Navigating Market Access Challenges in Life Sciences Commercialization

Today’s guest post comes from Bill Dupere, SVP of Product Development & Partnerships at Mercalis.

Bill discusses specialty therapy access barriers, including payer utilization management techniques and “no coverage” policies. Contact Mercalis to learn about their Patient Support Services.

Read on for Bill’s insights.

Drug Channels News Roundup, March 2024: My $0.02 of CarelonRx/Kroger & CVS, Provider-Owned Pharmacies, Shady AFPs, 340B Deception, and Lilly’s GLP-1 Ad

It’s finally spring in Philadelphia, home of Drug Channels. Along with sunshine and fine weather, the vernal equinox has ushered in a crop of new and noteworthy stories:

• What the CarelonRx/Kroger specialty pharmacy deal means for CVS Health

• Provider-owned specialty pharmacies expand in Medicare

• Payers are not keen on shady alternative funding programs (AFP)

• Hospitals’ association spreads 340B misinformation

Plus, Lilly trolls our nation’s celebrities.

P.S. Join my nearly 54,000 LinkedIn followers for daily links to neat stuff.

What’s ahead for the drug channel? Find out during Drug Channel Implications of the Inflation Reduction Act, a new live video webinar with Adam J. Fein, PhD. Click here to learn more and reserve your spot at our April 5 webinar.

Three Digital Intake Strategies For Eliminating Patient Enrollment Forms

Today’s guest post comes from Adam Stotts, SVP of Customer Success at AssistRx.

Adam discusses how patients seeking to access specialty therapies can benefit from a digital intake approach. He then explains three ways that specialty pharmaceutical companies can use digital intake strategies to speed patient enrollment.

To learn about AssistRx’s digital intake solutions, download Digital Intake for Specialty Drug Programs: Q1 2024 Progress Report.

Read on for Adam’s insights.

Mark Cuban: Five Ways that Big PBMs Hurt U.S. Healthcare–And How We Can Fix It

Today’s guest post comes from Mark Cuban, co-founder of the Mark Cuban Cost Plus Drug Company

A few weeks ago, Mark participated in the White House Roundtable on Lowering Healthcare Costs and Bringing Transparency to Prescription Drug Middlemen. I found Mark’s comments to be intriguing and highly provocative, so I invited him to publish an edited version exclusively here on Drug Channels.

Read on for Mark’s unfiltered view of the PBM industry. Feel free to add your own thoughts below or on LinkedIn.

How will the most consequential change in federal drug pricing policy affect drug pricing? Find out during Drug Channel Implications of the Inflation Reduction Act, a new live video webinar with Adam J. Fein, PhD. Click here to learn more and reserve your spot at the April 5 webinar.

NOW AVAILABLE: The 2024 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers

I am pleased to announce our new 2024 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers, available for purchase and immediate download.

• Download a free report overview (including key industry trends, the Table of Contents, and a List of Exhibits)

• HMP Global’s Drug Channels Institute releases ‘2024 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers’ (press release)

• Review pricing/license options and download the full 2024 report

We’re offering special discounted pricing if you order before April 8, 2024.

The 2024 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers, our 15th edition, provides a comprehensive, fact-based, and non-partisan tool for understanding the entire U.S. drug pricing, reimbursement, and dispensing system. This 2024 edition includes substantial new material—outlined on page ix of the report overview.

12 chapters, 500+ pages, 262 exhibits, nearly 1,100 endnotes: There is nothing else available that comes close to this valuable resource.

You can pay online with all major credit cards (Visa, MasterCard, American Express, and Discover) or via PayPal. Click here to contact us if you would like to pay by corporate check or ACH.

Email Paula Fein (paula@drugchannels.net) if you’d like to bundle your report purchase with access to DCI’s video webinars.

If you preordered the report, you should have already received an email with download instructions last week. Please contact us if you did not receive your email.

Read on for some additional details.

