Pharmacy Channels delivers timely analysis and provocative opinions on pharmaceutical economics and the pharmacy distribution system. It is written by Adam J. Fein, Ph.D., one of the country's foremost experts on pharmaceutical economics and channel strategy. Pharmacy Channels reaches an engaged, loyal and growing audience of more than 20,000 subscribers. Learn more...

Thursday, April 26, 2018

Pharmacy Channels News Roundup, April 2018: Copay Accumulators, Express Scripts, Pharmacy Pricing, Amazon, and Almost-Pharmacist Jack Nicklaus

Baseball season is finally here! Oil up your glove, lace up your cleats, and let's run the bases around this month's news stories. Remember: Sometimes you win, sometimes you lose, and sometimes it rains.

In this issue:
  • Green Monster: The pharmacy manufacturers that are most vulnerable to copay accumulators
  • Pop Fly: Express Scripts wants to pop the gross-to-net bubble?
  • Foul! Fresh evidence that uninsured consumers pay rip-off cash prices at retail pharmacies
  • Strikeout: My $0.02 on Amazon’s decision not to sell pharmacys to hospitals
Plus, from the diamond to the green: the secret pharmacy history of golf legend Jack Nicklaus.

P.S. For my daily pitches on the industry’s hits and misses, follow @PharmacyChannels on Twitter. My recent tweets have covered copay accumulators, the oncology market, pharmacy costs, biosimilars, PBMs, and more.

Tuesday, April 24, 2018

The Gross-to-Net Bubble Topped $150 Billion in 2017

In 2017, the gross-to-net bubble—the ever-growing pile of money between a manufacturer’s list price for a pharmacy and the net price after rebates and other reductions—hit a new high.

Based on new data from IQVIA, manufacturers of brand-name pharmacys in 2017 reduced list price revenues by an astonishing $153 billion. Those reductions came primarily from rebates, discounts, and other payments to the pharmacy channel. That figure has grown by 10% from the 2016 figure, even though net prices for brand-name pharmacys grew by only 1.9%.

We can no longer ignore the warped incentives created by our bubble buddy. As regular readers know, I think plan sponsors and insurers should be more transparent about what they do with the billions collected via pharmacy benefit managers (PBMs) from manufacturers—or even be forced to pass through these rebates to point of sale. Read on and let me know what you think.

Monday, April 23, 2018

CBI’s 14th Annual Commercial Contract & Chargeback Excellence

CBI’s 14th Annual Commercial Contract & Chargeback Excellence
June 20-21, 2018 | Philadelphia, PA

CBI’s Commercial Contract & Chargeback Excellence Summit, take a deep dive into ways to improve chargeback efficiency, navigate class of trade assignments, streamline membership management and optimize contract administration and operations. Through illustrating software solutions, case studies and perspectives from leading distribution partners, this conference is a comprehensive forum for pharmaceutical professionals to learn best practices and gain strategies to improve contract operations and retain revenue.

Download the agenda here.

2018 Program Highlights:
  • Partnership Pavilion – Collaborate with Distribution Partners, Manufacturers and Legal counterparts
  • Manufacturer Panel – Overcome Key Challenges of Contract Operations and Administration
  • Advanced Discussions on the hottest Topics Impacting Commercial Contracting:
    • Manage Tier Commitments and Compliance in Complex Contracting
    • Explore Key Benefits and Challenges of Outsourcing Chargebacks and Membership Functions
    • Apply Data Analytics to Sales and Chargebacks to Enhance Business Decision-Making
Visit www.cbinet.com/chargebacks for further details and to register. Pharmacy Channels readers will save $400 off the standard rate when they use discount code XYC552 and register prior to May 18th.

CBI will see you there!

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rate or non-profit rates. Other restrictions may apply.


The content of Sponsored Posts does not necessarily reflect the views of Pembroke Consulting, Inc., Pharmacy Channels, or any of its employees.

