Analysis

In CMS Forecast: Big Drug Spending Growth, But Hospitals and Doctors Will Still Capture Most Healthcare Spending, I examined the September 2014 drug spending forecasts from the Centers for Medicare and Medicaid Services (CMS).

After crunching the numbers again, I identified new insights into the 2023 drug market. As the charts below show, CMS expects that the employer-sponsored insurance market will shrink more than it had previously projected, while Medicare and Medicaid will grow even faster. CMS is still projecting that individually-purchased private insurance (via both public and private exchanges) will account for a small share of drug spending.

Is your organization prepared for the government’s unprecedented growth?

10th Life Sciences Trade and Channel Strategies
December 10-11, 2014 | Philadelphia, PA
www.cbinet.com/trade

I want to remind you about CBI’s upcoming Trade and Channel Strategies conference, being held this December in Philadelphia. This annual event has great networking opportunities and loads of solid content. Check out the agenda.

Drug Channels readers will save $400 off of the standard registration rate when they use code AUX474.* Hope you’ll join me in Philadelphia this December!

PERSPECTIVES FROM: AmerisourceBergen | Blue Fin Group | Boehringer Ingelheim | Depomed, Inc. | Deutsche Bank | Drug Channels Institute | IntegriChain | Jazz Pharmaceuticals | Johnson & Johnson Healthcare Systems Inc. | Mallinckridt Pharmaceuticals | McKesson Specialty Health | Pembroke Consulting, Inc. | RQ Global Pharma Strategies, LLC | RxTrace | SonexusHealth | Sunovion | Therapeutics MD | Therigy | Vertex Pharmaceuticals, Inc.

TOPICS: Specialty Channel Strategies | Alternative Go-to-Market Approaches | Economic Factors Impacting the Drug Channel | Impact of ABC, CAH and MCK Business Changes | Distribution Models Reshaping Trade Dynamics | Impact of ACA, CMS Final Rule, 340B and Shift from AWP Reimbursement | U.S. Serialization Requirements | Globalization, Vertical Integration and Product Specific Implications | and more!

You may be especially interested in the Trade Throwdown: Battle of the Experts. This year, Bill Roth of Blue Fin Group and Allen Dunehew or RQ Global Pharma Strategies will join me in CBI’s XTreme Battle Cage™. Three consultants will enter…but only three will leave!


Register today for this awesome event!

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rates. Other restrictions may apply.

Eeek! Time for my Halloween-themed roundup of Drug Channels news stories. In this issue:

• Icky: Walgreen’s ex-CFO alleges defamation

• Spooky: Generic inflation is changing benefit design

• It’s alive! An independent pharmacy thrives with a unique strategy

As your treat, watch a video of Cardinal Health CEO George Barrett jammin’ on stage with The Who’s Roger Daltrey. (Not a trick. Really.)

Yesterday, Gilead Sciences reported another blockbuster quarter for Sovaldi sales. (Read the press release.) But just how good was Sovaldi’s launch?

Mark Schoenebaum of ISI Group compared hepatis C treatment Sovaldi’s launch to the launch of such other legendary drugs as Avastin, Gleevec, Revlimid, and more. Based on the chart below, I think you’ll agree that Sovaldi is the most legendary of them all. Competitive launches and Sovaldi’s successor Harvoni will slow Sovaldi’s growth, but until then…wow!

Despite ongoing criticisms of Sovadi’s pricing, patients and physicians clearly want this biomedical innovation—and wholesalers, pharmacies, and PBMs have come along for the ride.

Here's a cool conference: The Pharmacy Benefit Management Institute (PBMI) will host its 20th Annual Drug Benefit Conference at the San Antonio Marriott Rivercenter hotel in San Antonio, TX, on March 2-4, 2015.

Many attendees will be from employers, health plans, and unions, so you’ll learn the payers' perspectives on pharmacy benefits. Highlights include sessions on specialty drug management, healthcare reform, biosimilars, and the latest pharmacy benefit strategies. Check out the program preview.

