Analysis

PAP Legal Update
September 21-22, 2016 | Alexandria, VA
www.cbinet.com/papupdate

As a critical update to CBI’s longstanding Patient Assistance Programs (PAP) Conference, this PAP Legal Update forum provides insight into key and pressing legal issues, emerging legislation and compliance considerations driven by the OIG to ensure that PAPs can continue to serve patients while compliantly remaining within the boundaries of laws and guidelines.

Advanced Discussion on Key Issues and the Path Forward for Patient Programs:

• Complexities of patient access programs in an era of ambiguity
• OIG’s jurisdiction relative to PAPs, Co-Pay Foundations and hub services
• Impact of the most recent OIG Special Advisory Bulletin
• Legal nuances and restraints with co-pay assistance and foundation support
• Compliant reimbursement services around patient coverage and benefits
• Projected evolution of PAPs and patient support programs

For more information, please download the complete agenda or visit www.cbinet.com/papupdate. Drug Channels readers will save $400 off of the standard registration rate when they use discount code UMF446.*

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category 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.

This week, the two largest pharmacy benefit managers (PBMs)—Express Scripts and the CVS/caremark business of CVS Health—released their 2017 formulary exclusion lists. They are available below for your downloading pleasure.

For 2017, Express Scripts made relatively few changes to its list, which has fewer products than it 2016 list. CVS Health, however, expended its list to 154 products, compared with 124 products last year. CVS also got much more aggressive with specialty drugs.

Read on for my head-to-head comparison, including comments on such high-profile specialty categories as hepatitis C, inflammatory conditions, biosimilars, and more.

Last week, drug wholesaler McKesson released its latest quarterly earnings, which confirmed the slowing revenue growth in its U.S. drug distribution business. The slowdown was not surprising, given the many market changes that I have highlighted here on Drug Channels. If Walgreens Boots Alliance completes its acquisition of Rite Aid, then McKesson will face another year of challenging revenue growth.

McKesson is working to counter the slowdown with acquisitions, cost cutting, its new Walmart deal, a strong oncology presence, and the impressive expansion of its Health Mart franchise. Manufacturers and pharmacies should expect McKesson to become more aggressive as it adjusts to these new realities.

See the chart below for a quantitative perspective on McKesson’s past few years along with my commentary on a few other highlights from the company’s quarterly report.

Electronic Benefit Verification & Prior Authorization Summit
October 25-26, 2016 | San Francisco, CA
www.cbinet.com/eBenefit

CBI’s 7th Annual Electronic Benefit Verification & Prior Authorization Summit convenes an elite multi-stakeholder speaking faculty, including manufacturers, associations, health plans, solution providers and prescribers to discuss challenges and share best practices regarding the implementation and operational management of electronic patient service technology.

Gain key insights on pressing issues including steps to integrate electronic prior authorizations and benefit verifications into existing systems, streamlining information exchange between key stakeholders, improving formulary management and prior authorization processes and much more!


Visit www.cbinet.com/eBenefit for more information. Drug Channels subscribers will save $300 off the standard registration rate when they use discount code BYU636.*

Gain Insights into the Integration and Management of Patient Access Technology:

• Hear case studies and discuss steps needed to integrate electronic prior authorizations (ePA) into existing systems
• Understand the future of benefit verification solutions, and identify steps needed to achieve real-time verifications
• Compare and contrast critical updates and innovations in patient access technology
• Explore the integration of patient portal technology and understand how this technology impacts patient autonomy
• Determine the connection between formulary data management and prior authorization processes
• Facilitate efficient information exchange between key stakeholders, including manufacturers, health plans, health systems, PBMs, and prescribers to expedite workflow

*Discount expires October 24, 2016; 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.

The hot and hazy days of summer are here. Go for a swim to cool off and then enjoy this refreshing selection of articles with the Drug Channels seals of approval.

In this issue:

• Great HBS research on biosimilars in Europe

• An entertaining video primer on the realities of regulating drug prices

• Say happy birthday to drug wholesaler Morris & Dickson

Plus, The New Yorker helps you interpret the latest scary health news.

P.S. Don’t forget to follow @DrugChannels on Twitter for my daily links to stuff worth reading.

The distribution channel for provider-administered oncology drugs is undergoing significant change—notwithstanding the Centers for Medicare & Medicaid Services’ (CMS) misguided and controversial Part B Drug Payment Model.

As you will see below, pharmacies—via white and brown bagging—have displaced buy-and-bill distribution channels for about one-quarter of oncology products. For the remaining purchases, community oncologists still rely on traditional buy-and-bill wholesale distribution channels. Hospital-based practices, however, are more likely to source products from the hospital’s pharmacy.

