Analysis

A fascinating new report sheds light on the changing sites of cancer treatment: Cost Drivers of Cancer Care: A Retrospective Analysis of Medicare and Commercially Insured Population Claim Data 2004-2014 (free download). It was commissioned by the Community Oncology Alliance (COA) and conducted by researchers at Milliman, an actuarial firm.

The report, which includes both Medicare and commercial claims data, confirms that the administration of chemotherapy infusion has shifted dramatically from lower-cost physician offices to higher-cost hospital outpatient settings. From 2004 to 2014, the buy-and-bill market share at physician offices dropped from about 90% to about 50%. See the chart below.

Commercial payers’ reimbursement approaches, combined with the 340B Drug Pricing Program, will continue to shrink buy-and-bill volume in physician offices. Unfortunately, these same factors also suggest that the Centers for Medicare & Medicaid Services (CMS) crazy Medicare Part B experiment will accelerate the shift of drug administration to hospital outpatient facilities.

On Drug Channels, I highlight the two primary reasons pharmaceutical manufacturers’ list prices don’t represent what third-party payers actually spend for drugs: (1) channel intermediaries add markups that account for the costs, profits, and value of the channel's services, and (2) manufacturers provide rebates and discounts to third-party payers.

The new 2015 Medical Pharmacy Trend Report (free download), from Magellan Rx Management, documents just how outrageous a channel’s markups can be.

As I show below, the reimbursement approaches that commercial payers use permit hospitals to get paid two to three times as much as physician offices—and to inflate drug costs by thousands of dollars per claim. Naturally, the 340B program plays a part in this sordid tale.

A few prominent hospital-based physicians have become very public critics of pharmaceutical list prices. It may come as no surprise that these physicians neglect the pricing behavior of their own employers, ignore the hospital-related factors affecting payers’ spending, and fail to examine drugs’ true net costs. I guess that when the media spotlight is shining, it’s better to take the money and run than be intellectually honest.

eyeforpharma Oncology Market Access & Pricing
June 23-24, 2016 | Philadelphia, PA


You know it and have heard and read it here before: Market access in oncology is no longer guaranteed. It means that innovative manufacturers need to collaborate with managed care to provide real value. There are few occasions where pharma leaders meet the key stakeholders – eyeforpharma’s 7th Annual Oncology Leadership Summit on June 16-17 is the Number One out there , and here’s why:


These are just a few program highlights to help you succeed in the shifting market:

• William Hinshaw, EVP, US Oncology, Novartis, shows how to adopt new business strategies that will help you prepare for stakeholders demands.
• Michael Ryan, SVP, US Value, Access & Policy, Bristol-Myers Squibb, guides us through steps to mastering a stronger market access trajectory by demonstrating your products’ value.
• Richard Schilsky, CMO, ASCO, guides us through ASCO’s Value Framework.
• Michael Kolodziej, National Medical Director, Aetna, leads the discussion on the various value-based pricing metrics and their importance in the future.
• Anil Kapur, VP & Global Head, Oncology Commercialization, Baxalta, discusses the newest trends in immuno-oncology commercialization to optimize your positioning on the market.

Attendees learn as much from the world-class speaking faculty as they learn from their peers. Recent registrants include:

• VP, HEOR & Pricing – Baxalta
• VP, Market Access - R-Pharma US
• Senior Director – Janssen
• Executive Director, Health Policy - Novartis
• Director, Market Research – Celgene
• Director, Market Access & Reimbursement - Eisai
• Director, Market Access – GSK
• Director, Advocacy & Policy- Eli Lilly

We’ve already confirmed dozens senior participants from: Aetna / American Society of Clinical Oncology/ AstraZeneca/ Bayer / Baxalta / Bristol-Myers Squibb / Cancerlinq / Celgene / Dana Farber / Eisai / Eli Lilly / GSK / Health Strategies Group / ICER / Janssen/ Merck / Novartis / Precision for Value / RAND / Roche / Takeda….

For those who like to stay ahead of the curve in Oncology Market Access & Pricing, this is a must-attend.

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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 sponsored guest post has exciting news from our friends at Armada Health Care. Read on to learn more...and be sure to register for the 2016 Asembia Specialty Pharmacy Summit (formerly the Armada Specialty Pharmacy Summit), happening in less than four weeks!

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Armada Health Care Changes Company Name to Asembia

By Armada Health Care

Rebrand to Focus on Enhanced Collaboration with Member Pharmacies, Manufacturers, Payers and other Industry Stakeholders to Develop Complete Solutions for Specialty Pharmaceuticals

Florham Park, NJ, April 7, 2016 – Armada Health Care, the nation’s leading specialty pharmaceutical channel management organization, announced today the launch of a new brand identity that includes a company name change. Armada Health Care’s new name will become Asembia.

Under the new Asembia name, the company will continue to expand on its specialty pharmaceutical service offerings which include collaboratively developed solutions that are specific to pharmacies, pharma/biotech manufacturers and payers.

“The specialty pharmacy market continues to grow at an incredible rate and our organization has expanded our services to fulfill the needs of our customers who are focused on this market. We are a very different company from when we first started more than a decade ago. In this regard, we are excited to announce our new corporate identity which we feel better reflects our broad array of capabilities and service offerings, each of which are developed collaboratively with our member pharmacy and manufacturer partners,” stated Lawrence Irene, RPh, chief executive officer.

