaller PBMs—Navitus and WellDyne. As you will see below, plan sponsors experienced another year of single-digit growth in overall pharmacy benefit drug spending.

For specialty drugs, utilization—more people taking more prescriptions—remained the driving force behind this higher spending. Specialty drug costs grew slowly—or even declined.

I’m sad to report that this year’s analysis is skimpier than usual. CVS Health has published only a bare bones summary, while Prime Therapeutics, MedImpact, and other large PBMs have stopped publishing trend reports. I document this disappointing state of affairs below.

Read on as I spread all the the k-poppin' details.

Why GoodRx—Not Amazon—May Be the True PBM Disrupter (rerun)

This week, I’m rerunning some popular posts while I prepare for this Friday’s live video webinar: Drug Channels Outlook 2022.

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

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The generic prescription market is being disrupted—but not by the big, bad spaceman from Seattle.

Instead, consider how GoodRx is affecting patients, payers, and PBMs.

Below I summarize the latest financial results for GoodRx’s discount card business. We estimate that the company accounted for $4.1 billion in U.S. prescription revenues for 2021. That’s about six times its 2016 figure.

GoodRx and its discount card competitors profit by incentivizing people to bypass their own insurance plans. Meanwhile, our crazy pharmacy pricing system deters pharmacies from pursuing consumer-driven pricing and PBMs from undercutting their own clients.

Consequently, discount cards could become the force that upends PBMs’ pharmacy benefit economics, plan sponsors’ decisions, and the entire generic market. Should PBMs continue to profit from discount cards’ rapid growth…while ignoring the risk that this growth could undermine the value of their benefit management services?

Read on and see what you think.

Employer Pharmacy Benefits 2021: Patient Specialty Costs Rise with Coinsurance and Accumulators

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

For 2021, employers backed away slightly from high-deductible health plans. However, their pharmacy benefit designs increased the use of coinsurance for specialty and fourth-tier drugs. These designs have significantly raised patients’ out-of-pocket obligations and are likely to have reduced adherence.

Manufacturers’ patient support funds help offset patients’ higher expenses. But employer plans are rapidly adopting copay accumulators, which allow payers and PBMs to absorb these funds.

Read on for my overview of cost sharing tier structure, copayment vs. coinsurance, out-of-pocket obligations, and accumulators—presented with this year’s dose of horrible Drug Channels tiers/tears puns.

Please join me for my upcoming live video webinar, Drug Channels Outlook 2022, on December 17, 2021, from 12:00 p.m. to 1:30 p.m. ET. Hundreds of people from your competitors, customers, and suppliers have already signed up. Will you be there, too?

Better Data, Better Outcomes: A LexisNexis® Risk Solutions and Q1 Productions Webinar

Better Data, Better Outcomes: A LexisNexis^® Risk Solutions and Q1 Productions Webinar
December 14, 2021
1:00 pm ET

This webinar is scheduled for a 45 minute presentation followed by 10 to 15 minutes of Q&A.

Click here to register for this complimentary webinar.

Your business depends on the data collected everyday across healthcare. That data not only drives the validation of the products and services your company offers today, but it also generates opportunities for new products and services. There are many data vendors that can supply the claims information from the day-to-day patient experience. But, how many vendors can target exactly the data you need and alert you in near real-time when those events occur? Moreover, how many data vendors can also provide you the opportunity to choose only the data points you need to inform your strategy tomorrow?

Join LexisNexis Risk Solutions and Q1 Productions for a webinar that will:

• Highlight how MarketView™ from LexisNexis Risk Solutions can provide the data you need and alert you when new data is available
• Uncover opportunities to access the specific data your business needs without having to filter through unnecessary data points
• Illustrate how life science companies can improve patient outcomes by analyzing population health data and analytics to intervene proactively rather than reactively

With access to the data you need in near real-time, life science companies have the unique opportunity to better plan, impact, and support both healthcare providers and the patients they serve. Join us and learn how adding customized data and alerting can drive opportunities for enhancing your research, real-world data, precision medicine, and more.

Register here for the LexisNexis Risk Solutions and Q1 Productions Webinar: Better Data, Better Outcomes: Enhance the Patient Experience With Unique Data Solutions.

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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. To find out how you can promote an event on Drug Channels, please contact Paula Fein (paula@DrugChannels.net)..

Drug Channels Recommends: “Uncontrolled Spread” by Scott Gottlieb

Looking for a thoughtful and timely stocking stuffer?

I suggest Uncontrolled Spread: Why COVID-19 Crushed Us and How We Can Defeat the Next Pandemic, by Scott Gottlieb, M.D. (Amazon link)

This book provides a comprehensive, well-written chronicle of the COVID-19 pandemic (as of mid-2021). Dr. Gottlieb documents—with great specificity—how and why our government’s public health infrastructure failed us during the pandemic. He also offers valuable recommendations for better planning.

Read on for my review of this fascinating and important book, along with notable highlights from the text.

Please join me for my upcoming live video webinar, Drug Channels Outlook 2022, on December 17, 2021, from 12:00 p.m. to 1:30 p.m. ET. Click here to learn more and register for this event.

CVS Pharmacy Downsizes: 10 Industry Trends Driving the Retail Shakeout

ICYMI, CVS Health recently announced that it will close about 900 of its retail pharmacies. This downsizing complements the company’s shift toward its healthcare delivery future.

This long-overdue move highlights the retail industry’s fundamental economic headwinds. The pharmacy shakeout is accelerating, as smaller competitors exit and larger companies reduce store count.

To help you make sense of CVS’s move, below I outline 10 crucial forces of change reshaping the retail pharmacy industry.

For more on pharmacy’s future, please register for Drug Channels Outlook 2022, my live video webinar that will air on December 17, 2021.

