Analysis

In CMS Confirms It: Drug Spending Slows, Hospital and Physician Spending Grows, I showed that growth in drug spending was significantly below the growth rate of overall national healthcare spending. Today, I delve into trends in third-party and patient payment for prescription drugs.

In 2016, all payers experienced a slowdown in spending. Employers' drug spending growth was nearly flat, while consumers (on average) paid less out of pocket. And for the third year in a row, spending by government payers exceeded spending by employers. The NHE are net of rebates, so gross-to-net bubblenomics play a part in these figures.

I suspect that the very slow growth in employers’ net costs occurred partly because employees are being forced to pay debilitating coinsurance—in some cases with no limit on out-of-pocket drug expenses.

The NHE data therefore suggest a troubling gap between haves and have-nots, based on benefit design and diagnosis. Some people can make do with inexpensive generic drugs, while others end up with sky-high out-of-pocket costs.

Read on for our wonktastic deep dive into the 2016 spending data.

Last week, the econowonks at the Centers for Medicare & Medicaid Services (CMS) released the 2016 National Health Expenditure (NHE) data. Links below.

It’s politically fashionable to blame healthcare spending growth on pharmaceuticals, but it’s also inaccurate. For 2016, growth in drug spending was a mere 1.3%—significantly below the growth rate of overall national healthcare spending.

Another fun fact: drug spending has grown more slowly than NHE in seven of the past ten years. Yes, really.

Our analysis also shows that spending on hospital care and healthcare professionals continues to expand much more quickly than drug spending. For 2016, those categories accounted for six times the spending on drugs dispensed from retail, mail, long-term care, and specialty pharmacies.

These new CMS data confirm the slowdown that I have highlighted in multiple Drug Channels articles. Once again, I must be the bearer of non-fake news. Read on for the details.

sPCMA Business Forum 2018
March 5 & 6, 2018
Hilton Bonnet Creek | Orlando, FL

The sPCMA Business Forum attracts many executives and decision makers from PBMs and the nation's largest specialty pharmacies. The two-day event offers invaluable networking and education for individuals and companies involved in specialty drug benefit management including specialty pharmacies, PBMs, pharma/biotech manufacturers, consultants, and others.


Conference features include:

• Timely and insightful sessions led by industry experts and decision makers;
• The ability to receive CPE credit;
• Dedicated time and facilities for private meetings;
• Valuable networking; and
• The new PCMA conference app allows users to access the attendee list, send messages to other attendees, create a personalized schedule, and access hotel maps, all in advance of the conference.

Contact PCMA

Please contact Jenny Bradham (jbradham@pcmanet.org) with questions or to request information about the Affiliate Program or conference sponsorships.

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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.

Today’s guest post comes from Tom Doyle, Executive Vice President Commercial Solutions at H. D. Smith / Triplefin.

Tom shares his views on how an ndependent patient services provider can enhance a manufacturer’s internal efficiency and the patient experience. He discusses patient assistance programs, automation, integration, and customer engagement.

To learn more about Triplefin’s full range of solutions, visit their booth at next week’s CBI Trade and Channel Strategies conference or visit www.triplefin.com.

Modern Distribution Management recently published my article 2017 MDM Market Leaders | Top Pharmaceuticals Distributors. It is an excerpt from our 2017–18 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors.

Below, I republish the section of the article highlighting five significant industry trends affecting the U.S. drug wholesaling industry. I think Drug Channels readers will enjoy this summary as we look toward an eventful 2018. Click here to download a free overview of the full report.

Many of the trends highlighted below have been headwinds for the wholesalers. They may help you understand why H.D. Smith sold its drug wholesaling business to AmerisourceBergen. Note that H.D. Smith did *not* sell its interest in the TripleFin business and Arete Pharmacy Network.

Surprise? CVS Health and Aetna announced their long-rumored merger. Relevant links below.

This transaction will create a healthcare organization with significant market share in the pharmacy, pharmacy benefit management (PBM), and health insurance businesses. There could be many potential opportunities for new consumer-oriented offerings. Finding the consumer value in this multi-headed $221 billion behemoth will be a major challenge.

Read on for my initial thoughts on the deal and what it means for PBMs, manufacturers, and pharmacies. I also highlight some of the implementation challenges.

Feel free to add your own thoughts on this mega-deal in the comments below. (Yes, you can comment anonymously.)

CBI’s 10th Hub and SPP Model Optimization
February 27-28, 2018 | Philadelphia, PA
www.cbinet.com/hubs

This February 27-28 in Philadelphia, join stakeholders from across the healthcare and life science industries to share and learn breakthrough strategies for service model design and enhancement to improve access and outcomes. You can read all about it here.