“Under the new Asembia name, we will continue to expand on our company’s tradition of providing our partners with valuable solutions ranging from high-touch patient support hub services, innovative technology platforms and collaborative contracting strategies for specialty pharmaceutical products,” Irene continued.

For consistency, all products or services that previously contained Armada in the name will also undergo the change, specifically the ArmadaOne Specialty Pharmacy technology platform will now be called Asembia1 and the company’s annual specialty pharmacy conference will transition to, the Asembia Specialty Pharmacy Summit.

For more information, please contact us at 973-564-8004 or visit the new website at www.asembia.com

About Asembia (Formerly Armada Health Care)

For more than a decade, Asembia has been working with member pharmacies, manufacturers, prescribers, payers and other industry stakeholders to develop solutions for the high-touch specialty pharmaceutical service model. Through collaborative programs, contracting initiatives, patient support hub services and innovative technology platforms, Asembia is committed to positively impacting the patient journey. For more information visit www.asembia.com.

On Tuesday, Walgreens Boots Alliance (WBA) held its latest quarterly earnings call. (See links below for materials.)

Regular readers know that earnings calls can yield invaluable, on-the-record insights straight from a management team. In fact, after reviewing January’s WBA call, I speculated about a future WBA partnership with OptumRx months before it happened. (See the last line of that post.)

Below, I highlight and comment on the WBA management’s latest intriguing statements on prescription margins, the company's retail transformation, Express Scripts, generic inflation, Rite Aid’s EnvisionRx PBM, Valeant, and more.

One downside on the call: The WBA execs clearly demonstrated that they have mastered the art of the earnings call non-answer answer.

Ronny Gal, Ph.D., a senior analyst at the investment bank Sanford C. Bernstein & Co., recently published a thought-provoking analysis of Teva and its strategy for defending multiple sclerosis specialty drug Copaxone from generic competition.

Gal argues that Sandoz is using a similar strategy to defend Gleevec against generic competition from Glatopa.

Below, I provide some context and include the highlights of Dr. Gal’s analysis. He notes that the strategies work best when there’s only one generic competitor. Given the likely approval paths for pharmacy-dispensed biosimilars, I expect that manufacturers of specialty drugs will use these tactics when defending their products, too.

CBI’s Pharmacy Channel Strategies for Specialty Products
June 23-24, 2016 | Philadelphia, PA
www.cbinet.com/pharmacychannel

CBI’s Pharmacy Channel Strategies for Specialty Products conference brings together key specialty product stakeholders to provide insight on which pharmacy models are impacting payer and patient access, adherence and abandonment. Learn the latest trends in pharmacy channel strategies for the opportunity to leverage the evolving dynamics of patient engagement with specialty products.

Speakers include representatives from Acadia Pharmaceuticals, Aureus Health Services, Biogen, BioPlus Specialty Pharmacy, Giant Eagle, Gilead Sciences, LiquidHub, Millennium, The Oncology Division of Takeda and more.

Plus, attend an in-conference workshop by Biogen: Navigate the Complexities of Managing and Creating Limited Distribution Networks Based on the Pharmacy Model.

For more information, please download the complete agenda or visit www.cbinet.com/pharmacychannel. Drug Channels readers will save $400 off of the standard registration rate when they use discount code PAB499.*

*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.

Time to pig out on this month’s squeal-worthy selection of news stories that we found while rooting around the pharmaceutical trough. In this issue:

• My $0.02 on Anthem’s Other Motivation for Its Express Scripts Lawsuit

• Trinity Health Fires Wholesaler Cardinal Health and Takes Its Supply Chain In-House

• Express Scripts Provides a Useful Look at the Generic Pipeline in 2016

P.S. For daily updates on the spam-free stuff that I think is interesting, join the cool kids who wallow with @DrugChannels on Twitter.

Rx Sample Management and Logistics Summit
April 19-20 | Philadelphia, PA
www.cbinet.com/sample

Greater efficiency and better results are no longer a competitive advantage, but are now a necessity in today’s complex, competitive and challenging healthcare environment. Through interactive discussions, robust panels, breakout sessions and in-depth presentations, CBI’s Rx Samples Management and Logistics Summit arms you with the tools and roadmaps you need to eliminate the gap in your brand’s sphere of influence.

At this year’s conference, delve into strategies for effectively connecting with HCP, NP and PA stakeholders while optimizing sample data collection and reporting processes to ensure greater efficiencies. Take advantage of this unique platform that provides you with actionable information on sample compliance, data and reporting while connecting you with leaders in the industry for solution-oriented and collaborative discussion.

Visit www.cbinet.com/sample for more information.

Speakers Include Representatives from:
Janssen | Johnson & Johnson | Pfizer | Novo Nordisk Inc. | Sanofi-Genzyme | Boehringer Ingelheim Pharmaceuticals, Inc. | Adherent Health, LLC | Alnylam Pharmaceuticals | | Shire | ZS Pharma, Inc. |

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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.

Our spidey sense tells us that Walgreens Boots Alliance (WBA) has been one busy company lately. As expected, WBA has increased its ownership stake in AmerisourceBergen to about 15%. A second seat on ABC's board is not far away.

Somewhat less expected: WBA has stepped into the parlor of UnitedHealth Group’s OptumRx PBM and become its preferred pharmacy partner.

Below, I provide some commentary to help you untangle these deals and figure out what they mean for the drug channels web.