Friday, April 20, 2018

Improving Patient Prescription Access and Adherence Journeys

Today’s guest post comes from Bill Nolan, VP/GM of McKesson Specialty Health.

Bill discusses ExpressCoverage™, a solution from McKesson and CoverMyMeds®. It offers new ways for McKesson’s Patient Support Services to electronically access and efficiently communicate with a vast network of physicians, payers, and pharmacies. Bill highlights how this tool improves the specialty patient’s access and adherence to therapy.

To learn more, download the free document ExpressCoverage™: Revolutionizing Patient Pharmacy Access For Pharmaceutical Companies.

Read on for Bill’s insights.

Thursday, April 19, 2018

Why Retail Pharmacies Still Overcharge Uninsured Patients—And What That Means for Amazon

Consumer Reports recently published a fascinating survey of pharmacies’ cash prices for five common generic pharmacy prescriptions.

The results were startling. Prescription prices ranged from $66 to $1,351—a nearly 2,000% difference. The big three retail pharmacystore chains—CVS, Walgreens, and Rite Aid—consistently had higher average prices compared with those of other pharmacies. Independent pharmacies had some of the lowest prices, but also some of the highest prices.

Our analysis of prescription profits highlights the pharmacy industry’s unfortunate pricing strategy for cash-pay prescriptions. Average profit margins ranged from $8 to $264 per prescription for the five pharmacys. We can only hope that consumers didn’t pay the pharmacies’ sky-high cash prices.

The results expose the insane soak-the-poor mentality baked into the U.S. pharmacy industry’s historical pricing models. The data also highlight the potential pharmacy opportunity for Amazon.

P.S. Before other states follow Maryland and pass laws against price gouging by generic manufacturers, perhaps they should take a closer look at the behavior of their own states’ pharmacies.

Tuesday, April 17, 2018

McKesson Leads Another Round of PSAO Consolidation

Last week, McKesson announced the formation of Health Mart Atlas (HMA), a joint venture between McKesson’s Access Health business and American Pharmacy Network Solutions (APNS). Click here to read the press release.

The combination extends McKesson’s position as the largest pharmacy services administrative organization (PSAO). PSAOs are the awkwardly named intermediaries that operate between smaller pharmacies and pharmacy benefit managers (PBMs), per our U.S. Distribution and Reimbursement System flowchart.

When the Arete Pharmacy Network was formed, in 2016, I predicted that the fragmented PSAO sector would begin a long-overdue consolidation. Given the PBM titans now sitting atop Mt. Olympus, the remaining PSAOs can’t shrug off Health Mart Atlas.

Monday, April 16, 2018

CBI’s 4th GPO Membership Eligibility & Class of Trade Maintenance

4th GPO Membership Eligibility & Class of Trade Maintenance
June 19-20, 2018 | Philadelphia, PA
www.cbinet.com/gpo

Assembling over 100 industry professionals representing manufacturers, GPOs, wholesalers, distributors, and solution providers, CBI’s 4th GPO Membership Eligibility & Class of Trade Maintenance conference provides a rare, interactive forum on membership data management, class of trade, and workflow efficiency. Join your colleagues this June to learn strategies and insights from peers and industry stakeholders, and acquire the ability to overcome significant operational challenges related to proper management of GPO membership data. For additional information on session topics and speaking faculty, download the agenda here.

Visit www.cbinet.com/gpo for further details and to register. Pharmacy Channels readers will save $400 off the standard rate when they use discount code NHY548 and register prior to April 20th.*

Compelling Sessions and Actionable Takeaways on Topics, Including:
  • Spotlight Panel Session: Ensure Seamless Membership Management and Accountability Across the GPO Supply Chain
  • Understand Best Practices for Efficient Membership Maintenance in a World on HCP Service Evolution
  • Kickback Risks of Arrangements with GPOs – Case Studies on Fraud and Abuse
  • Audit COT Designations to Find Inaccuracies
  • Develop Strategies to Streamline Communication With Your Distribution Network
  • Distinguished Speaking Faculty Includes: Kendrion Biopharma, Anada Inc., Sanofi, UCB, Zydus Pharmaceuticals, Amneal Pharmaceuticals, Prometric Biotheraputics, Lilly USA, Chiesi USA Inc., and more.
Visit www.cbinet.com/gpo for further details and to register. Pharmacy Channels readers will save $400 off the standard rate when they use discount code NHY548 and register prior to April 20th.*

CBI will see you there!