This shift has important implications for manufacturers’ channel strategies, specialty pharmacies’ business growth, distributors’ share of channel volume, and the expansion of 340B pricing to non-340B providers. When you eliminate the impossible, whatever remains, however improbable, must be the truth.

7th Hub and SPP Model Optimization
September 29-30, 2016 | San Diego, CA
www.cbinet.com/hubswest

With mounting cost pressures and increased demands for affordable, value-based treatment options, bio/pharma teams face an increasingly competitive market. Increasingly, industry must strategize to manage the most critical challenges associated with product and patient services.

CBI’s 7th Hub and SPP Model Optimization conference provides executives with strategies for developing and integrating hub programs and other patient-centric services to ensure product access and maximize reimbursement.

Gain expert insight into the latest operational challenges, including:

• Maximizing hub operations and field reimbursement teams
• Defining patient services and effectively managing their operation
• Streamlining ePA to maximize patient support
• Establishing the role of the SP and the Hub and streamlining information exchange between these two stakeholders

Plus, don’t miss two case studies on a manufacturer developed eHub and the Hub-Lite model!

For more information, please download the complete agenda or visit www.cbinet.com/hubswest. Drug Channels readers will save $400 off of the standard registration rate when they use code QRJ285.*

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category 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, the Centers for Medicare & Medicaid Services (CMS) released its latest forecasts for national health expenditures. See the Health Affairs article: National Health Expenditure Projections, 2015–25: Economy, Prices, And Aging Expected To Shape Spending And Enrollment. (Available for free to subscribers and to others for purchase.)

The boffins at CMS have again raised their forecasts for spending on outpatient prescription drugs. Their new projections show that through 2025, drug spending will grow slightly faster than will total U.S. healthcare spending. By 2025, the U.S. is expected to spend about $615 billion annually on outpatient prescription drugs.

Despite this growth, outpatient prescription drugs will still account for only about one of every nine U.S. healthcare dollars. By comparison, spending in 2025 on hospitals and physicians is projected to be $3.2 trillion, or more than five times the spending on outpatient pharmaceuticals.

Below, I delve into the latest numbers, explore how the new forecasts compare with previous prognostications, and highlight the variables driving CMS’s model.

Many 340B lobbyists frequently claim that the 340B Drug Pricing Program amounts to “only 2%” of total U.S. drug purchases and is therefore not a significant issue.

This is an extremely careless misrepresentation of the truth. As I document below, 340B now accounts for at least 4% of the U.S. drug market. That’s twice as large as the lobbyists’ “only 2%” figure, which hasn’t been true for at least 7 years. You can check my math below.

Regardless of whether you believe that 340B should be a bigger or a smaller part of the market, we shouldn’t be debating its actual share. Just remember our Drug Channels philosophy, courtesy of the late senator Daniel Patrick Moynihan: "Everyone is entitled to his own opinion, but not his own facts."

CBI’s 4th Annual Coupon and Co-Pay Offer Design Optimization
September 15-16, 2016 | Philadelphia, PA


Think coupon and co-pay programs are going away? Think again!

CBI's flagship Coupon and Co-Pay Offer Design Optimization conference returns to the East Coast in September for its fourth installment. Benefit from the life sciences industry’s foremost event devoted exclusively to ROI-generating coupon and co-pay programs.

Join the who's who in life sciences and discover leading-edge strategies to maximize products throughout the lifecycle by leveraging these powerful discount opportunities. The 2016 agenda boasts a diverse, experienced faculty from AstraZeneca, Bayer, Cempra Pharmaceuticals, EnvisionRx, GlaxoSmithKline, Novo Nordisk, United Healthcare UV Health System and many more!

Don't miss your chance to unite with leading innovators in co-pay offer design on the most important topics facing coupon and co-pay programs, including:

• Stakeholder opinions on the true value and benefit of manufacturer discount programs during a new Opening Luminary Showcase
• Strategies for combating the negative implication and patient perception on pharmaceutical pricing through effective marketing and distribution of co-pay programs
• Effective internal program management strategies for coupon and co-pay programs through a co-pay center of excellence
• Utilization of data analytics to determine co-pay offer and prescription value to properly target distribution efforts
• Streamlined and effective promotion of co-pay programs in large health systems to assist in patient first fill and reduction of re-admissions
• Alignment of offer strategy with contracting efforts to avoid “double-dipping” of rebate and co-pay offerings

*Discount offer valid through 8/14/2016; applies to standard rates only and may not be combined with other offers, categories, promotions or applied to an existing registration.

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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.