Drug Channels News Roundup, November 2021: Health Plans and Insulin, Gross-to-Net Bubble Update, CVS & 340B, and Amazon Redux

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

• How health plans profit—and patients lose—from insulin

• A fantastic new analysis of the gross-to-net bubble

• CVS acknowledges how its PBM profits from 340B

• Reconsidering Amazon

P.S. Please join the nearly 13,000 consumers of my daily commentary and links to neat stuff at @DrugChannels on Twitter. You can also find my daily posts on LinkedIn, where I have more than 21,000 followers.

Recent posts have covered: outcomes-based contracts, copay accumulators, hospitals’ drug profits, biosimilar interchangeability, managed Medicaid, DSCSA, CVS Health’s networks, unintended consequences of congressional drug pricing legislation, Walmart and TRICARE, McKesson’s European retreat, and more.

Please join me for my upcoming live video webinar, Drug Channels Outlook 2022, on December 17, 2021, from 12:00 p.m. to 1:30 p.m. ET. Hundreds of people from your competitors, customers, and suppliers have already signed up. Will you be there, too?

Pathway or Perish: The Two-Pronged Hurdle to Ensuring Access in Oncology

Today’s guest post comes from Carolyn Zele, Senior Manager of Solution Enablement at MMIT.

Carolyn describes how oncology pathways were developed to help standardize treatment and ensure quality care. She argues, however, that these pathways often shut manufacturers out of the market.

Click here to learn more about MMIT's Pulse Analytics solution, which provides insight into payer- and pathway-driven barriers to access.

Read on for Carolyn’s insights.

Small Pharmacies Continue to Run Away from Medicare Part D’s Preferred Networks

In my previous post, I highlighted the largest pharmacy chains that will participate in the 2022 Medicare Part D prescription drug plans (PDP).

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

As you will see here, the largest PSAOs are increasingly rejecting preferred networks. Below we provide details about the PSAOs owned by the three major wholesalers—AmerisourceBergen, Cardinal Health, and McKesson—along with information about AlignRx, the largest independent PSAO. There are some notable differences in strategy, as you will see from our handy scorecard below.

Smaller pharmacies’ rejection of Part D preferred networks shows that they are figuring out how to survive a highly challenging retail environment. Perhaps Part D is just a flesh wound?

Speaking of 2022, please join me for my upcoming live video webinar, Drug Channels Outlook 2022, on December 17, 2021, from 12:00 p.m. to 1:30 p.m. ET. Click here to learn more and sign up.

CVS, Walgreens, Walmart, and Supermarkets Keep Position in 2022 Part D Preferred Networks—With a Little Help from 340B

In Consolidation and Preferred Pharmacy Networks in 2022’s Medicare Part D Plans, I highlighted how those networks have hijacked the world of stand-alone Medicare Part D prescription drug plans (PDP) and become a major presence in Medicare Advantage prescription drug (MA-PD) plans.

Today, I examine the largest retail chains’ participation in the 21 major 2022 Part D preferred networks that the eight largest plan sponsors will offer. Below, we offer you a handy table for scoring not only each chain’s participation, but also all changes from 2021 to 2022.

Narrow networks force pharmacies to trade volume for profits, due primarily to substantial pharmacy direct and indirect remuneration (DIR) payments. One unexpected bright spot has been pharmacies’ participation in the 340B Drug Pricing Program. As you review chains’ eager participation in the 2022 Part D networks, ponder whether a material change in the 340b contract pharmacy market might tarnish the attractiveness of being preferred.

Speaking of next year, please join me for my upcoming live video webinar, Drug Channels Outlook 2022, on December 17, 2021, from 12:00 p.m. to 1:30 p.m. ET. Click here to learn more and sign up.

Drug Channels Outlook 2022 (NEW 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 a new live video webinar:

Drug Channels Outlook 2022
Broadcast live on December 17, 2021
12:00 p.m. to 1:30 p.m. ET

This page describes the event and explains how to purchase a registration.

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

WHAT YOU WILL LEARN

Join Dr. Fein as he helps you and your team get ready for the year ahead by outlining key issues and uncertainties that will surely affect your planning. This event can be both a capstone of your annual learning and a touchpoint for the future. The Outlook 2022 marks our third annual outlook webinar.

During the event, Dr. Fein will share his latest thinking on a wide range of topics, including:

• The prescription market in 2022

• Benefit design and plan sponsor strategies

• Federal and state drug pricing policy

• The 340B Drug Pricing Program

• Consolidation and vertical integration

• Specialty pharmacy trends

• Copay accumulators, maximizers, and utilization management tools

• Biosimilars

• Drug channel evolution and disruption

• And more!

PLUS: During the webinar, Dr. Fein will give participants an opportunity to unmute themselves and ask live questions.

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.

Why PBMs and Payers Are Embracing Insulin Biosimilars with Higher Prices—And What That Means for Humira

The Food & Drug Administration (FDA) recently approved the first interchangeable biosimilar insulin product: the insulin glargine-yfgn injection from Viatris. Read the FDA’s press release.

Alas, I’m sad to report that the warped incentives baked into the U.S. drug channel will limit the impact of this impressive breakthrough.

Viatris is being forced to launch both a high-priced and a low-priced version of the biosimilar. However, only the high-list/high-rebate, branded version will be available on Express Scripts’ largest commercial formulary. Express Scripts will block both the branded reference product and the lower-priced, unbranded—but also interchangeable—version. Meanwhile, Prime Therapeutics will place both versions on its formularies, leaving the choice up to its plan sponsor clients.

Consequently, many commercial payers will adopt the more expensive product instead of the identical—but cheaper—version. As usual, patients will be the ultimate victims of our current drug pricing system.

Below, I explain the weird economics behind this decision, highlight the negative impact on patients, and speculate on what this all could mean for biosimilars’ future. Until plan sponsors break their addiction to rebates, today’s U.S. drug channel problems will remain.