Informa Connect’s Life Sciences Pricing & Contracting USA

Informa Connect’s Life Sciences Pricing & Contracting USA
May 21-23, 2024 | New Orleans
Drug Channels readers save 10% with code 24DRCH10*

Whether your daily focus is on Medicaid, Government Pricing, 340B, Drug Price Transparency, Commercial Contracting or Chargebacks, we have you covered! Informa Connect is thrilled to announce Pricing & Contracting USA, an innovative summit that brings together three of the life science industry’s most well-known events (Medicaid & Government Pricing Congress, Drug Pricing Transparency Congress and the Contracts & Chargebacks Summit) together for enhanced learning and networking.

Join us in New Orleans on May 21-23 where you’ll gain critical insight into regulatory requirements, policy initiatives and best practices to enhance pricing and contracting models. Nearly 100 world class speakers are slated to present deep dive sessions, workshops and panels covering these topics and more:

• Wendell Potter, President, Center for Health and Democracy and Publisher, HEALTH un-covered shares an out of the box forecast of upcoming regulations, litigation and policies affecting the industry in what is set to be an action-packed election year.
• Understand the implementation and future of PDABs with Mallinckrodt and the director of the Colorado prescription drug affordability board and the manager of insurance data science.
• Get an OIG Update on AMP cap removal and potential consequences.
• Discuss the nuances of reporting and laws for key Medicaid and GP programs with Genmab and Miree Lee Consulting.
• Listen in as IL HFS Medicaid Drug Rebate Unit reviews rebates, reasonable assumptions, BFSF and best price.
• Hear from Lundbeck, Accord BioPharma, BeiGene and Mirati Therapeutics as they discuss best practices in operating a pricing review board.
• Join Bioventus, Amneal Pharma and CSL Vifor for an overview of the contracting process, types purposes and key considerations.
• Explore the commercial impact of GP decisions and vice versa with Pfizer.
• Hear from PhRMA and BIO on landscape of drug pricing transparency pressures.
• Hyman, Phelps & McNamara review the enforcement and penalties landscape within state drug pricing reporting.
• Novo Nordisk takes a deep dive into confidentiality concerns within SPTR.
• Hear from United Therapeutics and Lundbeck as they discuss synergizing MDRP and SPTR.
• Listen in as Takeda and Sanofi discuss IRA and AMP Cap Removal and how policy changes and evolving regulations will transform the contracting atmosphere.
• And more!

View the agenda for Pricing & Contracting USA to see the complete picture – the program, speakers, and more, and visit www.informaconnect.com/pricing-contracting-usa for further details and to register. Drug Channels readers will save 10% off when they use code 24DRCH10 and register prior to April 19, 2024.*

*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 HMP Omnimedia, LLC, Drug Channels Institute, its parent company, or any of its employees. To find out how you can publish a guest post on Drug Channels, please contact Paula Fein (paula@DrugChannels.net).

The Four Key Factors to Evaluate When Insourcing vs. Outsourcing Patient Support Programs

Today’s guest post comes from Josh Marsh, Vice President and General Manager of Sonexus™ Access and Patient Support at Cardinal Health.

Josh discusses factors that drive manufacturers to insource versus outsource patient support services. He shares data from a Cardinal Health survey of biopharmaceutical companies and offers four factors to consider when evaluating your patient support program.

To learn more, download the results from Cardinal Health’s survey: Insourcing and Outsourcing Trends for Patient Hubs.

Read on for Josh’s insights.

The Top 15 U.S. Pharmacies of 2023: Market Shares and Revenues at the Biggest Chains and PBMs

Next week, Drug Channels Institute (DCI) will release our 2024 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. It’s the 15th edition of our popular and comprehensive examination of the entire U.S. drug pricing, reimbursement, and dispensing system.

For 2023, DCI estimates that U.S. prescription dispensing revenues reached $621 billion in 2023, driven by accelerating GLP-1 prescriptions and an expanding post-pandemic market. The table below—one of 262 in our new report—provides DCI's first look at the 15 largest organizations that battled for those revenues.

