Analysis

CBI’s Specialty Therapies 2019
January 24-25, 2019 | Las Vegas, NV
www.cbinet.com/specialtytherapies

Kick off 2019 in Las Vegas at Specialty Therapies 2019! Don’t miss the chance to come together with colleagues from across the industry to examine disruptions in specialty drug distribution and the impact on access, quality and cost. You can read all about it here.

Visit www.cbinet.com/specialtytherapies for further details and to register. Drug Channels readers will save $400 off the standard rate when they use promo code BQH229 and register prior to November 30th.*

With the advent of innovative service delivery models, alternative payment models and an emphasis on data sharing and data standardization, the quest to drive better outcomes, ensure access and manage costs is more vital than ever.

Experts from Ochsner Health System, Ardon Health, Moda Health, Vanderbilt University Medical Center, Atrium Health, Indiana University Health, Fairview Specialty Pharmacy, MedImpact Health Systems, Boesen & Snow Law, Diplomat, VIVIO Health, University of Arizona Cancer Center and Blue Cross Blue Shield North Carolina lead robust discussions on topics such as:

• Investigate how distribution channels for specialty therapies are changing and the impact on cost, access and health outcomes
• Understand how in-house specialty pharmacies can enable health systems to accelerate a patient’s speed-to-therapy and improve quality of care through integrated clinical coordination
• Evaluate the potential impact of the removal of safe harbor for drug rebates
• Consider how distribution channels that accommodate 340B hospital pharmacies, PBM owned pharmacies, limited distribution drugs, any willing provider legislation and closed specialty networks affect clinical outcomes and costs
• Unravel the complexities within Copay Accumulator Programs and how they will affect specialty therapy utilization rates and long-term medical spend

Visit www.cbinet.com/specialtytherapies for further details and to register. Drug Channels readers will save $400 off the standard rate when they use promo code BQH229 and register prior to November 30th.*

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., Drug Channels, or any of its employees.

The evolving specialty market has just claimed another victim. Cardinal Health is selling its specialty pharmacy to BioMatrix Specialty Pharmacy LLC, a private-equity-backed company. There was no public announcement, so today's article counts as another Drug Channels exclusive. Below, I provide background about BioMatrix and the specialty pharmacies that wholesalers operate.

Cardinal’s capitulation highlights the challenges for smaller specialty pharmacies. Cardinal operates a small, sub-scale specialty pharmacy that has had difficulty attracting patients. What’s more, Cardinal’s overall size as a $137 billion business couldn’t help its pharmacy gain sufficient access to manufacturers’ and payers’ limited networks.

Each of the Big Three wholesalers—AmerisourceBergen, Cardinal Health, and McKesson—is encountering challenges to its diversification efforts. Will Cardinal’s move prompt a rethinking of wholesalers’ broad business portfolios over the next 12 to 18 months?

Boo! Time for my Halloween bag of Drug Channels news stories. This issue’s tricks and treats:

• Shocking! The gross-to-net bubble for Amgen’s PCSK9 product magically vanishes—and my $0.02 appears

• Creepy! Stefano Pessina of Walgreens Boots Alliance shares startling thoughts about Amazon, ABC, and more

• Scary! Shareholders vote today on whether Rite Aid should amputate its PBM

• Spooky! The Wall Street Journal conjures up a frightfully funny editorial about the drug channel

Plus, the Centers for Medicare & Medicaid Services summons Buy-and-Bill Murray for its latest foray into Part B reform.

P.S. Join the zombie horde who shamble after me at @DrugChannels on Twitter. It’s a great way to haunt me between Drug Channels articles.

CBI’s 6th Annual Reimbursement & Contracting Conference
January 23-24, 2019 | Philadelphia, PA
cbinet.com/Contracting

CBI’s 6th Annual Reimbursement & Contracting Conference is the ideal platform for bio/pharma manufacturers to unravel complexities associated with reimbursement, pricing strategies and commercial contracting. Join industry thought-leaders and colleagues in Philadelphia on January 23-24 at this CPE accredited event, and discover the necessary insights to navigate the evolving landscapes to develop innovative and competitive pricing strategies.

Featured Sessions from Our Distinguished Faculty Include:

• Best Practices and Implications of Contracting with Digital Therapeutics – Pear Therapeutics
• Unmet Medical Need – Can the Stakeholder Align? – Chiesi USA, Inc.
• 340B Summit – Case Studies and Provider Perspective – Boone County Hospital and ProMedica
• HEOR and RWE Around the World – Roles in Reimbursement and Contracting – BeiGene, Ltd.
• And more!
• Plus, Choose Between Two In-Conference Summits:
1. Foundational Summit: Principles of Reimbursement and Contracting – The Robinson Research Group, Inc.
2. Strategic Summit: Network Contracting Strategies — The Janssen Pharmaceutical Companies of Johnson & Johnson and Johnson & Johnson Health Care Services

Visit cbinet.com/contracting to view the complete agenda and speaker lineup, then register using the Drug Channels promo code MGS852 to save $400 off* the standard rate.

*Expires 1/22/18; applies to standard rate only and may not be combined with other offers or applied to existing registration.

---

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

This week, Express Scripts announced an innovative pharmacy benefit contracting model for members of the National Drug Purchasing Coalition (NDPC), a group of 18 large employers. Click here to read the fully-titled press release.