Informa Connect’s Trade & Channel Strategies

Informa Connect’s Trade & Channel Strategies
Delivered as a Hybrid Event
In-Person: December 13-14, 2021, Hilton Philadelphia at Penn’s Landing, Philadelphia, PA
Virtual: December 16-17, 2021
https://informaconnect.com/trade-channel/

The full agenda for this year’s Trade and Channel Strategies conference is available now! Year after year, the life science industry marks Informa Connect’s Trade and Channel Strategies as the “go-to” event for trade, channel, market access, account strategy and brand professionals. Join your industry counterparts this December to unravel the complexities of the channel, navigate high-impact topics transforming trade and benchmark winning pharmacy and distribution frameworks.

Drug Channels readers will save 10% off the current registration rate when they use promo code 10DC21*.

Meet The Expert Faculty

• Bill Roth, Founding Partner, Blue Fin Group
• Jeff Henderson, Vice President, Head of Global Market Access, Reimbursement and Distribution, VectivBio
• David Weiss, Vice President, Industry Solutions, IntegriChain
• Rena Goins, Executive Director, Global Trade, GPO & Distribution, Regeneron
• Stephen Samuel, CEO, Premier Specialty Pharmacy Services
• Shannon Wiley, Member, Bass, Berry & Sims
• Jerry Buller, DPh, MMHC, Chief Pharmacy Officer, Trellis Rx
• John Klimek, RPh, Senior Vice President, Standards and Industry Information Technology, NCPDP

Featured Sessions Include

• LANDSCAPE ADDRESS: Analyze Market Dynamics and Trends Impacting the Channel in an Ever-Changing Environment
• POLICY ADDRESS: Break Down Evolving Regulatory Reform Driving Innovation and Access Predict Novel Reimbursement Mechanisms and First Pharmacy Benefits for Biosimilars

Download your copy of the agenda today and join Informa Connect in December!

Drug Channels readers will save 10% off the current registration rate when they use promo code 10DC21*.

*Offer 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. To find out how you can promote an event on Drug Channels, please contact Paula Fein (paula@drugchannels.net).

Risk-Based Cancer Care: A Specialty Pharmacy’s Role

Today’s guest post comes from Ashleigh Burdette, Senior Director of Clinical Innovation at Biologics by McKesson.

Ashleigh explains how biopharma companies can help patients become more adherent and achieve better health outcomes by partnering with an experienced specialty pharmacy that offers risk-based care. 

To learn more about the risk-based care approach, download the free whitepaper: Risk-Based Care Helps Cancer Treatment Adherence.

Read on for Ashleigh’s insights.

Consolidation and Preferred Pharmacy Networks in 2022’s Medicare Part D Plans: Cigna, CVS Health, Humana, UnitedHealthcare, WellCare, and More

Open enrollment is under way for the 2022 Medicare Part D plans. Our exclusive analysis of Center for Medicare & Medicaid Services’ (CMS) data reveals that preferred cost sharing pharmacy networks will maintain their dominance as an established component of Part D benefit design.

For 2022:

• 98% of stand-alone Medicare Part D prescription drug plans (PDP) will have a preferred network.

• 66% of Medicare Advantage prescription drug (MA-PD) plans will have a preferred network.

Below, I provide historical data on preferred networks’ growth and update the top companies’ 2022 offerings. Two companies—Cigna and WellCare—have streamlined their PDP offerings by eliminating plans that had been acquired from other companies. I also provide our first analysis of the prevalence of preferred networks in three different types of MA-PD plans.

In upcoming articles, I’ll examine how chain and independent pharmacies will participate in these plans.

Sophia’s Story: Student, Daughter, Marketing Professional, Person Living with Crohn’s

Today’s guest post comes from Megan Marchal, Clinical Pharmacist at CoverMyMeds.

Megan shares the story of Sophia Garland, a young professional who is living with and learning to manage a chronic medical condition that requires specialty medication.

To learn more about technology and access to specialty medications, read the CoverMyMeds Medication Access Report: Complex Care & Specialty Edition.

Read on for Megan’s insights.

Drug Channels News Roundup, October 2021: PBMs’ Oncology Exclusions, Biosimilar Boom, BCBS vs. Hospitals, U.S. vs. the World, and CRISPR Comedy

Fortunately, Halloween can’t be scarier than any other day this year. So grab your pillow case and stuff it with treats from the great Drug Channels pumpkin patch:

• Spooky! PBMs are conjuring a terrifying number of formulary exclusions for oncology drugs

• Eerie! Brrr..did you hear that? It’s the biosimilar boom!

• Creepy! Scream as Blue Cross Blue Shield frightfully overpays hospitals

• Shocking! Believe it or not, U.S drug spending shambles into the middle of the herd

Plus, The Onion summons the only humorous article about CRISPR.

P.S. Please join the more than 12,700 consumers of my daily commentary and links to neat stuff at @DrugChannels on Twitter. You can also find my daily posts on LinkedIn, where I have more than 20,000 followers.

Recent posts have covered: Walgreens’ new direction; controversary over independent pharmacy counting; insurer consolidation; retail pharmacy M&A; drug pricing policy; Prime Therapeutics; 340B contract pharmacy litigation; pharmaceutical antitrust; oncology care model; and Peter Bach’s nuptials.

Follow the Vial: The Buy-and-Bill System for Distributing and Reimbursing Provider-Administered Outpatient Drugs

By reader request, we present below a channel flow chart illustrating the buy-and-bill process for provider-administered drugs. This chart complements Follow the Dollar: The U.S. Pharmacy Distribution and Reimbursement System for Patient-Administered, Outpatient Brand-name Drugs.

To further help you understand this channel, I have also included a brief video to explain the buy-and-bill system. The video is excerpted from my recent Drug Channels Update: Buy-and-Bill Trends video webinar.

This post is adapted from Chapter 3 of our new 2021–22 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors.

Machine Learning, AI, and Platform Technology: Drug Discount Management’s Big Leap Forward

Today’s guest post comes from Scott Johnsen, VP of Product at Kalderos.

Scott discusses the advantages of using artificial intelligence and machine learning to efficiently process reimbursement data and avoid duplicates.

