Analysis

Medicaid Drug Rebate Program (MDRP) Summit 2017
September 11-13, 2017 | Marriott Magnificent Mile | Chicago

Government rules and regulations affect every department at a pharmaceutical company. However, few areas are as directly-and as frequently-affected as the government programs, pricing, and reimbursement space.

Due to last year’s highly anticipated release of the AMP Final Rule, 340B Mega Guidance and Proposed Rule, HRSA's Rule on Dispute Resolution, and the recent release of CMS' Proposed Medicaid Managed Care Regulation, your day-to-day operations have fundamentally changed.

Join KNect365 in Chicago this September 11-13 at MDRP Summit 2017 the essential event positioned to provide insights into the implications of these inevitable changes. It’s the longest running and the largest MDRP event where 600+ industry, state, and federal government professionals come to get questions answered, gain clarity, and remain compliant.


Ensure you have the most comprehensive educational experience over three days with unparalleled access to government officials creating regulatory rules, the industry leaders interpreting them, and the pharmaceutical executives implementing them.


Collaborate with your peers and benchmark best industry practices to:

• Navigate Regulatory Hurdles
• Understand and comply with state processes, operations and requirements
• Address the impact of AMP Final Rule, 340B Guidance, along with State Policy changes

• Minimize Wasted Resources
• Develop strategies to streamline pricing and reporting
• New Interactive Think Tank & Innovation Theatre - Hear from the industry's leading service providers as they showcase new technologies and products to improve operations

• Optimize Finances
• Calculate liability and improve accuracy and accountability
• Discover the latest in Automation & Customization of finance systems

• EXCLUSIVE! Meet Face to Face with 14+ States in One-on-One Dispute Resolution Meetings where you can recoup or save millions of dollars in rebates and reimbursements.

Stay ahead of the curve by getting the best networking, education, and technology at MDRP Summit this September. There is no other MDRP event built like it.

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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 AmerisourceBergen executives Donna Gilbert, Vice President Specialty and Branded Strategic Accounts, Global Sourcing and Manufacturer Relations, and Akin Odutola, Senior Vice President, Specialty and Branded Product Access, Global Sourcing and Manufacturing Relations.

Donna and Akin discuss how a manufacturer’s channel strategies affect product access and commercial success. Click here to download Changing Channels, a complimentary ebook from AmerisourceBergen.

Read on for their insights.

Last Friday, I had the privilege of meeting with Secretary of Health and Human Services (HHS) Tom Price. I was invited to meet with Secretary Price for one of his listening sessions with industry experts and stakeholders. I appreciated the opportunity to share my perspectives.

In our meeting, I highlighted four ways that the 340B Drug Pricing Program is raising drug costs. I then offered eight specific recommendations for improving the program by addressing the widespread channel distortions the program has caused.

Read on for the recommendations and a summary of my comments to Dr. Price.

I have no idea if my suggestions will have any impact. Regardless, your friendly neighborhood blogger enjoyed spending time among some Washington insiders.

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.

Partnering with IDNs BioPharma Strategy Summit
August 16-17, 2017 | Philadelphia, PA

As health systems continue to grow and consolidate to form major Integrated Delivery Networks (IDNs), manufacturers are tasked with learning how to best contract with, and sell to, these evolving systems to ensure product success. With conflict of interest policies in place and restricted access to physicians, manufacturers are changing their sales approach to better reach and engage these new customers.

CBI’s Partnering with IDNs Strategy Summit convenes manufacturers and IDNs to discuss how to create a mutually beneficial partnership that contributes to continual care coordination, strategic product management and enhanced access.

Key Explorations Include:

• The IDN model of patient care coordination and what it can do to improve the patient experience on behalf of the provider, manufacturer, payer and other stakeholders
• Changes in the hospital reimbursement model, focused on quality tied to outcomes measures
• Effective ways manufacturers can partner with health systems
• Understand the size and scope of the current US hospital marketplace and the GPO’s contracting relationships with those providers
• Explore implications of value-based RWE on the healthcare manufacturing community in terms of contracting, distribution, and consumer engagement with payers and providers
• Gain perspective on how IDN SPs are gaining manufacturer network access

Confirmed Speakers Include:

• Jeff Prewett, Sr. National Account Director – Oncology GPO & IDN, Lilly USA, LLC
• Anindita Sinha, Director, Business Insights – Market Intelligence, Bayer
• William T. Lee, D.Ph, MPA, FASCP, Pharmacy System Director, Carilion Clinic Healthcare System
• Thomas Felix, M.D., R&D Policy, Intercontinental Region, Amgen
• Jerry Buller, Director, Specialty Pharmacy Services, Vanderbilt University Medical Center
• Michelle Templin, Vice President, Government Affairs and Business Development, MHA ACO Network

Visit www.cbinet.com/IDNStrategy for more information. Drug Channels readers will save $400 off the standard registration rate when they use discount code QJF259.*

*Discount may not be combined with other offers, category rates, promotions, or applied towards an existing registration. Offer not valid on workshop only or academic/nonprofit registrations. 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.

