Analysis

Life Sciences 2nd Annual Value-Based Contracting Summit
October 23-24, 2017 | Alexandria, VA
www.worldcongress.com/valuebased

The Life Sciences 2nd Annual Value-Based Contracting Summit brings together key stakeholders to examine risk sharing strategies to overcome operational challenges and execute successful value-based contracts.


How will you benefit?

• Learn about Pfizer's approach on the move from utilization to impact

• Examples of how Aetna operationalized value-based agreements to optimize the care experience

• Understand how value-based arrangements impact provider organizations
  

• Gain insight from payers on what they need from manufacturers when entering into a value-based arrangement
• Analyze how RXAnte and UPMC Health Plan are implementing alternative payment models for prescription drugs
• Understand how to leverage real world data in collaborations between pharma and payers
• Collaborate with fellow attendees to solve challenges associated with operationalizing a value-based contract during our hands-on working group
• Understand the implications on Medicaid, 340B Drug Discount Program, Medicare Part B Program and VA Program
• Ensure transparency in price negotiations with payers and comply with communication guidelines
• 6-for-1 ticket pricing! As part of your registration, gain access to any of the co-located events part of the Value-Based Health Care Congress - a 6 track event covering value-based network and contract management, MACRA strategy, ACO strategy, ACO & IDN collaboration, and value-based contracting.

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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.

This week, I’m rerunning some popular posts while I work on the forthcoming 2017-18 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. Click here to see the original post and comments from May 2017.

FYI, Asembia's 2018 Specialty Pharmacy Summit will be held on April 29 to May 2, 2018.

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Last week, Paula and I had the pleasure of attending Asembia’s 2017 Specialty Pharmacy Summit in Las Vegas, itself the summit of spectacle. We even met a new friend, as you can see from the photo on the right.

The Specialty Pharmacy Summit remains the most important forum for conducting business in the specialty marketplace. More than 5,000 people learned, networked, and connected at the wonderful Wynn Las Vegas. Thanks to Larry and Robert Irene for creating an annual event that brings the entire industry together. Click here to enjoy the social media action from #Asembia17.

Today marks the seventh year that I will violate Vegas code and tell you what happened there. Below, I offer reflections on key specialty industry trends, DIR fees, patient satisfaction controversies, and a link to the Featured Session slides. You’ll also find a few incriminating photos! Please add your own observations and photos to the comments section below.

This week, I’m rerunning some popular posts while I work on the forthcoming 2017-18 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. Click here to see the original post and comments from May 2017.

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CNBC reported last week that Amazon may enter the pharmacy and/or pharmacy benefit manager (PBM) market. Here’s the story: Amazon is hiring people to break into the multibillion-dollar pharmacy market.

The news made many people freak out and then begin speculating on all of the amazing ways that Amazon would change the drug channel. USA Today breathlessly mused: Could your next prescription come from Amazon?

Amazon has been successfully attacking the front-end business of chain drugstores. But could it really disrupt the pharmacy and PBM industries?

Below, I provide a reality check on how Amazon could compete—and what it is unlikely to do.

This week, I’m rerunning some popular posts while I work on the forthcoming 2017-18 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. Click here to see the original post and comments from March 2017.

ICYMI, I published a follow up analysis that includes OptumRx in Which PBM Best Managed Drug Spending in 2016: How Did OptumRx Compare?

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Four of the largest pharmacy benefit managers (PBMs)—CVS Health, Express Scripts, MedImpact, and Prime Therapeutics—have raised their swords and released their 2016 drug trend reports. (Links below.) That means it’s time for some Drug Channels-style fun! Below, I review what the reports reveal about drug spending—and which questions remain unanswered.

Drug trend measures the year-over-year changes in a plan sponsor’s pharmacy benefit drug spending. As you will see, all four PBMs reported that their drug trend percentages for 2016 were in low single digits. The unweighted average among them was a mere 3.5%. About one-third of PBM clients experienced year-over-year declines in drug spending.

Put more simply: The U.S. doesn’t have a drug spending problem. It's fake news.

Specialty drugs have doubled as a share of plan sponsors’ benefit costs. Since these products account for only about 1% of claims, pharmacy benefit management is increasingly focused on handling these patients and their complex, hard-to-treat diseases. Unfortunately, payers seem set on discriminating against people who receive these therapies.

Keep in mind that the PBMs’ reports are primarily marketing documents, not peer-reviewed research studies. But as many PBM executives have said: What we do in life echoes in eternity!

This week, I’m rerunning some popular posts while I work on the forthcoming 2017-18 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. Click here to see the original post and comments from June 2017.

ICYMI, I published a corresponding per-prescription analysis in Follow the Dollar Math: How Much Do Pharmacies, Wholesalers, and PBMs Make From a Prescription?

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Time for my annual review of the Fortune 500 list. Every year, this is one of my most popular posts, because it helps us “follow the dollar” and understand how drug channel intermediaries make money.

The 2017 list contains the same seven drug channel companies that the 2016 list did: AmerisourceBergen, Cardinal Health, CVS Health, Express Scripts, McKesson, Rite Aid, and Walgreens Boots Alliance.

Using the Fortune data, I explore the profitability and shareholder returns of the largest public drug wholesalers, chain pharmacies, and pharmacy benefit managers (PBMs). I compare these companies with the Fortune 500’s ten pharmaceutical manufacturers and a separate survey of independent pharmacies.

The Fortune data remind us that many multi-billion dollar businesses profit as drugs move through the U.S. reimbursement and distribution system. We must recognize this complex system in order to tackle the price and affordability of drugs.