For a sneak peek at the complete report, click here to download our free report overview (including key industry trends, the table of contents, and a list of exhibits). We’re offering special discounted pricing if you order before April 7, 2024.

How will the most consequential change in federal drug pricing policy affect the largest pharmacies and PBMs? Find out at my upcoming live video webinar, Drug Channel Implications of the Inflation Reduction Act, on April 5, 2024, from 12:00 p.m. to 1:30 p.m. ET. Click here to learn more and sign up.

Copay Comes Full Circle: An Industry Ready for Disruption

Today’s guest post comes from Logan Melchione, VP of Patient Affordability at Paysign.

Logan discusses the evolution of patient support programs. She then outlines how these programs must evolve to stay relevant and valuable.

To request an analysis of your copay savings program and learn more about Paysign’s patient affordability solutions, contact affordability@paysign.com or visit paysign.com/rx.

Read on for Logan’s insights.

Available for Preorder: The 2024 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers

On March 19, 2024, Drug Channels Institute will release The 2024 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. This report—our fifteenth edition—remains the most comprehensive, fact-based tool for understanding the entire U.S. drug pricing, reimbursement, and dispensing system. This unique, encyclopedic resource is your ultimate guide to the complex web of interactions within U.S. prescription drug channels.

12 chapters, 500+ pages, 262 exhibits, nearly 1,100 endnotes: There is nothing else available that comes close to this valuable resource.

We are providing you with the opportunity to preorder this thoroughly updated, revised, and expanded 2024 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 19.

• Review pricing/license options and place a preorder.

• 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.

Email Paula Fein (paula@drugchannels.net) if you’d like to bundle the report purchase with access to DCI’s video webinars.

Special preorder and launch pricing discounts will be valid through April 8, 2024.

Read on for more details.

Drug Channel Implications of the Inflation Reduction Act (NEW Live Video Webinar)

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

Drug Channel Implications of the Inflation Reduction Act
This event will be broadcast live on
Friday, April 5, 2024, from 12:00 p.m. to 1:30 p.m. ET

This post describes the event and explains how to purchase a registration. The webinar will be broadcast from the Drug Channels studio in beautiful downtown Philadelphia.

This event is part of The Drug Channels 2024 Video Webinar Series.

WHAT YOU WILL LEARN

In 2023, the Inflation Reduction Act of 2022 (IRA) began to alter the Medicare Part D program and trigger changes in beneficiary out-of-pocket spending, drug prices, pharmacy economics, and market access strategies. The IRA’s impact will extend far beyond the Medicare program into many aspects of the overall drug channel.

In this all-new webinar, Dr. Fein will unpack the intended and unintended consequences of the IRA for the commercial market and drug channel participants, including:

• What’s ahead for brand-name drug list and net prices

• The coming battles over high-list/high-rebate products

• The Medicare Advantage boom and the collapse of the stand-alone PDP market

• The gross-to-net bubble outlook for Part D

• The IRA’s spillover impact on the gross-to-net bubble in commercial markets

• How the IRA will impact Medicaid rebates and change the 340B Drug Pricing Program

• What’s ahead for utilization management

• Retail pharmacies’ coming financial challenges

• The uptick in consolidation of physician practices

• Biosimilar market uncertainties

• And much more!

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

As always, Dr. Fein will clearly distinguish his opinions and interpretations from the objective facts and data. He will also draw from exclusive information found in DCI's new 2024 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers.

Please note that Dr. Fein will focus on the IRA’s patient and commercial market impacts. The potential effect of the IRA on manufacturers’ new drug research and development strategies is beyond the scope of this webinar.

Read on for full details on pricing and registration.

The Promise and Challenges of Workflow Integration for Biopharma-Sponsored Patient Support Programs

Today’s guest post comes from Era Prakash, Vice President of Product Management at Cencora.

Era contends that workflow integration can help biopharma companies address challenges that limit provider utilization of patient support programs. She also outlines three major challenges related to the provider workflow technology market.

Click here to learn more about Cencora's Access Network technology solution, which offers an in-workflow, digitized enrollment process.

Read on for Era’s insights.