Analysis

The Academy of Managed Care Pharmacy (AMCP) recently published its latest Format for Formulary Submissions, version 3.1. (free download) Starting on page 34, the Format tries to answer two seemingly straightforward questions: What is a specialty drug? What is a specialty pharmacy?

The AMCP’s answers, which are intended for manufacturers, certainly won’t satisfy every constituent and may be rapidly outdated due to marketplace developments. Nonetheless, I find them useful for clarifying the discussion. Read on and see if you agree.

P.S. Today is the last day for discounted pricing on the 2012–13 Economic Report on Retail, Mail, and Specialty Pharmacies.

Posted by Drug Channels Institute, an HMP Global company on Tuesday, February 5, 2013

Labels: Specialty Drugs, Pharmacy Economics

Today’s guest post is from Kay Morgan, Senior Vice President of Drug Products and Industry Standards Research and Compliance at Elsevier’s Gold Standard.

In this guest post, Kay argues that payers should not simply deny access to brand-name drugs, even when generic equivalents are not available. Instead, she suggests that payers should use such technology tools as MEDalternatives to quickly and efficiently identify cost-effective therapeutic alternatives.

Please contact Marialuisa Curran, Product Marketing Manager, Commercial & Retail Pharmacy at Elsevier’s Gold Standard (m.curran@elsevier.com or 813-579-2794) with any questions about the article.

Posted by Drug Channels Institute, an HMP Global company on Monday, February 4, 2013

Labels: Sponsored Post, Guest Post

If you’re following the drug shortage situation, then check out this must-read article from the latest Clinical Pharmacology & Therapeutics: Economic and Technological Drivers of Generic Sterile Injectable Drug Shortages. The article, written by FDA staffers Janet Woodcock and Marta Wosinska, argues that that drug shortages trace back to the perverse market dynamics facing manufacturers of generic injectable drugs.

I’m heartened to see the FDA publicly acknowledge investment incentives and market failures, although there is a distinct “blame the healthcare buyer” view embedded in the FDA’s perspective. The FDA's new view also contains a not-so-subtle rebuke of Congressional critics who have blamed drug shortages on overzealous FDA inspections. Oddly, the FDA omits any discussion of gray markets, which distort incentives during drug shortages. Read on for my overview.

BTW, I’ll be delivering the keynote at next week’s HSCA/HISCI 2013 Pharmacy Forum, where I’ll be talking in part about drug shortages. Say hi if you attend!

Posted by Drug Channels Institute, an HMP Global company on Thursday, January 31, 2013

Labels: Enforcement, Generic Drugs, Drug Shortages

Baltimore vs. San Francisco! Brother vs. Brother! Buffalo wings vs. Nachos! Yup, it’s time for a weekend of blow-out commercials, occasionally interrupted by a football game. Hope you’ve been training all season to gorge at the Super Bowl-party level. But before you indulge, check out this month’s notable news stories from around the Drug Channels universe.

• Trick play: Walmart will offer primary care…or not?
• Sacking the bad guys: How Pfizer pfights pfakes
• Ask Manti Te’o: Are generics really the same as brands?

Plus, the White House responds to a Death Star petition, while an anti-preferred pharmacy network petition flops.

Posted by Drug Channels Institute, an HMP Global company on Tuesday, January 29, 2013

Labels: Generic Drugs, Pedigree, Drug Counterfeiting, Narrow Networks

The Pharmacy Benefit Management Institute (PBMI) just released the 2012-2013 Prescription Drug Benefit Cost and Plan Design Report, a highly informative report on employer-sponsored pharmacy benefits. (Free download with registration.) The report is chock full o’ enlightening tidbits about employers’ PBM contracting and pharmacy benefit design decisions. A hearty Drug Channels “Thank You” to Takeda Pharmaceuticals North America for sponsoring the research.

As far as I know, the PBMI report is the only public source for benchmarking (1) manufacturer rebates to PBMs, and (2) PBM-employer relationships. A few fascinating highlights:

• There is an amazing diversity of PBM rebate structures, including per-prescription guarantees and percentage shares. Many smaller employers get no rebates.
• Rebates average $17 per 30-day brand-name retail prescriptions, although the range is broad.
• Employers receive almost 90% of manufacturers’ rebates to PBMs.

The report will surely be a topic of conversation at PBMI’s 18th Annual Drug Benefit Conference in February.

Posted by Drug Channels Institute, an HMP Global company on Thursday, January 24, 2013

Labels: PBMs, Channel Management

I am pleased to announce the availability of our new report: The 2012-13 Economic Report on Retail, Mail, and Specialty Pharmacies. We’re offering special discounts if you order before February 5, 2013.