Learn more about Kalderos’ solutions to solve drug discount management challenges at scale during a free webinar on November 17: The Power of the Platform: How a Trusted Network Delivers Outcomes That Are a Win for All.

Fresh Evidence: How Health Systems Steer Prescriptions to Their Own Specialty Pharmacies

Hospitals and health systems are rapidly expanding their internal specialty pharmacies—and they’re using questionable tactics to boost revenues and profits.

A new American Society of Hospital Pharmacists (ASHP) survey of health system pharmacies offers fresh insights into how these systems steer prescriptions to their internal specialty pharmacies:

• For most health systems' in-house specialty pharmacies, more than 90% of specialty prescriptions are written by system-employed physicians.

• Nearly two-thirds of the larger health system specialty pharmacies operate as the exclusive pharmacy within self-insured health systems’ networks.

See below for data and details.

The 340B Drug Pricing Program’s explosive growth plays a crucial role in the economics of the health system specialty pharmacy channel. As manufacturers challenge external 340B contract pharmacies, health systems will become even more aggressive about guiding volume to their internal pharmacies.

P.S. I'll be presenting my "State of Specialty Pharmacy 2021," live and in-person at next week's Asembia Specialty Pharmacy Summit. (I'm speaking at 8:15 AM on 10/27 during the "Post-Pandemic Outlook for Specialty Pharmacy" session with Doug Long.) Hope to see you there!

What to Expect at This Year’s Asembia Specialty Pharmacy Summit (Guest Post)

Today’s guest post comes from Jayne Hornung, Chief Clinical Officer at MMIT.

Jayne discusses changes in the life science and specialty pharmacy industries since the COVID-19 pandemic began. She highlights three key trends that pharma companies, plan sponsors, and others will consider as we head to the upcoming Asembia Specialty Pharmacy Summit (October 26 to 29 in Las Vegas).

To learn more, schedule a meeting with one of MMIT's experts at the upcoming Asembia Specialty Pharmacy Summit.

Read on for Jayne’s insights.

White Bagging Update: PBMs’ Specialty Pharmacies Keep Gaining on Buy-and-Bill Oncology Channels

Payers have long sought to disrupt the buy-and-bill channel.

Coming out of the pandemic (maybe?), specialty pharmacies—via white, brown, and clear bagging—continue to displace buy-and-bill distribution channels for provider-administered oncology drugs. Check out the latest 2021 data below.

The battle for the specialty patient pits hospitals against insurers—and their respective specialty pharmacies. As you will see, UnitedHealthcare has been especially aggressive in accelerating channel change.

White bagging can boost profits and revenues for PBM-owned specialty pharmacies while increasing payers’ control over hard-to-manage medical benefit drugs. Hospitals, however, lose profits and face higher costs. Look for more drama as this squid game plays out.

FYI: The material in today’s article is adapted from Section 3.1. of our new 2021–22 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors, available at special introductory pricing until October 15.

Conducting Patient Access in an Evolving Market

Today’s guest post comes from Bill Dupere, Practice Lead and VP of Market Access Solutions and Eric Willis, VP of Operations Hub and Reimbursement Services at TrialCard.

Bill and Eric discuss the complexities of digital patient support program technologies and introduce TrialCard’s integrated suite of solutions.

To learn more, please contact Trialcard at sales@trialcard.com or visit them in booth #416 at the upcoming Asembia Specialty Pharmacy Summit from October 26 to 29, 2021.

Read on for Bill’s and Eric’s insights.

NEW: The 2021–22 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors

I am pleased to announce our new 2021–22 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors, available for purchase and immediate download.

• Click here to download a free report overview (including a summary of industry trends, the Table of Contents, and a List of Exhibits)

• New Drug Channels Institute Study: Biosimilars Are Delivering Higher Profits for Drug Distributors (press release)

We’re offering special discounted pricing if you order before October 15, 2021!

The 2021–22 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors—our 12th edition— remains the most comprehensive, fact-based tool for understanding and analyzing the large and growing U.S. pharmaceutical distribution industry.

This 2021-22 edition contains the most current financial and industry data along with detailed information about the strategies and market positions of the largest companies: AmerisourceBergen, Cardinal Health, and McKesson. It updates our annual analysis of each wholesaler’s business segments and underlying business profitability, based upon our proprietary economic models.

The notable new material in this 2021-22 edition includes three new sections:

• Section 4.2.5. analyzes how marketplace dynamics of provider-administered biosimilars affect wholesalers’ gross margins. (Section 4.4. in this edition introduces our estimates of these profits.)

• Section 7.4.4. reviews AmerisourceBergen’s entry into the European distribution market. (We consider McKesson’s exit from Europe in Section 9.4.3.)

• Section 6.1.5. summarizes key aspects of the wholesalers’ national opioid settlement.

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.

WHAT’S GOING ON

Twice a year, I spend my evenings and weekends writing two comprehensive, fact-based, and nonpartisan reports on drug channel economics. In some small way, I try to make the world a better and smarter place.

Licenses for our DCI reports are regularly purchased by nearly every company involved in the drug channel: pharmaceutical manufacturers, wholesalers, pharmacists, pharmacy owners, hospitals, buyers, benefit managers, managed care executives, policy analysts, investors, lawyers, consultants, and more. So, you can find out what your customers, partners, and competitors are reading.

The 2021–22 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors is the only resource of its kind available anywhere. It offers 142 proprietary charts, exhibits, and data tables.

FOUR FUN FACTS

• The 9 chapters are self-contained and do not need to be read in order. (Really!) There are loads of internal hyperlinks to help you navigate the document and customize it to your specific interests and priorities.

• We are offering the option to download an additional PowerPoint file with images of all 142 exhibits. This popular option helps you share the insights and data with others in your organization. (The exhibits appear in all license versions. The PowerPoint file option is available only with the purchase of a corporate license.)