4th Annual Rare Disease Market Access and Commercialization Summit
October 23-24, 2017 | Boston, MA
www.worldcongress.com/raredisease

Join your peers at the 4th Annual Rare Disease Market Access and Commercialization Summit for a deep examination of the challenges, innovations and techniques for achieving commercial success and navigating the payer landscape.

How will you benefit?

• Establish best practices when approaching value-based contracting, specifically for rare therapies
• Analyze recent policy and industry changes, paired with the rising status of the patient voice as a stakeholder, and their joint effect on the drug development lifecycle
• Payer guidance (Blue Cross Blue Shield of Minnesota) on the reimbursement conundrum
• Review Amgen and Harvard Pilgrim's outcomes-based contract for Repatha
• Explore Shire andPatientsLikeMe's collaboration expanding traditional clinical trial monitoring towards the use of real world data and consolidation in a single digital platform
• Gain insight from manufacturers' and Walgreens on how to develop a specialty pharma channel strategy for a rare disease product launch
• Hear specific examples of successful marketing strategies for recent rare disease product launches that satisfied stakeholders' needs

Register today – Use discount code DC200 and save $200!

Visit www.worldcongress.com/raredisease for more information.

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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.

The eclipse has passed! Now it’s time to enjoy this blinding collection of curious questions, filtered through the all-seeing Drug Channels viewfinder.

• What are Amazon’s actual prospects in the drug channel?

• What does Express Scripts think about Amazon's prospects?

• Why did Walgreens partner with KKR to buy PharMerica?

• What happens to patients when plans favor brand-name drugs over generics?

Plus, Jeff Bezos shares words of wisdom for budding entrepreneurs.

P.S. If everything under the sun is in tune, then you'll follow @DrugChannels on Twitter for my daily links to all that you love.

CBI’s Gross-to-Net Summit
November 15-16, 2017 | Philadelphia, PA
www.cbinet.com/GTN

A recent Drug Channels blog post focused on a QuintilesIMS report, discussing how the total value of pharmaceutical manufacturers’ off-invoice discounts, rebates, and other price concessions has more than doubled over the past five years, from $59 billion 2012 to an astonishing $127 billion in 2016.

What is the best way to position your organization to manage this increase? How are your colleagues from across the industry achieving success? Find out at CBI’s GTN Summit! Drug Channels readers will save $400 off of the standard registration rate when they use discount code SDP676.*

The 7th annual meeting covers a broad range of subjects related to strategic GTN forecasting, accounting estimates, data analytics and financial reporting specifically for life science companies. Some hot topics will be addressed, such as health care reform, GTN impacts of coupons and copay programs, revenue recognition based on the new standard, pipeline reserve accruals and much more! There are also session breakouts specifically for Pharma/Established Brands, Generics and Emerging Biotech/New Launch.

Featured Sessions

• Redefining Gross-to-Net – Moving Beyond Theory for Profitability, Streamlined Data, Organizational Transparency and Control
• Business Process Excellence – Instituting Best in Class Processes, Communication Flows and Data Frameworks for GTN
• Talent, Leadership and Organization Design – Prioritizing GTN
• Beyond Excel — GTN Data, Technology and Documentation: Sound-Off, Size-Up and Scale with Various Approaches to Systems and Automation

Workshops and Learning Streams on:

• Profitability and Managed Markets Strategy
  
• Inventory and Channel Forecasting
  
• Robotics and Artificial Intelligence in GTN
  
• Internal Controls and SOX Compliance
  
• Accounting and Reporting
  
• Financial Planning and Analytics
  
• Contract Strategy and Operations
  

Be one of the first to see the agenda here, and visit www.cbinet.com/GTN for further details and to register. Drug Channels readers will save $400 off of the standard registration rate when they use discount code SDP676.*

*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.

Last week, Diplomat Pharmacy released its quarterly earnings, which included new details about the financial impact of Direct and Indirect Remuneration (DIR) fees. I provide some background on DIR fees below.

Diplomat, as a public company, is the only entity that is obligated to publish truthful information about DIR fees. While reviewing its data, let’s recall our Drug Channels philosophy, courtesy of the late senator Daniel Patrick Moynihan: "Everyone is entitled to his own opinion, but not his own facts."

As you will see below, Diplomat’s exposure to DIR fees remains relatively modest. DIR fees as a share of its gross profit has even declined since last year. This shift is driven by an evolving business mix along with better accounting of and management control over DIR fees.

In part to counter DIR fees and other payer pressures, Diplomat is signaling its intention to play a more significant role in the pharmacy benefit management (PBM) business. Let the rumors begin!

Electronic Benefit Verification & Prior Authorization Summit
October 24-25, 2017 | San Francisco, CA
www.cbinet.com/eBenefit

CBI’s Electronic Benefit Verification & Prior Authorization Summit provides attendees with an understanding of key issues and developments in electronic patient services, including electronic benefit verification, real-time benefit verification, prior authorizations, health records and prescribing services.

Gain Critical Insights and Strategies to Improve Patient Access

• Examine challenges associated with ePA implementation, and understand planning and operational considerations associated with technology adoption
• Understand the implementation steps needed to achieve real-time benefit verification
• Compare innovations in electronic patient service technology to identify what solutions fit within company strategies
• Determine how to leverage patient support programs to overcome formulary barriers, help patients stay on therapy and drive positive physician coverage perception
• Discuss how to streamline electronic benefit verifications and prior authorization solutions into a hub model
• Facilitate efficient information exchange between key stakeholders, including manufacturers, health plans, health systems, PBMs and physicians

Visit www.cbinet.com/eBenefit for more information. Drug Channels readers will save $400 off the standard registration rate when they use discount code PSK783*

*Discount expires October 24, 2017; applies to standard rates only and may not be combined with other offers, category rates, promotions or applied to an existing registration. Offer not valid on workshop only or academic/non-profit registrations.

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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.