Solving the Copay and Best Price Challenge

Today’s guest post comes from Jason Zemcik, Vice President of Patient Affordability at TrialCard.

Jason discusses two approaches to address the CMS Final Rule on manufacturer coupons and Best Price: the pharmacy copay offer and direct reimbursement to the patient. He goes on to describe TrialCard’s reimbursement capability solutions.

To learn more about TrialCard Pay and how to prepare your copay program for the future, register for Solving the Best Price and Co-Pay Challenge – A Framework for Assessment and Action. This joint TrialCard/IntegriChain webinar is scheduled for Tuesday, March 15, at 1 PM ET. 

Read on for Jason’s insights.

Drug Channels News Roundup, February 2022: Mark Cuban vs. Generics, Novo Nordisk’s G2N, CVS & 340B, and My Favorite Chart

Winter—or at least February—is almost over. Celebrate the imminent return of spring with our selection of noteworthy news from around the drug channel. In this issue:

• Mark Cuban!

• Novo Nordisk confronts the gross-to-net bubble

• CVS Health finally acknowledges its profits from the 340B program

Plus, an update to my all-time favorite chart.

P.S. Please join the nearly 13,500 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 am approaching 25,000 followers.

Available for Preorder: The 2022 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers

On March 15, 2022, Drug Channels Institute will release The 2022 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. This report—our thirteenth edition—remains the most comprehensive, fact-based tool for understanding the entire U.S. drug pricing, reimbursement, and dispensing system.

12 chapters, 430+ pages, 216 exhibits, 800+ endnotes: There is nothing else available that comes close to this report.

We are providing you with the opportunity to preorder this thoroughly updated, revised, and expanded 2022 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 March 15.

CLICK HERE to download a free pre-publication overview
(including key industry trends, 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.

Special preorder and launch pricing discounts will be valid through March 28, 2022.

The 2022 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers is a definitive, nonpartisan resource that includes the most current information about pharmacy dispensing channels, third-party payers, pharmacy benefit managers (PBMs), patients’ financial contributions, government regulations, and much more.

As always, we have updated all market and industry data with the most current information available, including our annual analyses of the market positions of the largest pharmacies, specialty pharmacies, and PBMs.

This 2022 edition addresses COVID-19 and its ongoing impact on the pharmacy and PBM industries. Many sections and chapters have also been expanded and/or reorganized to better cover the latest industry developments. New sections cover: pharmacies’ administration of—and profits from—COVID-19 vaccines; smaller PBMs; PBM purchasing groups and GPOs; 340b split-billing software vendors; and shakeout and consolidation within retail pharmacy. We also present a more unified outlook for specialty drugs, including specialty generics and biosimilars.Download a free report overview for more details.

The chart below illustrates the depth and breadth of the 2022 edition. The numbers indicate the report chapter that corresponds to, explains, and analyzes each channel flow.

[Click to Enlarge]

Thank you for your interest in our work. If you have any questions before purchasing a license to the report, please email me. Enjoy!

Vertical Integration: Strategies to Align Care

Today’s guest post comes from Garry Marshall, Senior Director of Business Strategy at Wolters Kluwer, Health.

Garry discusses healthcare business vertical integration and its effect on care quality for patients and on providers' work experiences.

To learn more, download the Wolters Kluwer Expert Insight article Vertical Integration Strategies: Using Data to Align Partners and Reduce Variation in Care.

Read on for Garry’s insights.

Five Things to Know About the State of Independent Pharmacy Economics

Time to update Drug Channels' exclusive look at independent pharmacy owners’ business economics.

Our analysis again reveals that despite what you may have heard, many independent pharmacies continue to hang on in a highly challenging retail environment. Prescription profits remained stable, while the average pharmacy owner’s salary jumped for the second year.

Read on for the financial details. The U.S. retail pharmacy industry faces many powerful headwinds. But there are some emerging positive trends, including DIR reform and profits from COVID-19 vaccinations. Expect independents to keep hanging in there.

Clear Connections for Equitable Medication Access

Today’s guest post comes from John Beardsley, Senior Vice President of Corporate Strategy at CoverMyMeds.