• There are an astonishing 537 (!) endnotes, most of which have hyperlinks to original source materials. These source materials offer a handy way to build your knowledge base beyond what’s included in the full report.

• As usual, I have reluctantly stripped out the corny jokes and pop culture references.

If you have any questions (before or after reading the report), please email me.

Enjoy!

Informa Connect’s Rare Disease Innovation & Partnering Summit

Informa Connect’s Rare Disease Innovation & Partnering Summit
Hybrid Event
In person: December 6-10 | Boston, MA
Virtual: December 9-10
www.informaconnect.com/raredisease

Exclusive Offer – Be sure to use your exclusive promo code DC4RARE10 to save 10% off* of your registration

After over a year apart, Informa Connect is pleased to announce that Rare Disease Innovation & Partnering Summit will return this Winter as a hybrid event, in-person December 6-7 in Boston, MA and virtually December 9-10. Driven by industry, advocacy, policy and investor insights, the Rare Disease Innovation & Partnering Summit convenes diverse stakeholders to discuss opportunities for continued innovation, advancement of impactful patient advocacy and acceleration of commercial strategy success.

Join multi-stakeholders as they gather and discuss novel approaches to optimize value, access and commercial strategy, deliver insights on maximizing engagement and innovation through data, research and technology and dive into best practices for driving therapeutic progress and creating purposeful partnering. Do not miss this opportunity to advance your organization forward. In such trying times, 2021 is a must-attend.

Exclusive Offer – Download the agenda and register today – Be sure to use your exclusive promo code DC4RARE10 to save 10% off* of your registration

Whether you choose to attend in-person or virtual (or both!), Rare Disease Innovation & Partnering Summit is sure to deliver impactful discussions, inspiring leaders and meaningful connections that will help advance the rare community forward. Tackle to most pressing challenges surrounding patient access, reimbursement, commercialization, launch, partnering and more with experts from across the industry.

Can’t Miss Content Highlights:

• PANEL: Fostering Effective Relationships Between Industry and Advocacy
• Leverage Genetic Testing for Value for Rare Disease Patients
• Harness the Power of Data to Drive Progress
• TECHNOLOGY SPOTLIGHT: Developing and Scaling Digital Therapeutics for Rare Diseases
• Reverse Engineering for Drug Development in Rare Diseases
• REGULATORY SPOTLIGHT: Navigate FDA Updates on Rare Disease Product Development
• Risks and Rewards of Rare Disease Drug Development — Highlight Opportunities and the Way Forward

PLUS! Tailored Breakouts for Customizable Learning:

• Patient Driven Progress
• Reimbursement, Value and Access
• New Launch and Commercialization
• Partnering, Investment and Portfolio Strategy

How Does Hybrid Work?

ALL ACCESS PASS includes the in-person event December 6-7 AND the virtual experience December 9-10

VIRTUAL EXPERIENCE PASS includes recorded presentations from the in-person event, as well as daily live streaming content December 9-10 (plus, 30-day portal access)

Exclusive Offer – Download the agenda and register today – Be sure to use your exclusive promo DC4RARE10 to save 10% off* of your registration
Informa Connect will see you there!

*Cannot be combined with other offers, promotions or applied to an 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. To find out how you can promote an event on Drug Channels, please contact Paula Fein (paula@drugchannels.net).

Supporting Patient Adherence Through Electronic Prior Authorization and First Fill Copay Programs

Today’s guest post comes from David Fidler, Senior Director of Product Innovation at ConnectiveRx. David discusses how electronic prior authorization (ePA) and first-fill, buy-down programs can boost patient adherence to specialty therapies.

On November 3rd at 1:00 pm ET, ConnectiveRx will host First Fill, No Wait: How to Make it Happen, a free webinar about copay ePA. Click here to register.

Email inquiries@ConnectiveRx.com with any questions.

Read on for David’s insights.

Drug Channels News Roundup, September 2021: Hospitals’ 340B Profits, Drug Prices Deflate, U.S. vs. EU, Amazon vs. CVS, and More Bad Blood for Theranos

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

• Fresh insights about hospitals’ specialty drug profits

• SSR Update: Drug prices keep dropping

• My $0.02 on international benchmarking goes viral

• Amazon is finally disrupting CVS—but not how you expected

Plus, the best article ever about Elizabeth Holmes’s Theranos trial.

P.S. Please join the more than 12,500 consumers of my daily commentary and links to neat stuff at @DrugChannels on Twitter. You can also find me on LinkedIn, where I have more than 20,000 followers.

My recent social media topics have included: the ASPE report, biosimilar reimbursement, non-profit hospital shenanigans, HRSA’s reorganization, MTM in Part D, PBMs’ GPOs, pharmacy GPOs, channel strategy, white bagging, and the soothing sounds of pills being counted.

Informa Connect’s Trade & Channel Strategies

Informa Connect’s Trade & Channel Strategies
Delivered as a Hybrid Event
In-Person: December 13-14, Hilton Philadelphia at Penn’s Landing, Philadelphia, PA
Virtual: December 16-17
www.informaconnect.com/trade-channel/

Year after year, the life science industry marks Informa Connect’s Trade and Channel Strategies as the “go-to” event for trade, channel, market access, account strategy and brand professionals. Join hundreds of your industry counterparts this December to unravel the complexities of the channel, navigate high-impact topics transforming trade and benchmark winning pharmacy and distribution frameworks.

Drug Channels readers will save 10% off the current rate when they register and use code 21DC10*.

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

• Analyze Market Dynamics and Trends Impacting the Channel in an Ever-Changing Environment
• Unpack Emerging Product Specific Trends in 3PL, Distribution and Pharmacy
• Break Down Evolving Regulatory Reform Driving Innovation and Access
• Navigate Major Market Mergers and Forecast Future Evolution in the Industry
• Discover Pharmacy-Level Innovations Redesigning Care and Driving eCommerce

Customize Your Experience with Tailored Content:

• Benefit from sessions covering the full product mix
• Build your own agenda with focused breakouts on critical topic areas
• Hear from key stakeholders along the supply chain continuum
• Attend the Diversity, Equity and Inclusion Summit taking place December 14th

Drug Channels readers will save 10% off the current rate when they register and use code 21DC10*.