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rate or non-profit rates. Other restrictions may apply.


The content of Sponsored Posts does not necessarily reflect the views of Pembroke Consulting, Inc., Pharmacy Channels, or any of its employees.

Friday, April 13, 2018

Copay Accumulator Programs: TrialCard Measures the Impact on Patients and Pharmaceutical Manufacturers

Today’s guest post comes from Mark Bouck, President and CEO of TrialCard.

Mark reviews copay accumulator adjustment programs and shares some of TrialCard’s unique data about these programs. He also discusses TrialCard’s proprietary methodology for identifying patients affected by this benefit design. This topic is crucial for 2018 (per my own article from January), so I encourage you to review his commentary.

To learn more about TrialCard’s approach to copay accumulator programs, download the free e-book The Rise of Co-Pay Accumulator Programs: Are Your Brand’s Patients at Risk?

To learn more about TrialCard’s solutions for accumulators, email Mark Droke, TrialCard's Senior Vice President, Patient Affordability & Virtual Engagement Business Units, at mark.droke@trialcard.com. You can visit Trialcard in booth 610 at Asembia’s upcoming 2018 Specialty Pharmacy Summit.

Tuesday, April 10, 2018

EXCLUSIVE: A Record Number of Specialty Pharmacies Now Have Accreditation

It’s time for Pharmacy Channels Institute’s annual update on the accreditation of specialty pharmacies.

Our spooky research team (pictured at right) is back! We have counted every pharmacy location that has achieved accreditation by an independent organization. Our exclusive findings:
  • The number of specialty pharmacies with accreditation expanded again in 2017. We identified 729 unique pharmacy locations that by the end of 2017 had achieved accreditation from the three major independent accreditation organizations. The 2017 figure is almost double the 2015 figure.
  • For the second consecutive year, pharmacy locations owned by healthcare providers—such as hospitals, health systems, physician practices, and providers’ group purchasing organizations—were the fastest-growing category of accredited specialty pharmacies.
See below for the complete details of our exclusive analysis. Notes for fellow arithmomaniacs are in the final section.

Pharmacies that compete to dispense specialty therapies are owned by a diverse set of organizations: pharmacy benefit managers (PBMs), retail chains, health plans, pharmaceutical wholesalers, physician practices, and hospital systems. There are also many independent specialty pharmacies. The battle for control of the specialty market is accelerating, though PBMs continue to dominate the market as channels narrow.

Monday, April 09, 2018

CBI’s 20th Annual Medicaid and Government Pricing Congress

CBI’s 20th Annual Medicaid and Government Pricing Congress
May 21-23, 2018 | Orlando, FL
www.cbinet.com/medicaid

Join the Government Pricing industry for YEAR 20 of CBI's Medicaid Congress at Disney’s Yacht & Beach Club in Orlando! Take a deep dive into sessions on 340B expansion, state pricing and transparency, FSS contracting, value-based frameworks, reasonable assumptions, Medicare coverage and more. You can read all about it here.

Visit www.cbinet.com/medicaid for further details and to register. Pharmacy Channels readers will save $300 off the standard rate when they use discount code BMK348 and register prior to April 27th.

