Analysis

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

The 2016 list contains seven drug channels companies—AmerisourceBergen, Cardinal Health, CVS Health, Express Scripts, McKesson, Rite Aid, and Walgreens. Assuming the Rite Aid-Walgreens deal happens, it will be six companies next year.

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 11 pharmaceutical manufacturers and a separate survey of independent pharmacies.

It’s politically fashionable to bash drug makers. These data remind us that many other multi-billion dollar businesses make some gold as drugs move through the U.S. reimbursement and distribution system.

National Association of Specialty Pharmacy (NASP) 2016 Annual Meeting & Expo
Omni Shoreham Hotel | Washington, DC | September 26-28, 2016

The NASP Annual Meeting & Expo is a comprehensive national meeting for all stakeholders in the specialty pharmacy industry. Join the leaders of specialty pharmacy as they gather for the 2016 NASP Annual Meeting, September 26-28, at the Omni Shoreham Hotel in Washington, DC.

This year’s NASP meeting is an expanded education program with more than 30 sessions in a compact, 2-day format, over 8 hours of exhibit and networking time, social events, and updates on national policy issues facing specialty pharmacy.

In addition, the first NASP Specialty Pharmacy Law Conference will be held immediately before the Annual Meeting. See the NASP website for additional information about this unique, 1-day conference for attorneys and others concerned with legal and regulatory aspects of managing and operating a specialty pharmacy.

The education program for the 2016 Annual Meeting includes a look at specialty pharmacy from the patient’s perspective, biosimilars, 340b, best practices in specialty pharmacy, value-based reimbursement, employer perspectives on specialty pharmacy, the coming impact of developments in genomics, specialty pharmacy in health systems, a perspective on how the upcoming presidential election will affect specialty pharmacy, and clinical sessions on immuno-oncology, multiple sclerosis, and NASH.

Don’t forget to make your hotel reservations. Discounted room rates are available to NASP Annual Meeting attendees on the NASP website.

Interested in visibility opportunities for your company at the NASP Annual Meeting?

NASP Annual Meeting attendees are CEOs, pharmacy directors, and executives from the nation’s leading specialty pharmacies as well as pharmacy directors and executives from health plans, health system pharmacies, GPOs, distributors, and more.

Sponsorship gives your company visibility to those influential audiences. For additional information about sponsorship or exhibiting, contact Firas Kwara of The Lynx Group at FKwara@the-lynx-group.com.

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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 group purchasing organization (GPO) Premier announced its acquisition of two specialty pharmacies from Lincare Holdings. Read the press release.

This deal shows just how crucial specialty pharmacy opportunities are for hospitals and health systems. Premier is betting that its members want to outsource specialty pharmacy dispensing and services to their GPO’s external pharmacy. But as I describe below, many hospitals are building their own in-house specialty pharmacies or outsourcing specialty pharmacy services (but not dispensing) to such third parties as Diplomat Pharmacy.

Read on for my overview of these developments. Manufacturers will find themselves increasingly challenged by the high apple pie in the sky specialty pharmacy hopes of hospitals and health systems. Oops, there goes another specialty pharmacy!

Reimbursement and Access 2016
August 17-18, 2016 | Philadelphia, PA
www.cbinet.com/reimbursement

Now in its 4th year, CBI’s Reimbursement and Access Congress provides manufacturers with invaluable learning and benchmarking, covering the most impactful pricing and reimbursement trends and access strategies. Attendees come together to align thinking on complex issues, overcome regulatory hurdles, demonstrate product value and maximize product access.

The Most Dynamic and Content-Rich Agenda to Date Featuring Interactive Panels, Compelling Sessions and Expert Insights:

• Marketplace changes impacting specialty drug management
• Political pathway analysis, scenarios and anticipated changes
• 340B’s growing role in reimbursement and access and future policy
• Innovative opportunities to focus on the value of specialty products
• Global trends influencing payer decision-making and market access
• Specialty drug utilization management and cost containment
• Approaches and attributes for value proposition enhancement
• Evolving OIG controls and kickback concerns
• Hub and SPP models to streamline processes and support access
• Potential Part B payment changes and impact on patient access

New for 2016 – Customize your Conference Experience!

