Analysis

The Centers for Medicare & Medicaid Services (CMS) recently released its latest forecasts for national health expenditures. They are summarized in a new Health Affairs article: National Health Expenditure Projections, 2014–24: Spending Growth Faster Than Recent Trends (Available to Health Affairs subscribers or for purchase).

I crunch the underlying prescription drug data below. In 2014, prescription drug spending growth was higher than the growth in total U.S. healthcare spending. Over the next 10 years, however, drug spending is projected to closely track overall healthcare spending.

By 2024, the U.S. will spend about $560 billion annually on outpatient prescription drugs. Despite this growth and the perceptions that drugs prices are “too high,” outpatient prescription drugs will only account for about one of every 10 U.S. healthcare dollars. Hospitals and physicians will still account for nearly 60% of U.S. healthcare spending—or about six times as much as spending on pharmaceuticals.

Being part the CMS forecasting team is not easy. If any members of the Office of the Actuary are caught with bad projections, the Secretary of Health and Human Services will disavow all knowledge of their actions.

CBI’s Specialty Product Distribution and Dispensing Optimization
October 13-14, 2015 | Philadelphia, PA

CBI’s Specialty Product Distribution and Dispensing Optimization Conference specifically addresses the need for innovative, highly-evolved distribution models as the specialty marketplace continues to grow. Join us for the only event where key stakeholders discuss strategies for creating an optimal distribution network in order to reach patients in need.

Hear perspectives from BIND Therapeutics, Biogen, Biologics, Blue Fin Group, Cardinal Health Specialty Pharmacy, Carolinas HealthCare System, CSL Behring, Diplomat Specialty Pharmacy, Genzyme, Incyte Corporation, Independent Health, Intercept Pharmaceuticals, King & Spalding, McKesson, Omnicare, Onco360, Orsini Healthcare, Prime Therapeutics, UBC: An Express Scripts Company, VHA-UHC Alliance, Walgreens, and more!

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

Drug Channels readers will save $300 off of the standard registration rate when they register with code GZR984.* Join the hundreds who have benefited from this conference to date!

*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.

You gotta strike when the moment is right without thinking. And its looks like the Centers for Medicare & Medicaid Services (CMS) might finally be doing so.

Apparently, the oft-delayed Federal Upper Limits (FUL) and the Final Rule on Covered Outpatient Drugs, a.k.a., the Average Manufacturer Price (AMP) Final Rule, is now officially under final review at the Office of Management and Budget (OMB). The announcement is pasted below, because you probably don't believe it either.

Does this mean that CMS will finally accomplish this policy goal? How quickly will the pharmacy industry sue to stop implementation? Are you wondering which of the buggars to blame for the delay?

Read on for the proof and some background.

The two largest pharmacy benefit managers (PBMs)—Express Scripts and CVS Caremark—have just released their 2016 formulary exclusion lists.

CVS Caremark’s 2016 list has 124 products, including 31 new additions. Express Scripts, which is much more public about its strategy, has only 80 products and fewer additions to its list.

Below, I share some observations on each company’s strategy, differences in each PBM’s approach to specialty drugs and the hepatitis C category, and other related topics. I also provide links, so you can download and review the complete 2016 lists yourself. Enjoy!

Coupon and Co-Pay Off-Set Strategies

October 6-7, 2015 | Philadelphia, PA

Think you know everything there is to know about coupon and co-pay programs? Think again!

With the release of the OIG report, dramatic shifts in formulary coverage and the rising prices of branded medications, manufacturer-driven discount programs are facing new challenges with providing patient affordability options while remaining effective and compliant.

CBI's Coupon and Co-Pay meeting returns to the East Coast in October for its third installment — The first and leading event that brings together the best minds in the industry to provide manufacturers with cutting-edge strategies to maximize products throughout the lifecycle by continuing to leverage these essential discount opportunities. The 2015 agenda boasts a diverse, senior-level faculty from Actavis, Allergan, Bayer, Bristol-Myers Squibb, Churchill Pharma, Pfizer and many more!

Key 2015 Highlights:

• An in-conference workshop on navigating the changing managed care ecosystem, including NDC blocks, step therapy programs and high-deductible plan effects
• A patient advocate panel exploring how to overcome patient affordability concerns to limit patient out-of-pocket costs
• An update from members of NCPDP’s Working Group Number 9 on potential processes to enhance safeguards against anti-kickback
• Specialty Round-Robin Roundtables on three of the biggest challenges facing co-pay programs for specialty products
• A stakeholder panel on how to improve patient adherence through a reduction of behavioral barriers

*Discount offer valid through 8/14/2015; 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.