Be sure to sign up today and save your seat!

*Offer 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. To find out how you can promote an event on Drug Channels, please contact Paula Fein (paula@drugchannels.net).

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

This week, I’m rerunning some popular posts while I prepare for today's live video webinar: Drug Channels Update: Buy-and-Bill Market Trends.

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

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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.

How Cigna’s Growing Pharmacy Platform Expands Its Channel Power (rerun)

This week, I’m rerunning some popular posts while I prepare for this Friday’s live video webinar: Drug Channels Update: Buy-and-Bill Market Trends.

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

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Last week, Cigna released its earnings for the first quarter of 2021. Links below.

I was struck by how quickly Cigna’s Express Scripts PBM business has increased revenues and prescriptions from its retail pharmacy network. Our second chart below highlights this growth.

The businesses in Cigna's Evernorth segment—especially Express Scripts, Ascent Health Services, and InsideRx—are already providing rebate negotiation, network management, and/or a sourcing platform for Prime Therapeutics, Kroger, Humana, GoodRx, and Amazon. 

I expect Cigna’s influence over the drug channel to expand further as other businesses step onto this burgeoning platform.

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

This week, I’m rerunning some popular posts while I prepare for this Friday’s live video webinar: Drug Channels Update: Buy-and-Bill Market Trends.

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

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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.

DCI’s Top 15 Specialty Pharmacies of 2020: PBMs Expand Amid the Shakeout—While Walgreens’ Outlook Dims (rerun)

This week, I’m rerunning some popular posts while I prepare for this Friday’s live video webinar: Drug Channels Update: Buy-and-Bill Market Trends.

Click here to see the original post and comments from May 2021. BTW, my prediction about AllianceRx Walgreens Prime is already starting to come true. Prime Therapeutics recently alleged that Walgreens is competing against the companies' joint venture.

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In Drug Channels Institute's list of the top 15 pharmacies of 2020, we show that many of the largest U.S. market participants are now central-fill mail and specialty pharmacies operated by PBMs and insurers.

To complement that broader ranking, we present below our exclusive list of the top 15 pharmacies based on specialty drug dispensing revenues. You will see that PBMs and insurers have increased their dominance over specialty drug channels. Many of the largest independent companies have been acquired.

As we look ahead, CVS Health and Cigna’s Express Scripts seem best positioned for further growth. However, AllianceRx Walgreens Prime—the joint venture between Walgreens Boots Alliance and Prime Therapeutics—faces significant market share loss.

Read on for all the details.

Informa Connect's Pharma/Biotech GTN Summit

Informa Connect's Pharma/Biotech GTN Summit
Hybrid Event
In-Person: November 17-19, 2021 in Philadelphia
Virtual: November 22-23, 2021
www.informaconnect.com/gtn

Join the life sciences community this fall at Informa Connect’s GTN Summit, now in the 11th year. Whether you register with an All-Access Pass (attending in-person on November 17-19, 2021 with access to Virtual content) or register with a Virtual Pass (attending from your home or office on November 22-23, 2021 with access to the In-Person event recordings), you'll be able to benefit from all the expert-led sessions and panels on the agenda.

Visit www.informaconnect.com/gtn for further details and to register. Drug Channels readers will save 10% off when they use code 21DRCH10 and register prior to October 20th.*

Session topics include:

• Comprehensive and Strategic Roadmap for Optimizing GTN Processes
• GTN and Strategic Finance in a Revolutionary Marketplace
• Changing Policy and Drug Pricing Proposals
• Product Pricing Pressures and Trends within the Payer Marketplace
• Medicaid Accruals and Forecasting and 340B
• Ensuring Audit Readiness and Optimal Governance of GTN Processes and Financial Reporting
• Methodology Showcase and Platform-Centric Strategies for GTN Optimization
• Medicare, Part D Discount Rate and Impact on GTN
• Implementing Salesforce Initiatives to Maximize GTN
• Value-Based Contracting Agreements and GTN
• Untangling the Complexities between Access Programs, Coverage Decisions and GTN
• Visibility and Predictability for Inventory and Product Returns
• GTN's Importance and Materiality into the Broader Business Equation
• Organizational Alignment, Process Excellence and Transparency to Maximize GTN Accuracy and Efficiency
• GTN Implementations - Best Practices, Purpose-built Launch Planning and GTN Readiness to Ensure Product Success

These sessions will be presented by senior-level finance executives from companies such as Agile Therapeutics, Collegium Pharma, Currax Pharmaceuticals, Eisai, GSK, Horizon Therapeutics, Incyte, Karyopharm, Lannett Pharmaceuticals, Merck, Sandoz and more.

View the agenda to see the complete picture – agenda, speakers, and more! Plus, in-person participation qualifies for CPE credits!*

Visit www.informaconnect.com/gtn for further details and to register. Drug Channels readers will save 10% off when they use code 21DRCH10 and register prior to October 20th.*

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category 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. To find out how you can promote an event on Drug Channels, please contact Paula Fein (paula@drugchannels.net).

Connected Solutions Are Simplifying Specialty Medication Access

Today’s guest post comes from Vicki Muscarella, Vice President of Specialty at CoverMyMeds.

Vicki discusses the advantages of integrated technology solutions in enhancing specialty patients' access to therapy, affordability, and adherence. CoverMyMeds now includes RelayHealth, RxCrossroads by McKesson, and McKesson Prescription automation.

Click here to sign up for complimentary early access to the specialty edition of the CoverMyMeds 2021 Medication Access Report.

Read on for Vicki’s insights.

How and Why I Was Overcharged by Penn Medicine and My Blue Cross Health Plan (A True Story)

Sometimes, a little knowledge can be a bad thing.

