Analysis

Today’s guest post comes from Megan Marchal, Director of Specialty Pharmacy Strategy at CoverMyMeds.

Megan discusses the access and affordability challenges faced by specialty therapy patients. She describes how CoverMyMeds’ centralized technology solutions—paired with experts familiar with each therapy—help patients navigate these challenges. And, she shares one patient’s personal journey.

To learn more about CoverMyMeds’ technology solutions, visit Booth 229 at the Asembia Specialty Pharmacy Summit in Las Vegas, May 2-5, 2022.

Click here to sign up for CoverMyMeds’ Asembia Specialty Pharmacy Summit recaps.

Read on for Megan’s insights.

The econowonks at the Centers for Medicare & Medicaid Services (CMS) recently released the latest projections for U.S. spending on healthcare. (See links below.) These data provide our first official look at post-pandemic U.S. healthcare spending.

As you will see below, outpatient prescription drugs dispensed by retail and mail pharmacies are projected to remain a small share (8.4%) of total U.S. healthcare spending. What’s more, taxpayers—via Medicare and Medicaid—will continue to crowd out the private insurance market. One bright spot: consumers will account for an ever-smaller share of drug spending.

Thus, the government actuaries expect that pharmaceuticals will not be the key driver of U.S. healthcare spending growth. Will someone tell our elected officials?

Speaking of prescription drug payment, be sure to sign up for my new live video webinar, PBM Industry Update: Trends, Controversies, and Outlook, on April 22, 2022, from 12:00 p.m. to 1:30 p.m. ET.

Informa Connect's Life Sciences Commercial Contracts & Chargebacks 2022 Hybrid
May 24-25, 2022 | Philadelphia, PA
www.informaconnect.com/contracts-chargebacks

Save 10% by using code 22DC10

The Life Sciences Commercial Contracts and Chargebacks conference returns as a hybrid event May 24-25 with the options of attending in-person in Philadelphia or virtually.

Visit informaconnect.com/contracts-chargebacks to view the complete agenda, then register using the exclusive Drug Channels discount code 22DC10 to receive 10% off!

Join industry leaders from bio/pharma manufacturers, wholesalers, GPOs and more for interactive dialogues and strategic best practices to optimize commercial contract models, maximize chargeback efficiencies and streamline eligibility management.

The content-rich agenda boasts an incredible speaking faculty joining the event, including experts from Ingenus Pharmaceuticals, McKesson, Hikma Pharmaceuticals, Cardinal Health, Teva Pharmaceuticals, Tolmar Pharmaceuticals, FFF Enterprises, IntegriChain, Mallinckrodt Pharmaceuticals, UCB Pharma, Chronicled, Fresenius-Kabi USA, Premier Inc., NS Pharma, and Atrium Health, to name a few.

You will benefit from learnings on timely topics in an innovative format, including:

• Manufacturer/Wholesaler Team-to-Team Meet and Greets
• Membership Management Optimized and Reimagined
• GPO Leadership: Revolutionary Practices to Adapt and Implement
• Regulatory Highlight: Plan for 2022 and Beyond
• Case Study: MediLedger Network for Data & Trading Partner Alignment as Best Practice for Error Elimination

Visit informaconnect.com/contracts-chargebacks to view the complete agenda, then register using the exclusive Drug Channels discount code 22DC10 to receive 10% off!

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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 guest post comes from Michael Carr, CoAssist Group Vice President at AssistRx

Michael discusses patient support challenges that are unique to specialty-lite pharmaceuticals. He goes on to describe four new categories of patient solutions and pharmacy models specific to this growing market segment.

To learn more about CoAssist and AssistRx specialty therapy initiation and patient support services, click here to schedule a meeting with AssistRx at the Asembia Specialty Pharmacy Summit on May 2-5, 2022.

Read on for Michael’s insights.

The highly-consolidated PBM market notched another year of increased concentration.