Features for 2018 Include:
  • Three Tailored Content Strategy Streams:
    • 1. Strategic Pricing and Transparency
    • 2. Statutory Reporting Requirements
    • 3. Finance and Compliance Operations
  • Six Interactive Workshops:
    • 1. GTN Strategies and Solutions
    • 2. Product Acquisition Due Diligence and GP Considerations
    • 3. Generic Inflation Penalty Operational Guidance
    • 4. Value-Based Frameworks and Government Pricing Strategies
    • 5. Medicaid and GP Reporting – Build or Buy?
    • 6. Supplemental Rebates – Current Events and Operational Effectiveness
  • Plus, a State Medicaid Director Panel, 101 Boot Camp, Senior Executive Think Tank, Healthcare Innovation Keynote and much more!
Speakers include representatives from CMS, Duke Margolis Center for Health Policy, OIG, Sidley Austin, BIO, Arnold & Porter, Deloitte, UCB, Eli Lilly, BMS, Novartis, Pfizer, Cumberland Consulting, Sunovion, J&J, Insmed, Kite Pharma, King & Spalding, KPMG and more.

Visit www.cbinet.com/medicaid for further details and to register. Pharmacy Channels readers will save $300 off the standard rate when they use discount code BMK348 and register prior to April 27th.

CBI will see you there!

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rate or non-profit rates. Other restrictions may apply.


The content of Sponsored Posts does not necessarily reflect the views of Pembroke Consulting, Inc., Pharmacy Channels, or any of its employees.

Friday, April 06, 2018

Connect With Pharmacy Channels at #Asembia18

In three weeks, Pharmacy Channels Institute will hit Las Vegas for Asembia’s 2018 Specialty Pharmacy Summit.

Here are three ways that you can interact with us in Las Vegas:

1) Learn how Pharmacy Channels can help your business.

Pharmacy Channels reaches a large, diverse audience throughout the pharmaceutical and healthcare industries. We have an engaged and growing audience of more than 21,000 readers who regularly open, click, forward, and share our content.

Pharmacy Channels has an engagement rate that is more than twice that of the average media platform.

To discover how you can reach our audience, you can speak personally with my wife and business partner, Paula Fein, M.S.Ed. Paula is Pharmacy Channels Institute’s VP of Business Development. FYI: In the picture, she's on the left. Email her at paula@pharmacychannelsinstitute.com and she’ll be happy to meet with you.

In the meantime, download the 2018 Pharmacy Channels Media Kit for an overview of the site, our traffic, and opportunities for sponsored posts.

[Click to Download]

2) Join me at the Featured Session.

On Tuesday, May 1, I’ll lead the event’s Featured Session, titled Specialty Pharmacy Industry Outlook: What’s Happened & What’s Ahead. I'll be joined by Doug Long from IQVIA and Lisa Gill from J.P. Morgan Securities. See you in the Encore Ballroom at 9:00 AM!

[Click to Enlarge]

3) Just say hello!
We love meeting and talking with Pharmacy Channels readers, so please introduce yourself. Don’t worry: It will all be off the record. What we discuss in Vegas will stay in Vegas. ;)

See you soon!

P.S. To prep for the Summit, check out Chapter 3 (“Specialty Pharmacys and Specialty Pharmacies”) of our new 2018 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers.

Thursday, April 05, 2018

Payer Power: Why Eli Lilly, Janssen, and Merck Deeply Discount Their Pharmacy Prices

Over the past few weeks, three of the largest pharmaceutical manufacturers—Eli Lilly, Janssen, and Merck—have publicly reported the 2017 gross and net price changes for their U.S. product portfolios, along with average discounts. As far as I know, these are the only manufacturers that have publicly reported these data. See the links below.

As you will see, the three companies have provided average discounts from list prices of 42% to 51%. Two of the three companies experienced a year-over-year decrease in average net prices.

Payers and PBMs frequently recommend that manufacturers just lower the cost of their pharmacys. These data demonstrate that’s exactly what these three companies have done. Of course, the price cuts were provided in the form of rebates and discounts to the pharmacy channel. We still don’t know how, if at all, patients benefited from the declining prices for their pharmacys.