Analysis

Today’s guest post comes from ConnectiveRx’s Lauren Cole, Senior VP of Launch Excellence at ConnectiveRx.

Lauren outlines key success factors when transitioning or launching a patient hub.

To learn more, join Lauren on April 4th at 1:00 p.m. ET for a free online panel discussion: Lessons from the Edge—Six Things That Can Make a Hub Launch Go Wrong.

Lauren will also be exploring hub launch excellence at Informa Connect’s Hub and Specialty Pharmacy Models East conference on March 20-22.

Read on for Lauren’s insights.

As you've surely heard, Amgen has just launched Amjevita, the first non-interchangeable biosimilar of Humira. Our crazy drug channel led Amgen to launch both a high-list/high-rebate and a low-list/low-rebate version of the drug. Its strategy echoes the pricing of the first interchangeable insulin biosimilars—as I predicted in 2021.

Unfortunately, we should expect most PBMs and plan sponsors to embrace the high-list/high-rebate version. The plans that adopt the higher-priced biosimilar will get bigger rebates, while patients with coinsurance and deductibles end up paying more out-of-pocket.

As Mark Twain said: “History doesn’t repeat itself—but it often rhymes.” So, below, I revisit the surprising market dynamics for the interchangeable insulin biosimilars and highlight Amgen’s experience lowering the list price of its PCSK9i product. The story is more complex than you might expect, so perhaps there is hope that low-list-price versions will connect.

Informa Connect’s Access USA

Hybrid Event | March 20-23, 2023, Philadelphia Marriott Downtown

www.informaconnect.com/accessusa

Exclusive Offer – Be sure to use your exclusive promo 23AUSA10 to save 10% off* of your registration

We would like to introduce to you Access USA, industry’s resource for accelerating access, partnerships and collaboration to deliver superior patient outcomes.

What is Access USA? Access USA will unite PAP – Patient Assistance & Access Programs, Hub and Specialty Pharmacy Models East and Rare Disease Innovation & Partnership Summit, three industry-leading access conferences under one roof for one week of collaborative discussions and opportunities to expand your network and establish powerful partnerships.

Who will be there? Join leading bio/pharma manufacturers, impactful non-profit organizations, top-tier hospitals, foremost health clinics, top-notch PBMs, inspiring advocates, prominent specialty pharmacies, highly regarded academics, leading solution providers and more as they unite to tackle the barriers of patient access and take the necessary steps toward ensuring no patient worry about access to care.

What does that mean for you? In one week, meet with hundreds of key stakeholders across the access landscape and benchmark with, learn from and network with leaders paving the way in patient access. Just choose your preferred event and prepare to walk away inspired and armed with the knowledge necessary to drive patient access forward.

Here are just a few can’t miss content highlights from PAP – Patient Assistance & Access Programs. View the full agenda here.

• State of the Industry: The Changing Landscape of Healthcare Coverage and Access
• PhRMA Keynote Address
• Equity Spotlight: Understanding the Importance of Equitable Healthcare, Education and Partnerships
• Manufacturer PAP Spotlight: Gain Insight on Best Practices and Industry Standards
• Customizable Track Programming by PAP Legal & Policy, Patient Adherence Strategies or Technology, Innovation & Automation
• Workshop Breakout – Advocacy Insights to Enhance Patient Care or Partnership and Development to Optimize Patient Access

Here are just a few can’t miss content highlights from Rare Disease Innovation & Partnership Summit. View the full agenda here.

• Navigate FDA Updates on Rare Disease Product Development
• Establish and Navigate the Relationship between Industry and Advocacy
• Advancing Rare Disease Research with Patient Centrality and Precompetitive Approaches – A Screen4Care Case Study
• Rare Disease Awareness – Delivering Authentic Lived Experiences in a Challenging Regulatory Landscape
• The 4Ps of Precision Medicine – Patients, Providers, Partners and Pharma
• Breakout into Tracks – Access and Reimbursement Strategies, Investing and Partnering, and Drug Development and Clinical Innovation

Here are just a few can’t miss content highlights from Hub and Specialty Pharmacy Models East. View the full agenda here.

• Policy Address – State of the 2023 Industry and Payer Landscape for Industry Trend Updates
• Hubs Stakeholder Showcase – Opportunities and Challenges in Accelerating Patient Access with Manufacturer, SPP and Consultant Perspectives
• Copay Landscape – Changes in the Accumulator/Maximizer Landscape and How to Prepare
• Enforcement Panel – Explore Evolving Regulatory Reform in the Patient Support Services and Hub Models Space
• Customizable Tracked Programming by Patient Support & Engagement or Digital & Technological Innovation

Exclusive Offer – Choose your preferred event and register today – Be sure to use your exclusive promo 23AUSA10 to save 10% off* of your registration

Informa Connect will see you there!

*Cannot be combined with other offers, promotions or applied to an existing registration. 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. To find out how you can promote an event on Drug Channels, please contact Paula Fein (paula@drugchannels.net).

Here at our worldwide headquarters in Philadelphia, Eagles Super Bowl fever has landed. The police are already getting extra Crisco for the light poles. (Yes, really.)

