Analysis

Last week, Cigna released its earnings for the first quarter of 2021. Links below.

I was struck by how quickly Cigna’s Express Scripts PBM business has increased revenues and prescriptions from its retail pharmacy network. Our second chart below highlights this growth.

The businesses in Cigna's Evernorth segment—especially Express Scripts, Ascent Health Services, and InsideRx—are already providing rebate negotiation, network management, and/or a sourcing platform for Prime Therapeutics, Kroger, Humana, GoodRx, and Amazon.

I expect Cigna’s influence over the drug channel to expand further as other businesses step onto this burgeoning platform.

Posted by Drug Channels Institute, an HMP Global company on Wednesday, May 12, 2021

Labels: Group Purchasing Organizations (GPOs), Mergers and Acquisitions, Discount Cards, Pharmacy, Channel Management, PBMs

Informa Connect’s Formulary, Reimbursement and Access Summit 2021
July 27-29, 2021 | Virtual Event
www.informaconnect.com/formulary-access/

Formulary, Reimbursement and Access Summit provides a forum for industry to convene, benchmark and gain strategies to explore new and impending access and managed market challenges within the value-based landscape while providing insights on valuable patient services and support programs, healthcare market coverage and strategies to improve overall access and reimbursements of commercialized drugs.

Drug Channels readers are eligible for an exclusive savings of 10% off* the current rate by using promo code 21FRADC10, be sure to reserve your seat today!

Gain critical insights from a distinguished speaking faculty including:

• Michael Thompson, President & CEO, National Alliance of Healthcare Purchaser Coalitions
• D.R. McCale III, MDY, RMC, Director, Market Access and Reimbursement, Akcea Therapeutics
• Shannon D. Ashmon, MBA, Senior Manager, Access & Reimbursement, Oncology Business Unit, Eisai, Inc.
• Peter Avalos, National Reimbursement Director, Daiichi Sankyo, Inc.
• Jeff Blake, Senior Vice President, Payer Relations, Hemophilia Alliance
• Shawn Gremminger, Health Policy Director, Pacific Business Group on Health
• And many more!

Transform Access Strategies with Compelling Discussions Around

• Formulary Insights – Advancements in Design and Management
• The Future of Rebate Reform – Explore Current and Pending Legislation
• Assess the Landscape for Prior Authorization and Reimbursement Support - Reexamining the Roles of the Manufacturer and the Pharmacy
• Value-Based Contracting Frameworks and Considerations
• Digital Therapies and Telehealth – Define their Role in the Evolving Healthcare Landscape
• And so much more!

Plus! Choose between 3 Interactive Workshops on Day 2!

Drug Channels readers are eligible for an exclusive savings of 10% off* the current rate by using promo code 21FRADC10, be sure to reserve your seat today!

*Offer may not be combined with other offers, category rates, promotions or applied to an existing registration. Offer not valid academic/non-profit registrations.

---

The content of Sponsored Posts does not necessarily reflect the views of Pembroke Consulting, Inc., Drug Channels, or any of its employees.

Posted by Drug Channels Institute, an HMP Global company on Monday, May 10, 2021

Labels: Sponsored Post

Today’s guest post comes from Jill Brown Kettler, Executive Editor at AIS Health, a division of MMIT.

Jill discusses MMIT's proprietary data on how the COVID-19 pandemic affected enrollment in commercial plans, Medicaid, and health insurance exchanges.

To learn more about 2020 enrollment changes and the 2021 outlook, register for MMIT’s free webinar on May 18 at 1:00 pm ET: Meet the Expert: Predicting Enrollment Changes in the Covid Era.

Read on for Jill’s insights.

Posted by Drug Channels Institute, an HMP Global company on Friday, May 7, 2021

Labels: Guest Post, Sponsored Post

In Drug Channels Institute's list of the top 15 pharmacies of 2020, we show that many of the largest U.S. market participants are now central-fill mail and specialty pharmacies operated by PBMs and insurers.

To complement that broader ranking, we present below our exclusive list of the top 15 pharmacies based on specialty drug dispensing revenues. You will see that PBMs and insurers have increased their dominance over specialty drug channels. Many of the largest independent companies have been acquired.

As we look ahead, CVS Health and Cigna’s Express Scripts seem best positioned for further growth. However, AllianceRx Walgreens Prime—the joint venture between Walgreens Boots Alliance and Prime Therapeutics—faces significant market share loss.

Read on for all the details.

Posted by Drug Channels Institute, an HMP Global company on Tuesday, May 4, 2021

Labels: Mergers and Acquisitions, Pharmacy, Specialty Drugs, PBMs

Informa Connect’s Annual Commercial Contracts & Chargebacks Congress
June 23-25, 2021 | Virtual Event
informaconnect.com/contracts-chargebacks

Informa Connect’s 17th Annual Commercial Contracts & Chargebacks Congress, taking place virtually June 23-25, offers crucial updates on policy changes and contracting best practices to increase efficiency, reduce revenue leakage, and streamline chargeback excellence.

This annual event has become a must-attend for pricing and contracting professionals in the life sciences industry with seasoned leaders and forward-thinking strategies on display. Join industry stakeholders, including manufacturers, wholesalers, GPOs and more, for a robust three-day event offering extended content and actionable strategies in key interest areas in the ever-evolving contracting landscape.