Choose From Two In-Depth Workshops:A. Outcomes-Based Contracting and Rebating B. Reimbursement Models for Specialty Products Move between Two Tracks of Content: 1. Payer Strategies and Reimbursement 2. Access and Affordability

PLUS! Benefit from a Strategic Medicare Pricing and Contracting Deep Dive


Visit www.cbinet.com/reimbursement for more information. Drug Channels readers will save $400 off the standard registration rate when they use discount code EDH535.*

*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.

On Tuesday, Valeant Pharmaceuticals, the troubled hedge fund masquerading as a drug maker, finally released its first quarter earnings. It also lowered its 2016 guidance. Valeant’s stock dropped 15% on Tuesday, and is down 90% over the past year.

On its earnings call, Valeant disclosed new details about its relationship with Walgreens Boots Alliance (WBA). The news was not good. Due to what Valeant euphemistically called “speed bumps,” it ended up losing money on many prescriptions that Walgreens dispensed.

Thanks to the shrewd negotiations by the WBA team, Walgreens had no financial risk on these prescriptions. I conservatively estimate that in 2016, Walgreens may earn $50 million or more in dispensing fees from Valeant. Our global channel overlord wins again.

Read on for my best guess as to what’s happening with the Valeant-Walgreens relationship.

Last month, McKesson released the annual report for its 2016 fiscal year, which ended on March 31, 2016.

The report provided one big surprise: McKesson’s sales to CVS Health, its largest customer, grew to $38.7 billion—up by an astonishing $12 billion (+44%) from the previous year’s figure. We estimate that CVS Health accounted for about one-quarter of McKesson’s total North American drug distribution revenues. Wow.

Below, I review the history of the McKesson-CVS relationship and explain the factors that have driven this recent hockey stick growth.

This much is clear: The change has come.

Partnering with IDNs BioPharma Strategy Summit
August 17-18, 2016 | Philadelphia, PA
www.cbinet.com/IDNStrategy

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 BioPharma 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
• Change 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

Visit www.cbinet.com/IDNStrategy for more information. Drug Channels readers will save $400 off the standard registration rate when they use code DTJ972*.

*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.

Today’s guest post comes from Kay Morgan, Vice President of Drug Products & Industry Standards Clinical Solutions at Elsevier.

Kay discusses the complexities of identifying and labeling biosimilar drugs. She also explains the FDA’s existing draft guidelines and the market’s reaction to those guidelines.

For more background on biosimilars and drug pricing, read Kay’s article below and download Elsevier’s free white paper: Rising Drug Prices: Impact of Biosimilars.

It’s time to review the recently released EMD Serono Specialty Digest (12th edition), which provides an updated look at health plans’ specialty drug management strategies and tools. You can view it for free with site registration at specialtydigest.emdserono.com. (For some bizarre reason, you can’t download the report.)

The latest digest has some useful facts on specialty drug spending under the pharmacy and medical benefits. The report is also chock full of data about health plans’ busy oversight of specialty drugs.

This year's edition, however, reveals some troubling news lurking just below the cheerily colorful charts. As I highlight below, a few of the survey questions inadvertently reveal that even health plan executives lack confidence in the effectiveness of their own specialty drug management tools. Read on to see if I’m barking up the wrong tree.

340B Manufacturer Summit
August 18-19, 2016 | Washington, DC
www.cbinet.com/340B

With the evolving regulations impacting 340B programs, pharma manufacturers are faced with uncertainty on how to strengthen program compliance and integrity. The 340B Manufacturer Summit will breakdown and clarify the impending regulations, provide strategies to develop self-disclosure response and auditing processes and best practices for collaboration with contract pharmacies and covered entities.


PLUS - Critical Updates, Interactive Discussions and Valuable Takeaways:

• Implication of 340B Mega Guidance
• AMP Final Rule Interpretation for Successful Implementation
• Civil Monetary Penalties and Dispute Restoration
• 340B 101 Bootcamp
• Contract Pharmacy Arrangements
• Perspectives and Experiences of Leading 340B Covered Entities’ Solution Providers and Consultants
• Respond and Resolve Self-Disclosure Letters
• Manufacturer Perspectives on Implementing Change and Continuous Improvement within the 340B Program
• Auditing from all Angles — Facilitate Comprehensive Audits, Ensure Compliance and Sustain Program Integrity

For more information, please download the complete agenda or visit www.cbinet.com/340B.

Drug Channels readers will save $400 off of the standard registration rate when they use code KDB483.*

*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.