If you like Drug Channels, then you'll love this report! The completely updated, revised, and expanded report thoroughly dissects the pharmacy channel and its interactions with consumers, PBMs, payers, wholesalers, government agencies, and more. The 2012-13 edition also dives deeply into such future trends as healthcare reform, specialty at retail, 340B, and much more.

I worked hard to make the report into an essential tool for pharmaceutical manufacturers, wholesalers, pharmacists, pharmacy owners, benefit managers, managed care executives, healthcare policy analysts, investors—anyone who wants to understand and benefit from this ever-evolving healthcare sector. Whether you're a newbie or a grizzled veteran, the 2012-13 Economic Report on Retail, Mail, and Specialty Pharmacies will help you and your team build deep business acumen about U.S. dispensing channels.

Read on for more details, or download your very own copy today. Enjoy!

Posted by Drug Channels Institute, an HMP Global company on Tuesday, January 22, 2013

Labels: Industry Trends, Pharmacy, Pharmacy Economics

Today, I welcome PBMI’s 18th Annual Drug Benefit Conference as a Drug Channels Sponsor. This year's conference will be held at the MGM Grand Hotel in Las Vegas, Nevada on February 18-20, 2013.

Many attendees will be from employers, health plans, and unions, so it's a great opportunity to learn about payers' perspectives on pharmacy benefits. PBMI has added a lot of specialty drug content to this year's meeting.

Educational sessions will be led such companies as Aetna, Citi Investment Research, Envision Rx Options, Express Scripts, HealthPartners, Humana, inVentiv Medical Management, Pharmaceutical Strategies Group, PMSI, Premera Blue Cross, Prime Therapeutics, RegenceRx, Source Healthcare Analytics, UnitedHealthcare, Walgreen and more.

Check out the official description below. BTW, the early bird discount ends on January 24!

Posted by Drug Channels Institute, an HMP Global company on Monday, January 21, 2013

Labels: Sponsored Post

Last night, the Centers for Medicare and Medicaid Services (CMS) released the first batch of 2013 enrollment data for Medicare Part D Prescription Drug Plans (PDPs). These close-to-final numbers offer an exclusive Drug Channels first look at the PDP winners and losers.

The highlights:

• Sixteen of 2013's 190 PDPs have a preferred pharmacy network design.
• More than 4 out of 10 seniors enrolled in one of these 16 plans.
• The Humana Walmart-Preferred Rx Plan is now the fourth-largest PDP.
• Walgreen is a preferred pharmacy in plans with 30% of total PDP enrollment.
• SmartD, the Walgreens-plus-independents plan, was a bust.

Part D beneficiaries annually choose their own new plan, rather than having a benefit administrator or insurance plan provide a few choices for them. Thus, these new data convincingly demonstrate the consumer appeal of preferred networks. This year’s Part D market should dispel any doubts about the narrow network revolution.

Posted by Drug Channels Institute, an HMP Global company on Friday, January 18, 2013

Labels: PBMs, Narrow Networks, Benefit Design, Medicare Part D

Today’s guest post is from Kevin Dolgin, Meeting Facilitator at eyeforpharma.

In this guest post, Kevin recaps the recent eyeforphama Disruptive Ideas workshop which is part of the eyeforpharma Philadelphia conference launch. More industry-led panels on this topic will be held at eyeforpharma Philadelphia on June 5, 6, and 7 in Philadelphia, PA.

Please contact Theo Fellgett, Event Director at eyeforpharma (theo@eyeforpharma.com or 201-234-4802) with any questions about the article or event.

Posted by Drug Channels Institute, an HMP Global company on Friday, January 18, 2013

Labels: Sponsored Post, Guest Post

Here's something we hope you'll really like.

Mass merchandiser Costco Wholesale has just started publicizing Costco Health Solutions (CHS), its very own pharmacy benefit manager (PBM). January’s Costco Connection magazine highlights the heretofore publicity-shy business in A Prescription for Success.

Below, I outline how Costco’s PBM strategy exemplifies six key dynamics facing the pharmacy and PBM industries. In this slow prescription growth environment, retail pharmacies are looking for new growth drivers. With its PBM, Costco is emulating CVS Caremark's tactics for driving prescription store traffic. Walmart has a robust narrow network strategy and Walgreen is funding RxAlly and Smart D (but sold its PBM). So, who's next?

Posted by Drug Channels Institute, an HMP Global company on Thursday, January 17, 2013

Labels: Specialty Drugs, PBMs, Narrow Networks, Pharmacy