I want to share with you, dear reader, the strange but true tale of my recent foray into the wonderful world of hospital price transparency for routine lab services.

I discovered—with great effort—that the rates my health plan negotiated with the largest local health system in Philadelphia were greater than the self-pay, cash price. Ultimately, my baffling and unexpected out-of-network bill required me to pay more out-of-pocket than the total cash price.

This tale neatly summarizes why so many people hate our healthcare system—and why the average patient will have trouble benefiting from transparency regulations.

Learn more about how hospitals get paid for provider-administered drugs during my upcoming live video webinar, Drug Channels Update: Buy-and-Bill Market Trends, on September 24, 2021, from 12:00 p.m. to 1:30 p.m. ET. CLICK HERE TO LEARN MORE AND SIGN UP.

Available for Preorder: The 2021-22 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors

On October 5, 2021, Drug Channels Institute will release The 2021–22 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. This report—our twelfth edition— remains the most comprehensive, fact-based tool for understanding and analyzing the large and growing U.S. pharmaceutical distribution industry.

We are providing you with the opportunity to preorder this thoroughly updated and revised 2021-22 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 5.

CLICK HERE to download a free pre-publication draft overview
(including the Table of Contents and a List of Exhibits).

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 15, 2021.

I'll discuss new data from the 2021-22 report during DCI’s upcoming live video webinar, Drug Channels Update: Buy-and-Bill Market Trends, on September 24, 2021, from 12:00 p.m. to 1:30 p.m. ET. CLICK HERE TO LEARN MORE AND SIGN UP.

Informa Connect’s Drug Pricing Transparency Congress

Informa Connect’s Drug Pricing Transparency Congress
Delivered as a Hybrid Event
In-Person: November 9-10 | Philadelphia, PA
Virtual: November 16-17
www.informaconnect.com/drug-pricing-transparency
Save 10% by using code 21DPT10

The 2021 Drug Pricing Transparency Congress, an important event dedicated to providing critical updates on federal and state reporting requirements, policy initiatives and strategic best practices for compliance, returns this November as a HYBRID event, with the in-person component being held November 9-10 in Philadelphia and the virtual component being held November 16-17.

Exclusive Offer for Drug Channels Readers:

Use Promo Code 21DPT10 to Receive 10% off Your Registration

Thought-leaders and colleagues from federal agencies, bio/pharma manufacturers, consultants, industry trade associations and law firms will gather to discuss key insights on how current and future drug pricing transparency regulations will impact commercialization, reimbursement, pricing and compliance practices.

The content-rich agenda features fresh perspectives, along with many of the well-respected experts typically on the program. Key impactful sessions include:

• BIO and PhRMA ADDRESS: Examining New Legislation and Addressing Current Industry Efforts — Pharmaceutical Research and Manufacturers of America (PhRMA), Biotechnology Innovation Organization (BIO)
• ENFORCEMENT SPOTLIGHT: Explore Developments in Enforcement Action — Winston & Strawn LLP, The United States Attorney’s Office for the District of Massachusetts, The United States Attorney’s Office for the Eastern District of Pennsylvania
• Strategize Best Practices for Compliance in Drug Pricing Transparency — Pfizer
• INDUSTRY PULSE: Analyzing Benchmarking Results — ClassOne Insight
• PANEL DISCUSSION: Ask the Experts – What Keeps You Up at Night? — Chiesi, Sidley Austin LLP, Hyman, Phelps & McNamara, P.C., Porzio Life Sciences
• And many more!

Choose how you attend with the All-Access Pass, registration to both the in-person and virtual events, or the Virtual-Only Pass. Whichever you choose, be sure to use your exclusive promo code 21DPT10 when securing your place to receive 10% off!

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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. To find out how you can promote an event on Drug Channels, please contact Paula Fein (paula@drugchannels.net).

Improving the Provider Experience to Accelerate Patients’ Access to Specialty Therapy

Today’s guest post comes from Vicki Muscarella, Vice President of Specialty Product at CoverMyMeds.

Vicki discusses the value of a centralized patient support services solution. She argues that such a solution improves the provider experience, enhances the patient experience, and accelerates speed to therapy.

To learn about CoverMyMeds’ integrated patient support services solution, download the free Medication Access Report: Healthcare Technology.

How CVS Health Drives Cardinal Health’s Distribution Financials

Cardinal Health recently released the annual report for its 2021 fiscal year, which ended on June 30. See the links below.

Today, I delve into the financials behind Cardinal’s relationship with its largest customer, CVS Health. In Cardinal’s 2021 fiscal year, CVS purchased more than $42 billion in pharmaceuticals from the wholesaler—about double the figure from 10 years ago. The new report also reveals that CVS Health’s payment terms with Cardinal give the wholesaler an often-overlooked cash flow benefit.

I also compare Cardinal’s relationship with CVS to McKesson’s relationship with CVS. The two wholesalers sell more than $90 billion in pharmaceuticals to CVS Health—making it the largest U.S. drug purchaser.

Like McKesson, however, Cardinal Health has discovered that CVS is its worst best friend.

Learn about how changes in the the provider-administered drug market affect wholesalers during DCI’s upcoming live video webinar, Drug Channels Update: Buy-and-Bill Market Trends, on September 24, 2021, from 12:00 p.m. to 1:30 p.m. ET. CLICK HERE TO LEARN MORE AND SIGN UP.

Drug Channels Update: Buy-and-Bill Market Trends (NEW 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 video webinar:

Drug Channels Update: Buy-and-Bill Market Trends
Friday, September 24, 2021, from 12:00 p.m. to 1:30 p.m. ET

This page describes the event and explains how to purchase a registration.

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

During the September event, Dr. Fein will focus on the latest market developments in the buy-and-bill market, including:

• The key channels for provider-administered drugs

• The flow of funds and product in the buy-and-bill system

• The latest data on reimbursement models and methodologies

• The impact of COVID-19 on provider-administered channels

• Crucial market developments and insights regarding:
• Consolidation and vertical integration
• Hospital transparency
• Biosimilars
• The 340B Drug Pricing Program
• Medicare Part B policy
• PBM and payer tactics
• Specialty distributors

• And more!