Drug Channels readers will save $400 off the standard rate when they use discount code MGK734 and register prior to December 15th.*

Led by chairperson Stella Vnook, Head of Patient and Access Services, Jazz Pharmaceuticals, the 10th installment of the Hub and SPP Model Optimization meeting features a broad range of perspectives:

• Industry Snapshot – Roxanne Schwans, Vice President, Managed Markets, Horizon Pharma
• Compliance Spotlight – Bradford Patrick, Division Counsel, AbbVie Inc.
• Collaborating with Hub and SPs – Matt Zeller, Vice President and Head, Patient and Specialty Services, Novartis Pharmaceuticals
• Hub Optimization – Meghan Szczeck, Director, Patient Services, Ipsen
• SPP Report Card – Caroline Teachey, HUB Program Liaison, Chiesi

You’ll also benefit from three Hub Lifecycle Learning Labs:

• Preparation Phase – Assessing Product Needs to Determine the Approach (Insource, Outsource or Hybrid)
• Development Phase – Selecting the Right Model for Your Therapy and Disease State
• Transition Phase – Minimizing Disruptions with Changing Partners

And three interactive and inclusive summits:

• Auditing Third-Party Providers and Measuring Program Performance to Ensure the Highest Quality of Service
• Contracting Course – Beyond the Data
• Hub Enrollment – Propelling Stakeholders to Go the Extra Step for their Patients

Plus! Attend our inaugural Technology Trailblazer Showcase – Statistical and Data-Driven Insights Unveiled.

Visit www.cbinet.com/hubs for further details and to register. Drug Channels readers will save $400 off the standard rate when they use discount code MGK734 and register prior to December 15th.*

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.

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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.

ICYMI: In early November, McKesson paid CVS Health $735 million for the RxCrossroads patient services hub business. A few weeks later, Express Scripts sold its United BioSource Corporation (UBC) hub business to a private equity firm.

These intriguing transactions make sense for all of these key drug channel players. CVS Health and Express Scripts divest businesses that could be perceived to conflict with their pharmacy benefit manager (PBM) business. McKesson deepens its investment in non-wholesaling manufacturer services for specialty products.

Below, I review the market landscape for hub service providers and explain the business issues that motivated the two PBMs to sell and McKesson to buy. I also ponder a crucial question: Did the PBMs get out at the right time?

Hope you enjoyed the Thanksgiving holiday! I remain ever-thankful for your support and readership.

Now that you’ve stretched your stomach, stretch your mind with some food for thought. In this issue:

• ICYMI: Actually, Amazon will not distribute drugs (for now)

• Premier tries to preempt worries about Amazon and GPOs

• Have you heard? Diplomat bought two PBMs

Plus, I share some thoughts on Alex Azar, nominee to head the Department of Health and Human Services.

P.S. Follow my daily musings and links to neat stuff at @DrugChannels on Twitter.

PBMI 2018 Annual National Conference
March 5-7, 2018 | Palm Springs, CA

The pharmacy benefit management business is evolving rapidly. Stay current by joining me at the PBMI 2018 Annual National Conference next March.

I'll be delivering the keynote address: The Outlook for Pharmacy Benefit Management: Evolution or Disruption?

Drug Channels readers can save $200 by using discount code PEM18 and registering before February 23, 2018.

I look forward to seeing you in sunny Palm Springs!

A MESSAGE FROM PBMI

PBMI invites you to join hundreds of industry thought leaders and benefit decision makers to its 23rd Annual National Conference. The meeting will be held at the Westin Mission Hills Golf Resort & Spa Hotel in beautiful Palm Springs, California.

Over the course of two and one-half days, attendees can get up to speed on the evolution of the pharmacy management industry and be educated on relevant issues and trends of drug cost management by industry experts.

The meeting will kick off with an opening keynote from industry expert Dr. Adam J. Fein as he provides you with his outlook for the pharmacy and PBM industries. He will:

• Explain the crucial trends reshaping the PBM market
• Describe key strategic responses by PBMs, payers, and other drug channel participants
• Examine the outlook for disruption of the current PBM business model
• Highlight implications for plan sponsors, PBMs, manufacturers, and others

New for the PBMI 2018 Annual National Conference is an expanded conference agenda. Attendees will now have the option to select from four track sessions as well as attend one of two pre-conference workshops to make the most of their conference experience. The conference tracks include:

• Track 1: Designing the Drug Benefit
• Track 2: Contracting and Industry Relations
• Track 3: Clinical and Trend Management
• Track 4: Innovation and Technology

Drug Channel readers will save $200 on conference registration fees when they use discount code PEM18 and register prior to February 23, 2018.

The PBMI team hopes you will join them in Palm Springs. To register, click here.

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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.