Drug Channels readers can register with promo code PC2015 and receive an additional $300 off registration. Thanks, PBMI!

On Monday, The Wall Street Journal broke the news that CVS Health’s Caremark PBM will offer a new twist on preferred pharmacy networks. Consumers will face higher co-payments at pharmacies that sell tobacco products. See Caremark to Charge Extra Co-Pay at Pharmacies Selling Cigarettes. (The article includes comments from your friendly neighborhood blogger.)

The story generated plenty of other press coverage, much of it favorable for CVS Health. Below, I consider the move’s impact, including the payer’s perspective, the future of preferred networks, likely adoption rates, potential competitive effects on other drugstores, and whether CVS will replace $2 billion of lost tobacco revenue.

As a bonus, I tell you about Thank You For Smoking, one of my favorite movies.

NOTE: This post has been updated. See notes at the bottom.

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In my previous post (For 2015, almost 9 out of 10 Medicare Part D plans will have a preferred pharmacy network), I highlighted the plans whose preferred pharmacy networks will dominate next year’s Medicare Part D prescription drug plans (PDP).

Today, I examine the pharmacy chains in the biggest plans’ networks. Walmart again leads the pack in preferred network participation. Walgreens has a big bet on preferred networks, while CVS and Rite Aid have been more cautious. Independent pharmacies feature prominently in many plans, which should—but probably won't—mute critics of preferred networks.

Read on for our exclusive look at 2015’s preferred network participants, along with some comments on DIR fees and pharmacy profits.

Specialty Data Optimization Summit

December 11, 2014 | Philadelphia, PA

www.cbinet.com/specialtydata

CBI’s Specialty Data and Optimization Summit is the first and only event laser-focused on strategies for leveraging pharmacy data for the commercialization and market penetration of specialty products. This cutting-edge forum will provide you with in-depth discussions and key industry perspectives on how to maximize data to make informed, targeted decisions that take ROI to the next level.

Hear multi-stakeholder perspectives from Altometrixs, AstraZeneca, AxelaCare, Blue Fin Group, Exelixis, IMS Health, LiquidHub, Paragon, Prime Therapeutics, Vertex Pharmaceuticals, Xcenda, and more!

Drug Channels readers will save $200 off of the standard registration rate when they use code SHA526.*

Register today!

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rates. Other restrictions may apply.

Today’s guest post comes from Stephen C. Vogt, Pharm.D., President and CEO of BioPlus Specialty Pharmacy.

Dr. Vogt offers a thoughtful perspective on specialty pharmacies' shortfalls in managing patients with hepatitis C virus (HCV) infection. He then describes the BioPlus RxSteward™ drug management program, which uses real-time patient data to reduce unnecessary drug utilization while maintaining excellent clinical outcomes. Dr. Vogt also shares data on the program's substantial cost savings. He sees RxSteward™ transforming BioPlus from a dispenser to a partner in a patient's pharmaceutical care.

Read on for details, including a look at drug-cost savings by HCV drug regimen and HCV genotype. Please contact BioPlus for more information about RxSteward™.

Tomorrow, Medicare Part D kicks off its open enrollment period. Through December 7, America’s seniors can keep their current plan or switch to a new one.

Who ya gonna call to understand the latest preferred pharmacy network trends? Drug Channels, of course!

For 2015, our analysis reveals that an astonishing 87% of Medicare Part D regional prescription drug plans (PDP) will have a preferred cost sharing network. That’s a big Twinkie!

Read on for our exclusive look at the 2015 Part D landscape, which includes insights on the major health plans—UnitedHealthcare, Humana, Express Scripts, et al—behind the PDPs.

Are pharmacies headed for a disaster of biblical proportions? In an upcoming article, I’ll look at pharmacy participation in the biggest plans’ networks.