Jimmy Page, Eric Clapton, and…George Barrett?

Not convinced? Check out the video below, which shows Cardinal Health Chairman and CEO George Barrett onstage at The Rock and Roll Hall of Fame Roadshow concert.

Highlights include:

• Barrett's harmonizing on CSNY's Woodstock at 1:46

• Barrett's solo (!) cover version of John Mayer’s Gravity at 3:00

Well, at least we know he has the drugs and rock n’ roll covered!

The hot and hazy days of summer are here. Cool off with my refreshing selection of articles that cut through the steamy haze. In this issue:

• A handy primer on CVS Health’s history and strategy

• Allergan’s CEO explains how channel consolidation led to the Teva deal

• The New York Times attacks specialty pharmacies!

Plus, a sizzling update on The Amy Schumer Disappointing Lap Dance $5,000 Matching Challenge for Multiple Sclerosis. Please help me hit our goal by making a tax-deductible donation, and I will make my own donation of $5,000. Thank you!

Let’s review the latest edition of EvaluatePharma’s World Preview 2015, Outlook to 2020. (The document is free with site registration.) This annual report projects for prescription drug sales and R&D activity in the U.S. and abroad.

Below you'll find my handy summary table comparing 2020’s best-selling U.S. drug products with the top sellers of 2014. The report projects that, in 2020, 9 of the 10 best-selling drugs by revenue will be specialty drugs, compared with 3 drugs in 2010 and 7 in 2014.

EvaluatePharma’s predictions seem to downplay biosimilar competition. It still projects that AbbVie’s Humira will stay on top, although Humira's sales are expected to peak in 2017. You may also be surprised by the PCSK9 inhibitor forecasts.

The overall EvaluatePharma projections suggest that net sales of brand-name drugs will grow by almost 8% annually over the next six years. $400 billion will buy a lot of beer.

Value-Based Pricing and Contracting for Biopharmaceuticals
October 8-9, 2015 | Philadelphia, PA

The most successful biopharmaceutical pricing strategies are built to accommodate the changes occurring in healthcare today including price pressure from PBMs and payers, new launches of brilliant innovative therapies, lessons learned from the Sovaldi case study and payer restructuring as a result of the Affordable Care Act.

CBI’s groundbreaking Value-Based Pricing and Contracting for Biopharmaceuticals conference covers the evolution of focusing solely on “price” to focusing on the “cost-value” proposition. You won’t want to miss it.


Drug Channels readers will save $400 off the standard registration rate with code ZJP399.*

Leverage Key Conference Takeaways:

• Value-based pricing — How do you focus development to support price?
• Understand the real reasons why Sovaldi® triggered a firestorm — Looking at the evidence
• Consider product success in the post-Sovaldi® world — Demonstrating real value
• Brainstorm strategies for global price optimization
• Tips for conducting and applying cost effectiveness studies
• Ruminate the “new” health economics — Managing uncertainty at product launch
• Absorb case studies in successfully incorporating market access into the product plan early in development
• Analyze the risk versus reward for key market access investments in your brand
• Prepare for the launch of biosimilars
• Understand the pressure for plans to offer restricted formularies

Join a leading speaking faculty to discuss the issues most critical for success in pricing biopharmaceuticals in a value-based market.


Visit www.cbinet.com/biopharmpricing for more information. Drug Channels readers will save $400 off the standard registration rate with code ZJP399.*

*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 Gary Rice, RPh, MS, MBA, CSP, Vice President of Clinical Services at Diplomat Pharmacy. Gary provides insights on ways that sales teams can understand and convey a product’s value,not simply its cost. He offers strategies one can use to better understand, measure, and increase a specialty product’s value.

On August 6th at 12 P.M. (EDT), Gary Rice and other experts are coming together for CMR Institute’s webinar, Navigating and Selling in Today’s Specialty Market. They will discuss recent changes in the specialty pharmaceutical market and explore how healthcare sales teams can benefit from these opportunities.

The standard registration fee for the webinar is $149. CMR Institute is offering Drug Channels readers an exclusive opportunity to register for $75 via THIS LINK ONLY. (Please note that registration via the CMRI website requires a $149 registration fee.)