This week, I’m rerunning some popular posts while I attend Asembia’s 2017 Specialty Pharmacy Summit. Click here to see the original post and comments from January 2017.

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Last week delivered significant announcements that will shake up the market for epinephrine auto-injector pens. CVS began promoting a lower-cost EpiPen alternative. Small pharma company Kaléo relaunched the AUVI-Q. Meanwhile, Mylan’s new generic EpiPen continued to gain traction.

It’s a good time to revisit the EpiPen situation and see what it tells us about U.S. pharmaceutical industry pricing. After last week’s announcements, there are now four key products, each with its own list price and rebate arrangements:

• An EpiPen with a $608 list price and rebates to pharmacy benefit manages (PBMs)

• An EpiPen with a $300 list price, but no rebates

• Adrenaclick, an alternative product with a $110 cash price at CVS pharmacies

• Auvi-Q, another alternative, with a $4,500 (!) list price

As I explain below, these variations wonderfully illustrate the warped incentives embedded in our crazy drug channel. Will we make progress in popping the gross-to-net bubble?

This week, I’m rerunning some popular posts while I attend Asembia’s 2017 Specialty Pharmacy Summit. Click here to see the original post and comments from December 2016. FYI: I updated a few links with our more current market data.

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Modern Distribution Management recently published my article 2016 MDM Market Leaders | Top Pharmaceuticals Distributors. It is an excerpt from the 2016-17 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors.

Below, I republish the section 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 2017.

This week, I’m rerunning some popular posts while I attend Asembia’s 2017 Specialty Pharmacy Summit. Click here to see the original post and comments from December 2016.

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Pharmacy benefit managers (PBMs) are facing unprecedented criticism about their business practices and levels of transparency. Which got me wondering: What do plan sponsors—the PBMs’ customers—think about their PBMs?

For the answer, I turned to Pharmacy Benefit Management Institute (PBMI) 2016 Pharmacy Benefit Manager Customer Satisfaction Report (available for purchase.) It rates 11 PBMs based on feedback from more than 500 plan sponsor customers.

The data show a strong association between a PBM’s perceived transparency and a plan sponsor’s satisfaction. As you will see in the charts below, plan sponsors are more satisfied with PBMs that are more transparent.

Yet the causality of this relationship isn’t entirely clear. Smaller plan sponsors tend to work with smaller PBMs, which are rated more highly on transparency and alignment of goals. Are more transparent PBMs truly better? Or, are we observing a selection effect, whereby plan sponsors with fewer internal resources choose PBMs with different business and profit models? And if PBM transparency is so wonderful, why don’t all plan sponsors insist on it?

DIR Fees, Rebates, Pharmacy Economics, and the Future of Medicare Part D
This week, I’m rerunning some popular posts while I attend Asembia’s 2017 Specialty Pharmacy Summit. Click here to see the original post and comments from February 2017.

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The Centers for Medicare & Medicaid Services (CMS) just released a controversial and important new report: Medicare Part D – Direct and Indirect Remuneration (DIR).

The report shows mixed consequences of DIRs in the Medicare Part D program. For example, manufacturer rebates (the biggest part of DIRs) reduce plan costs and Part D premiums. However, beneficiaries pay higher out-of-pockets costs because coinsurance amounts are based on the undiscounted, pre-rebate retail price. Meanwhile, the government is paying a growing share of drug costs due to catastrophic coverage.

The CMS report has important implications for how we think about rebates, gross-to-net discounts, plan premiums, and patients’ out-of-pocket expenses. That’s why industry reactions have ranged from outrage to defensiveness. I encourage you to read the report and think about how it lays the groundwork for changing the Medicare Part D program.

This week, I’m rerunning some popular posts while I attend Asembia’s 2017 Specialty Pharmacy Summit. Click here to see the original post and comments from February 2017.

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Next week, Drug Channels Institute will release our updated 2017 Economic Report on Pharmacies and Pharmacy Benefit Managers (known in our previous editions as The Economic Report on Retail, Mail, and Specialty Pharmacies)

The exhibit below—one of 143 in our new report—provides a first look at the largest pharmacies, ranked by total U.S. prescription dispensing revenues for calendar year 2016. As you will see, the growth of specialty drugs is reshaping the pharmacy and PBM industries.

For a sneak peek at the complete report, download the free overview. Enjoy!