You should pay close attention to this b.i.g. news. It is structured so that Express Scripts will not profit from the flow of funds from a brand-name manufacturer to a plan sponsor. What’s more, the PBM’s compensation will be fully delinked from drug list prices. Instead, Express Scripts will earn only fixed management fees plus additional at-risk compensation tied to clinical outcomes.

I spoke to Express Scripts and the NDPC’s consultant to clarify how the new model will differ from more conventional structures. As I see it, this PBM compensation approach could be an important step in our industry’s journey toward a world without rebates.

For now, it only applies to a sliver of Express Scripts’ revenues. But if the new pricing model is widely adopted, Express Scripts (Cigna) will be able to escape drug channel disruption unscathed.

The biggest unknown is how employers will behave as they select pharmacy benefits. Will the funds flowing transparently through the PBM be put toward solving the reverse insurance issue the gross-to-net bubble? Will this lower out-of-pocket costs for patients? As they say: Mo money, mo problems.

Last week, I highlighted the largest pharmacy chains that will participate in next year’s Medicare Part D prescription drug plans (PDP).

Today, I examine independent pharmacies’ participation via the pharmacy services administrative organizations (PSAOs) that represent these pharmacies in negotiations with plans.

This year’s results show a major divergence in strategies. Three of the four biggest PSAOs will participate in a comparable number of Part D networks, as the big chains do. AmerisourceBergen’s Elevate network, however, continues to go its own way and will skip preferred status in the major Part D networks. You will find its reasoning below.

Are we at a turning point for preferred pharmacy networks? Remember that Humana will trigger a small pullback by switching two of its plans from preferred to open networks for 2019. Have pharmacies decided to stop digging holes in their income statements?

CBI’s Specialty Product Data Strategies Summit
December 12, 2018 | Philadelphia, PA
www.cbinet.com/specialtydata

Specialty Product Data Strategies 2018 is your next step towards leveraging internal and third-party data to drive product access, uptake, adherence and outcomes. This unique and cutting-edge forum provides you with breakthrough data discussions and key industry perspectives on how to strategically contract, analyze and utilize specialty data to measure outcomes and illustrate value. You can read all about it here.


Innovative Discussions and Compelling Case Studies:

• Leverage Artificial Intelligence (AI) to Drive Specialty Channel Insights and Examine Emerging Pharmacy Models Driving New Data Sets for Specialty Drugs
• Transform Specialty Product Data Sets into Cutting-Edge Dashboards to Gain Actionable Insights
• Update on NCPDP’s New Specialty Pharmacy Work Group and Task Group Activities
• Partnership Pavilion— Collaborating with the Right Complex Patient Data Providers to Drive Value
• I Know What I Want, but How Do I Get There? Building an Effective, Innovative Commercial Operations Organization
• Value-Based Therapy Management Driven by Data Collection throughout the Patient and Product Journey
• Revamp and Restructure Contracting Agreements for Specialty Data to Create Operational Efficiencies
• Strategies to Foster High Quality Data for Advanced Analytics
• Opportunities for Data-Driven Patient Services

Visit www.cbinet.com/specialtydata for further details and to register. Drug Channels readers will save $200 off the standard rate when they use discount code HXF785 and register prior to November 2nd.*

CBI will see you there!

REMINDER: Upgrade your registration and come in a day early to attend CBI’s Trade and Channel Strategies meeting. To register for both events, please visit this site, sign up for the Trade and Channel event and chose the Specialty Data track.

*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., Drug Channels, or any of its employees.

Today’s guest post comes from Shawn Seamans, President of McKesson Life Sciences.

Shawn discusses the channel and commercialization complexities associated with launching and managing specialty medications. He then outlines McKesson Life Sciences, a business that brings together McKesson's multiple solutions for connecting biopharma companies, providers, pharmacies and payers. These solutions also help patients access their therapies.

To learn more, visit McKesson Life Sciences or email LifeSciences@mckesson.com.

Read on for Shawn’s insights.

In Humana Triggers a Pullback for Preferred Pharmacy Networks in 2019 Medicare Part D , I highlighted how preferred pharmacy networks will dominate next year’s Medicare Part D prescription drug plans (PDP).

Today, I examine chain pharmacies’ participation in 24 major 2019 Part D preferred networks. Some highlights:

• CVS, for the second year, has strengthened its position as a preferred pharmacy in many 2019 networks.

• Walmart and Kroger have maintained the strong positions that they have established over the past few years. Walgreens, however, has slipped as the other chains grow.

• Poor ol’ Rite Aid will again be a preferred pharmacy only in the single plan offered by its EnvisionRx subsidiary.

Below, we provide you with a handy table for scoring each chain’s participation and all changes from 2018 to 2019. Get ready to do The Floss!

The Centers for Medicare & Medicaid Services (CMS) has recently released the initial raw data on the 2019 Medicare Part D plans.

Our exclusive analysis of these data reveals that preferred cost sharing pharmacy networks will be slightly less popular next year. For 2019, 92% of Medicare Part D regional prescription drug plans (PDP) will have a preferred network. This figure compares with 99% of plans in 2018. The decline will occur primarily because two Humana plans will switch from preferred to open networks for 2019.

Below, I provide historical context on preferred networks’ growth and then discuss the top nine companies behind the 2019 plans. As you will see, narrow pharmacy networks are now an essential and established component of Part D benefit design.

Especially notable will be CVS Health’s SilverScript Allure, the first Part D plan with point-of-sale (POS) rebates for brand drugs. Is Allure the next generation of Part D plan design, or an unattractive offer that helps CVS stop a mandated policy shift that it opposes?