As always, Dr. Fein will clearly distinguish his opinions and interpretations from the objective facts and data.

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.

Read on for full details on pricing and registration.

A Video History of Pharmacies and Prescription Prices: From Soda Fountains to GoodRx

Charlotte Morabito at CNBC has put together “Why Pharmacies Overcharge,” an entertaining and provocative video on the pharmacy industry and its generic prescription pricing.

It’s definitely worth your time. I especially enjoyed the cool visualizations of Drug Channels Institute’s industry data. Links below.

The video covers the history of pharmacy, from the “Soda Fountain Era” to “Lick, Stick, and Pour” to the rise of PBMs and GoodRx. 

It also includes a wide variety of expert perspectives, including $0.02 from your friendly neighborhood blogger at Drug Channels. See the list below.

Grab some popcorn and enjoy the show!

Drug Channels News Roundup, August 2021: OptumRx’s New GPO, Pharmacy DIR Fees, State Biosimilar Laws, UM Views, and a Newspaper Delivers

Our not-quite-post-pandemic summer is coming to an end. Time to pack away the bathing suit and get serious again—with these curated curiosities combed from the now-barren Drug Channels beach:

• OptumRx joins the PBM GPO game

• Pharmacy DIR fees hit $11 billion

• A terrific resource on state biosimilar laws

• Patient views on utilization management

Plus, my social media success…from a (print) newspaper ad!

P.S. Please join the more than 12,100 consumers of my daily commentary and links to neat stuff at @DrugChannels on Twitter. You can also find me on LinkedIn, where I have more than 19,500 followers. Recent topics have included: Express Scripts’ 2022 formulary exclusion list, Amazon’s pharmacy, generics in Part D, 340B research, zero-dollar copay, pass-through rebates, PBMs’ spread pricing, Rite Aid’s Bartell deal, healthcare pricing trends, the DSCSA, John Venn, and more.

Leveraging Mobile Patient Support to Boost Adherence

Today’s guest post comes from Ian Ocilka, Senior Vice President of Client Solutions at ConnectiveRx.

Ian discusses how mobile platforms like mobileCare Manager can boost patient adherence to specialty therapies.

To learn more, register for ConnectiveRx's free panel discussion on September 15, 2021, at 1:00 p.m. ET. Email inquiries@ConnectiveRx.com with any questions.

Read on for Ian’s insights.

Why GoodRx—Not Amazon—May Be the True PBM Disrupter

The generic prescription market is being disrupted—but not by the big, bad spaceman from Seattle.

Instead, consider how GoodRx is affecting patients, payers, and PBMs.

Below I summarize the latest financial results for GoodRx’s discount card business. We estimate that the company accounted for $4.1 billion in U.S. prescription revenues for 2021. That’s about six times its 2016 figure.

GoodRx and its discount card competitors profit by incentivizing people to bypass their own insurance plans. Meanwhile, our crazy pharmacy pricing system deters pharmacies from pursuing consumer-driven pricing and PBMs from undercutting their own clients.

Consequently, discount cards could become the force that upends PBMs’ pharmacy benefit economics, plan sponsors’ decisions, and the entire generic market. Should PBMs continue to profit from discount cards’ rapid growth…while ignoring the risk that this growth could undermine the value of their benefit management services?

Read on and see what you think.

Informa Connect’s Coupon & Copay

Informa Connect’s Coupon & Copay
Hybrid Event | October 13-20
In-Person: October 13-14 in Philadelphia, PA
Virtual: October 19-20
www.informaconnect.com/couponcopay

It’s time to get the gang back together! With an improving landscape, Informa Connect is pleased to announce that Coupon and Copay will return this Fall as a hybrid event, in-person October 13-14 in Philadelphia, PA and virtually October 19-20. 

Benefit from crucial and timely updates addressing access challenges and exploring the impact of copay accumulators, maximizers and drug pricing legislation on patient affordability. In such a fluid year for medication access and affordability, join influential stakeholders as they innovate on copay program design and operations, identify key trends in market access, patient affordability and the future of the drug pricing and analyze the impact of cost sharing on out of pocket costs and high deductible health plans. 2021 is a must-attend.

Exclusive Offer – Download the agenda and register today – Be sure to use your exclusive promo code USAVE10 to save 10% off* of your registration.

Whether you choose to attend in-person or virtual (or both!), Coupon and Copay is sure to deliver. The largest and longest standing forum focused on the role of coupon and copay programs in assisting in patient access and affordability to higher priced drugs, hear multi-stakeholder perspectives on the most pressing issues, including:

Can’t Miss Content Highlights:

• Two Part Trailblazer Exchange
• Explore Alternative Copay Strategies to Respond to the Rise of Copay Accumulator and Maximizer Programs
• The Future of Copay Programs- Where Do We Go From Here
• Address Utilization of Step Therapy and Bridge Programs
• Advocacy and Policy Panel: Analyze State and Federal Progress Regulating Copay Programs
• DOJ Updates: Government Enforcement Trends Impacting Copay Assistance
• Physician Perspective – Uncover the Need for Streamlined Efficiencies in Copay Programs
• Specialty Brands Copay Programs Deep Dive
• And more!

How Does Hybrid Work?

ALL ACCESS PASS includes the in-person event October 13-14 AND the virtual experience October 19-20

VIRTUAL EXPERIENCE PASS includes recorded presentations from the in-person event, as well as daily live streaming content October 19-20 (plus, 30-day portal access)

Exclusive Offer – Download the agenda and register today – Be sure to use your exclusive promo code USAVE10 to save 10% off* of your registration.

Informa Connect will see you there!

*Cannot be combined with other offers, promotions or applied to an 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. To find out how you can promote an event on Drug Channels, please contact Paula Fein (paula@drugchannels.net)