Consider Drug Channels Institute's latest estimates of pharmacy benefit manager (PBM) market share, shown in the chart below. For 2021, we estimate that the three biggest PBMs accounted for 80% of total equivalent prescription claims. Significant business relationships among the largest companies continue to shift market share.

As I explain below, the prospects for market disruption remain low, so the controversial warped incentives of the rebate system will continue to distort the drug channel.

To get a handle on this complex market, join me on April 22 for a new live video webinar, PBM Industry Update: Trends, Controversies, and Outlook. I’ll examine DCI’s latest PBM market data, the emergence of PBM purchasing groups, specialty market developments, PBMs’ evolving compensation models, and much more. Click here for more details.

Rare Disease Innovation & Partnering Summit
Hybrid Event
May 17-19, 2022 | Boston, MA
www.informaconnect.com/rare

Don’t miss the Rare Disease Innovation & Partnering Summit, coming up May 17-19, 2022 in Boston, MA.

Visit www.informaconnect.com/rare for further details and to register. Drug Channels readers will save 10% off when they use code 22DRCH10 and register prior to April 29, 2022.*

When you join us this spring, you’ll be part of the important discussions surrounding patient access, reimbursement, commercialization, launch, partnering and more. Come together with experts from across the rare disease community, in-person or virtually, to unite in areas of unmet medical need and create life-transforming therapies and breakthroughs.

We’ll cover the hottest topics impacting you today, from speakers representing Alexion, Angelman Syndrome Foundation, bluebirdbio, Cognito Therapeutics, CURECMT4J, Cydan, the FDA, Global Genes, NS Pharma, Rafael Pharma, Sanofi, TaretCancer Foundation, Tremeau Pharma, Ultragenyx, and more.

• Strengthening Patient Relationships Authentically to Enhance Therapeutic Development
• The Search for Novel Funding - Preparing for and Expanding Successful Partnering
• Understanding the Patient Journey
• Clinical Management of Patients with Complex Conditions
• Discovering Patient Support Program Needs for Patients
• Patients and Payers: Perspectives on Developing Gene Therapies for Rare Diseases
• Prioritizing RWE Collection in a New Era of Novel Gene Therapy
• Optimizing Strategic Partnership Models and Investment for Orphan Drug Products
• Developing and Scaling Digital Therapeutics
• Leveraging Genetic Testing for Value
• Fostering Relationships Between Industry and Advocacy
• Uncovering Risk Disclosures for Gene Therapies
• Optimizing Decentralized Trials to Support the Future of Rare Disease Research
• PLUS - Your registration to the Summit includes a complimentary pass to Selections from The DISORDER Channel, an annual viewing of short films addressing the day-to-day challenges and struggles of rare disease patients and their families.

View the agenda to see the complete picture – the program, speakers, and more!

Visit www.informaconnect.com/rare for further details and to register. Drug Channels readers will save 10% off when they use code 22DRCH10 and register prior to April 29, 2022.*

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rates or other offers. 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 guest post comes from Fauzea Hussain, Vice President of Public Policy at McKesson.

Fauzea succinctly describes the complicated and contradictory aspects of the Centers for Medicare & Medicaid Services' Final Rule on Best Price, a.k.a. the Medicaid copay accumulator rule. She then outlines how the rule, if implemented, is likely to hurt patients.

For information about the Best Price Rule and how CoverMyMeds can help identify solutions, contact them at: InfoBP@mckesson.com. To learn more about solutions to help patients access, afford and adhere to their medications, read CoverMyMeds’ 2022 Medication Access Report.

Read on for Fauzea’s insights.

Ah, it’s finally spring in downtown Philadelphia, our home base. (Photographic evidence on your right.) Along with sunshine and fine weather, this vernal equinox has ushered in a crop of new and noteworthy stories:

• Health inequities in utilization management

• Insurers compute big white bagging savings

• The biosimilar boom accelerates

• The patient upside of manufacturers’ copay support

• Whoa. CVS Health takes the red pill.

P.S. Join my more than 26,000 LinkedIn followers for daily links to neat stuff. You can also find my daily posts at @DrugChannels on Twitter, where I am approaching 13,700 followers.