Before you start training to gorge at your game day party, tackle this month’s selection of notable news stories, intercepted for you from the Drug Channels gridiron:

• Offsides: My $0.02 on the latest moves by Amazon and OptumRx

• Trick play: OptumRx attacks alternative funding programs

• Offensive line: Shocking Wall Street Journal expose of 340B abuses

• Touchdown! Accumulators and maximizers go mainstream

Plus, tipping culture comes to healthcare.

P.S. Join the nearly 37,000 people who run after me on LinkedIn. You can also chase me at @DrugChannels on Twitter. Every day, I tackle links to neat stuff for you.

Today’s guest post comes from Saket Patel, Consultant, Advisory Services at MMIT.

Saket discusses market access and contracting strategies for medical benefit products when pharmacy benefit biosimilar therapies launch. He then describes how to automate formulary and medical policies to protect manufacturers from overpayment.

Click here to learn about MMIT’s Contract Validation solution.

Read on for Saket’s insights.

Now that 2023 is underway, let’s review employer-sponsored coverage for prescription drugs and speculate on what’s ahead.

Below I examine the latest data on pharmacy benefits: cost sharing tier structures, copayment vs. coinsurance, and out-of-pocket obligations. As you will see, pharmacy benefit designs again increased the use of coinsurance for specialty and fourth-tier drugs.

These designs significantly raise patients’ out-of-pocket obligations—and contribute to the controversy over copay accumulator adjustment and copay maximizers. In 2023, employers’ savings and PBMs’ profits from these programs will decline—which will trigger a coming crackdown on specialty drug benefits. Beneficiary beware!

P.S. As usual, you will also enjoy some terrible Drug Channels tiers/tears puns.

Informa Connect’s PAP – Patient Assistance & Access Programs | Part of Access USA
Hybrid Event | March 20-22, 2023, Philadelphia Marriott Downtown
www.informaconnect/pap

Exclusive Offer – Be sure to use your exclusive promocode 23DCPAP10 to save 10% off* your registration.

The last thing a patient should worry about is access to care. With growing demand for patient assistance, accelerating prescription access and affordability is as crucial as ever. PAP – Patient Assistance & Access Programs is back March 20-22 and bringing together key stakeholders to collaborate and strategize on methods to meet that growing demand and navigate the access and reimbursement barriers faced daily.

Join your peers, leading experts and top solution providers for unparalleled networking opportunities and fresh perspectives on how to further access to care, understand current changes in legislation and policy and optimize PAP programs for better patient outcomes. Industry standards are evolving. Secure your spot now to ensure you and your organization are not left behind.

Do not miss this opportunity to unite with pharma, foundations, health clinics and more and benchmark on industry standards and stay on top of evolving trends to propel program performance. Can’t miss content highlights include:

• State of the Industry: The Changing Landscape of Healthcare Coverage and Access
• PhRMA Keynote Address
• Equity Spotlight: Understanding the Importance of Equitable Healthcare, Education and Partnerships
• Patient Perspective
• Manufacturer PAP Spotlight: Gain Insight on Best Practices and Industry Standards
• Three Customizable Tracks
• PAP Legal & Policy
• Patient Adherence Strategies
• Technology, Innovation & Automation
• Two Workshops
• Advocacy Insights to Enhance Patient Care
• Partnership and Development to Optimize Patient Access
• And more!

PLUS, EXTENDED NETWORKING IN 2023!

PAP 2023 will take place as part of Access USA, the access event bringing together three industry-leading conferences under one roof. Benefit from robust networking opportunities with all Access USA participants (that is an expected 600+ access professionals!) and expand your network and establish powerful partnerships.

Exclusive Offer – View the agenda and register today – Be sure to use your exclusive promocode 23DCPAP10 to save 10% off* your registration..

Informa Connect will see you there!

*Cannot be combined with other offers, promotions or applied to an existing registration. 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. To find out how you can promote an event on Drug Channels, please contact Paula Fein (paula@drugchannels.net).

Today’s blog post comes from Andrew Duncan, Vice President of Business Operations and Analytics at PHIL.

Andrew discusses how manufacturers can use data-driven strategy to understand utilization, increase patient access and adherence, and optimize gross-to-net.

Click here to learn more about PHIL’s access and commercialization solutions.

Read on for Andrew’s insights.

Consolidation has brought together large, economically significant insurer/PBM/specialty pharmacy/provider organizations within U.S. drug channels. At least half of all U.S. healthcare spending flows through these seven familiar entities: Blue Cross Blue Shield, Centene, Cigna, CVS Health, Elevance Health, Humana, and United Health Group.

In the brief video clip below, I review these businesses and offer some thoughts on their positioning for 2023. As you’ll see, the vertical strategy shakeout is underway.

If this clip whets your appetite for more, purchase a replay of the full 90 minute Drug Channels Outlook 2023 video webinar. Or register for my forthcoming 2023 video webinar series.

Today’s guest post comes from Clay Courville, Chief Product Officer at CoverMyMeds.

Clay discusses the ongoing problem of medication errors. He describes CoverMyMeds’ provider alerts solution, which is designed to minimize medication errors. Click here to learn more about CoverMyMeds’ Provider Medication Alerts solution.

Read on for Clay’s insights.