Drug Channels News Roundup, November 2022: Mark Cuban vs. Elon Musk, Lessons from Semglee, Gen Z vs. Pharmacy Careers, 340B Transparency, and I ♥ the 90s

I hope everyone enjoyed the Thanksgiving holiday! Now that you’ve stretched your stomach, stretch your mind with some food for thought. In this issue:

• Mark Cuban schools Elon Musk on PBMs

• Market access lessons from Semglee

• Gen Z rejects the pharmacy career path

• A potent call for 340B transparency

Plus, get ready to love the ‘90s again!

P.S. Join my more than 34,000 LinkedIn followers for daily links to neat stuff. If you haven't quit Twitter, you can also find my daily posts at @DrugChannels on Twitter, where I have more than 15,500 followers.

Please join me for my upcoming live video webinar, Drug Channels Outlook 2023, on December 16, 2022, from 12:00 p.m. to 1:30 p.m. ET. Click here to learn more and sign up.

Mark Cuban on PBMs, @mcuban on Twitter

OK, I admit I did not have “Mark Cuban corrects Elon Musk and Bernie Sanders about insulin pricing and the gross-to-net bubble” on my 2022 bingo card, but here we are.

Let’s review what happened:

• As you may have heard, a fake but “verified” Lilly account tweeted out a bogus message about insulin. (Lilly reportedly pulled millions in Twitter advertising over the stunt.)

• Senator Bernie Sanders quoted the fake tweet, adding his ill-informed commentary about insulin list prices.

• Elon Musk responded to Senator Sanders with an irrelevant tweet about “original insulin” vs. “New, higher efficacy analog variants”

• Finally, Mark Cuban added crucial perspective on the role of PBMs, writing: “It's actually more complex than that. The manufacturers of most drugs don't set the retail price. It is set by PBMs, who then play games with discounts and rebates to create a pricing spread so the patient pays too much. Which is why we created @costplusdrugs”

Cuban’s comments echo the points he made in the video that I shared in October’s news roundup.

See, Twitter can still be fun!

Lessons from Semglee: Early Perspectives on Pharmacy Biosimilars, IQVIA

In Why PBMs and Payers Are Embracing Insulin Biosimilars with Higher Prices—And What That Means for Humira, I explained how the warped incentives baked into the U.S. drug channel will limit the impact of the first interchangeable biosimilar insulin product.

It gives me no pleasure to report that my suppositions were correct. This great new IQVIA analysis examines the first few months after the launch of two identical versions of Viatris’ interchangeable biosimilar:

• Semglee (insulin glargine-yfgn) injection, a branded interchangeable product

• Insulin Glargine (insulin glargine-yfgn) injection, an authorized interchangeable biosimilar

The chart below shows adoption rates for new-to-brand prescriptions by three different payers:

[Click to Enlarge]

As you can see, commercial payers preferred the high-list/high-rebate biosimilar over its low-list price version, while Medicaid opted for the lower-priced drug. Meanwhile, Medicare Part D plans stuck with Lantus, the high-list/high-rebate reference product.

Next year, Humira the best-selling drug in the U.S., will face multiple biosimilar competitors. The Semglee story reminds us just how weird the 2023 and 2024 formularies could become. I'll share my $0.02 during the Drug Channels Outlook 2023 webinar on December 16.

2021-2022 PharmCAS Applicant Data Report, American Association of Colleges of Pharmacy

Here’s some grim news on the pharmacist pipeline.

According to American Association of Colleges of Pharmacy (AACP), the total number of pharmacy school applicants has dropped by 36%, from 17,617 in 2012-13 to 11,219 in 2021-22.

[Click to Enlarge]

Clearly, fewer young people see “pharmacist” as an attractive career path. I guess news about the retail pharmacy shakeout and declining salaries for retail pharmacists has reached Gen Z.

In case you are wondering, applications to medical school have grown significantly over the same time period.

After 30 years of 340B, it’s time for data and an honest conversation , STAT

Please check out this fabulous op-ed from John O'Brien of the National Pharmaceutical Council. John rightly calls out the lack of transparency in the 30-year old 340B Drug Pricing Program. As he notes:

“…the 340B program lacks even the simplest of transparency requirements. The federally funded health clinics, nonprofit hospitals, contract pharmacies, and third-party administrators that are part of the 340B pipeline don’t disclose how many patients receive 340B drugs and whether or not they received the 340B discount, leaving researchers to come up with inventive methods to peer into this box of mysteries.”

Long-time readers know that to get even the most basic program information, I have had to pester our government with Freedom of Information Act (FOIA) requests. Let’s hope John’s piece begins the long-overdue process of bringing much-needed transparency to the opaque 340B program.

WXPN’s 90s A – Z, WXPN

We here in Philadelphia are blessed to have 88.5 WXPN, the nationally recognized leader in Triple A (adult, album, alternative) radio. It’s non-commercial, member-supported radio for grown-ups who like music.

Full disclosure: I am on the WXPN Policy Board. (Yes, I’m also a music nerd!)

Beginning at 8 a.m. on December 1st, WXPN will play only music from the 1990s—in alphabetical order. This crazy stunt will go 24/7 for more than one week, with no commercials. You’ll hear the hits, the deep cuts, the one-hit wonders, and forgotten favorites from the 1990s. Plus, XPN will play all genres—modern rock, electronica, hip-hop, R&B, alternative rock, singer-songwriters, and more.

It will be a super fun and diverse trip down memory lane. I hope you tune in!

Click here to listen for free online or ask your Alexa to “Play WXPN.”