Register for my new video webinar, PBM Industry Update: Trends, Controversies, and Outlook. This event will be broadcast live on April 22, 2022, from 12:00 p.m. to 1:30 p.m. ET.

Dr. Adam J. Fein, CEO of Drug Channels Institute (DCI) and the author of Drug Channels, invites you to join him for a new video webinar:

PBM Industry Update: Trends, Controversies, and Outlook
Broadcast live on April 22, 2022, from 12:00 p.m. to 1:30 p.m. ET

The webinar will be broadcast from the Drug Channels studio in beautiful downtown Philadelphia. This page describes the event and explains how to purchase a registration to participate in the event.

This event is part of The Drug Channels 2022 Video Webinar Series. Anyone who registered for the entire series will receive an email with a link to access the April event.

WHAT YOU WILL LEARN

Join Dr. Fein as he helps you and your team stay on top of the latest trends, market data, and strategies for pharmacy benefit management. He will draw from exclusive information found in our new 2022 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers.

During the event, Dr. Fein will cover a wide range of topics, including:

• The industry position and strategies of the largest PBMs, including DCI’s exclusive market share data

• The emergence and strategies of PBM-owned purchasing groups

• The opportunities and challenges for insurer/PBM/specialty pharmacy/provider organizations

• DCI’s latest data on PBMs’ position in the specialty pharmacy market

• How PBM compensation models are evolving

• PBMs’ battle for specialty benefit management and the risks from specialty carve-out vendors

• Our latest insights on copay accumulators and maximizers

• Risks from disruption of 340B contract pharmacies

• Prospects for smaller PBMs

• Assessment of state and federal PBM legislation

• And more!

PLUS: During the webinar, Dr. Fein will give participants an opportunity to unmute themselves and ask live questions.

As always, Dr. Fein will clearly distinguish his opinions and interpretations from the objective facts and data.

Read on for full details on pricing and registration.

Informa Connect’s Medicaid & Government Pricing Congress
Hybrid Event
In-Person: May 23-25, 2022, Philadelphia, PA | Virtual: June 1-2, 2022
www.informaconnect.com/medicaid-government-pricing

Don’t miss the Medicaid & Government Pricing Congress, coming up May 23-25, 2022 (in-person in Philadelphia) and June 1-2, 2022 (virtually)! You'll be part of the important discussions surrounding the critical policy updates and approaches to effectively contract, report and comply with state and federal healthcare programs.

Visit www.informaconnect.com/medicaid-government-pricing for further details and to register. Drug Channels readers will save 10% off when they use code 22DRCH10 and register prior to April 29, 2022.*

The 2022 format includes 3 days of in-person programming, plus a virtual offering of select sessions and recorded presentations available on-demand for 10 business days. Both the in-person and virtual options will include networking opportunities to connect with industry peers and colleagues.

The Medicaid & GP Congress features coverage on the hottest topics impacting you today, from speakers representing United Therapeutics, AstraZeneca, Pfizer, Gilead, GSK, Eisai, Novartis, Vertex and more!

• A block of sessions covering the CMS 2023 Medicare Advantage and Part D Proposed Rule and potential Federal Drug Pricing Changes under what’s currently called the Build Back Better Act
• Updates to the Mandated OIG Prescription Drug Studies
• Portal User Sessions – Step-by-Step reviews of some of the most frequently used portals for managing government reporting with representatives from Gainwell Technologies and Magellan AND MDP System Updates: The Mechanics, Changes and Processes from the new CMS Portal
• An in-depth interactive session on Product Unit of Measurement and Understanding NDC Numbers in the MDRP
• FSS and Government Pricing and Contracting Strategies for Combination Products, Duals, Med Device and MedTech
• And more!

View the agenda to see the complete picture – the program, speakers, and more!

Visit www.informaconnect.com/medicaid-government-pricing for further details and to register. Drug Channels readers will save 10% off when they use code 22DRCH10 and register prior to April 29, 2022.*

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rates or other offers. 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).