John discusses some of the findings in CoverMyMeds’ recently published report on medication access. He describes patient-centric, data-driven solutions to help patients access, afford, and adhere to their therapies.

To learn more, download CoverMyMeds’ 2022 Medication Access Report.

Read on for John’s insights.

Four Reasons Why PBMs Gain As Maximizers Overtake Copay Accumulators

More than four years ago, I warned about the emerging trend of copay accumulators and outlined the costly consequences for patients.

The latest data reveal that copay accumulator adjustment programs are now in the word list for a growing share of pharmacy benefit designs. What’s more, adoption of copay maximizers now exceeds that of copay accumulators. Maximizers avoid the brutal patient adherence problems of accumulators, while allowing plan sponsors to extract even more patient support funds.

Despite this impressive growth, you may not yet have considered PBMs’ business model for these tools. Below, I outline why PBMs have incentives to prefer maximizer programs over accumulators and alternatives such as specialty carve-out programs.

I look forward to hearing your thoughts on these developments in the comments below or on social media: LinkedIn (preferred) or Twitter.

Drug Pricing Transparency Congress

Drug Pricing Transparency Congress
Hybrid Event
March 28-29, 2022 | Philadelphia, PA
www.informaconnect.com/drug-pricing-transparency

Don’t miss the Drug Pricing Transparency Congress on March 28-29, 2022! You'll be part of the important discussions on how current and future drug pricing transparency regulations will impact commercialization, reimbursement, pricing and compliance practices. Experts will assess how companies are planning internally for these changes, provide updates impacting drug pricing transparency and explore what’s to come in 2023.

Visit www.informaconnect.com/drug-pricing-transparency for further details and to register. Drug Channels readers will save 10% off when they use promo code 22DRCH10 and register prior to March 4, 2022.*

The 2022 unique format includes 2 days of in-person programming, plus a virtual offering with live streaming of select sessions and recorded presentations available on-demand for 10 business days. Both the in-person and virtual options will include networking opportunities to connect with industry peers and colleagues.

What you’ll experience…

• Attend the Industry Pulse Session to Analyze Benchmarking Results
• Join the Ask the Experts Panel Discussion to Discuss Challenges and Gain Practical Solutions
• Hear Updates in the BIO and PhRMA Address on Examining New Legislation and Addressing Current Industry Efforts
• Engage in Conversation on State Drug Price Transparency Tools and Strategies to Ensure Operational Readiness
• Gain Insights into Implications and Requirements for New Product Launches
• And More!

View the agenda to see the complete picture—the program, speakers, and more!

Visit www.informaconnect.com/drug-pricing-transparency for further details and to register. Drug Channels readers will save 10% off when they use promo code 22DRCH10 and register prior to March 4, 2022.*

*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).

A Solution to the Medicare Copay Problem

Today’s guest post comes from Jeff Berkowitz, CEO of advisory firm Real Endpoints.

Jeff describes problems with Medicare copays that reduce adherence and persistence among seniors. He then describes RE Assist, Real Endpoints’ tech-enabled solution with key information on foundations for more than 30 diseases.

To learn more about Medicare copayments and how the RE Assist solution helps patients, register to view Real Endpoints’ free webcast: Solving the Medicare Co-pay Dilemma.

Read on for Jeff’s insights.

Still Not Skyrocketing: New CMS Data Reinforce the Truth About U.S. Drug Spending

The boffins at the Centers for Medicare & Medicaid Services (CMS) recently dropped the latest National Health Expenditure (NHE) data, which measures all U.S. spending on healthcare. (See links below.) These data provide our first official look at how the pandemic has affected U.S. healthcare spending.

Today, I examine the key insights from these latest figures.

As you will see, outpatient drug spending remains a small—and shrinking—share of the $4.1 trillion spent on U.S. healthcare. What's more, drug spending again grew more slowly than overall healthcare spending.

Meanwhile, consumers shoulder a much higher portion of this spending compared with their share of hospital spending.

Demonizing pharmaceuticals as a driver of U.S. healthcare spending growth is simply inaccurate. Sadly, our politicians and journalists will probably continue to ignore the facts in favor of their opinions.