Drug Channels readers are eligible for an exclusive savings of 10% off* the standard rate by using promo code 21CCCDC10, so download the complete conference agenda and reserve your seat today!

Featured Faculty Driving the Conversation:

• John Shakow, Partner, King and Spalding
• Susanne Somerville, Chief Executive Officer, Chronicled
• Edward McAdam, Director, Government Pricing, Contracting Operations & Analytics, Indivior
• Mike Domanico, Vice President Finance, Revenue, Sandoz (Novartis)
• Beth Stevens, Associate Director, Contracts & Pricing, TOLMAR Pharmaceuticals
• Sherice Koonce, Director of Contracts, Hikma Pharmaceuticals
• Fred Fieder, Director, Contract Administration, McKesson
• Susan Lowe, Senior Vice President, Supply Chain Operations, FFF Enterprises
• Brian Green, Head of Contract Operations, UCB Pharma
• Felicia Manning, Associate Director, Market Access, Pricing & Reimbursement, Theravance BioPharma US
• And many more!

Hight Impact Topics Transforming the Market Include:

• Policy Update on 340B and Pharmacy Channel Evolution
• Contract Management Reimagined — Operational Excellence Strategies for Increased Process Efficiencies and Reduced Revenue Leakage
• Strategic Contracting Industry Insights Panel — The Confluence of Data, Financial Analytics and Value
• Revolutionize and Automate Transactions using Blockchain
• GPO Panel featuring Vizient, Premier Inc. and more!
• Contract Administration Industry Insights Panel — Process Improvement in Contract Administration and Management — Streamlining Chargeback Operations, GPO Rosters and Channel Operations

Drug Channels readers are eligible for an exclusive savings of 10% off* the standard rate by using promo code 21CCCDC10, so download the complete conference agenda and reserve your seat today!

*Expires 6/25/20210; applies to standard rate only and may not be combined or applied to existing registrations; other restrictions may apply.

---

The content of Sponsored Posts does not necessarily reflect the views of Pembroke Consulting, Inc., Drug Channels, or any of its employees.

Posted by Drug Channels Institute, an HMP Global company on Monday, May 3, 2021

Labels: Sponsored Post

Today’s guest post comes from Natalie Tyler, Director of Pharmacy Operations & Strategy at ConnectiveRx.

Natalie discusses how non-commercial pharmacies boost patient access and adherence to specialty therapies. They also help physicians deliver better care.

On May 24 at 1:00 pm ET, ConnectiveRx will host an online panel discussion on non-commercial pharmacy services with experts from ConnectiveRx and AstraZeneca. Click here to register here for this free event. Email inquiries@ConnectiveRx.com with any questions.

Read on for Natalie’s insights.

Posted by Drug Channels Institute, an HMP Global company on Friday, April 30, 2021

Labels: Guest Post, Sponsored Post

While we all roll up our sleeves for a full reopening, let’s spring into this month’s selection of noteworthy news:

• Thoughts on Cigna’s payments to patients for non-medical switching

• 340B’s explosive specialty pharmacy growth

• An excellent analysis of GoodRx

Plus, my $0.02 on U.S. drug pricing policy.

P.S. Join the more than 11,600 followers of my daily links to neat stuff at @DrugChannels on Twitter. Recent posts have covered biosimilars, pharmacist workloads, formularies, pricing, PSAOs, Part D spending, copay accumulators, H.R.3, and more. You can also join my more than 17,000 followers on LinkedIn.

Posted by Drug Channels Institute, an HMP Global company on Tuesday, April 27, 2021

Labels: 340B, Health Care Policy, Benefit Design, Discount Cards, Specialty Drugs, PBMs, Pharmacy Economics

At Kalderos, we use data-driven solutions to deliver unifying technologies to solve problems facing the U.S. healthcare system, so that everyone can focus on the health of patients. We created the world’s first Drug Discount Management platform. This platform uses sophisticated models and machine learning to identify and then resolve noncompliance in drug discount programs.

On April 20, we released Making Health Policy Work for Patients: How Platform Solutions Enable More Affordable Drugs (free download), our first-ever annual report.

Our 2021 annual report shares our perspective on challenges with discount and rebate programs in the drug channel and reports on our rapid growth as a health tech platform. It explores:

• How systemic inefficiencies mean patients pay more for drugs
• Why past drug price interventions have failed the patients who need them most
• The tech-enabled, data-driven way to fix drug distribution and put patients first

The report also includes never-before-published insights leveraged from Kalderos’ proprietary data, drawing on our tech-enabled solutions for Discount Monitoring in the 340B Drug Pricing Program:

• Our estimated total amount of duplicate discounts between 340B and Medicaid in 2019 based on our platform gathering more than four years of good-faith inquiry data from covered entities
• Key metrics describing Kalderos’ growing network of relationships with stakeholder partners and increasing impact in 340B

The 2021 annual report also sets a vision for our company’s future as we continue our trajectory of rapid scaling, with a product roadmap that includes an expansion into data-driven, transparency-minded platform solutions for other drug discount programs.

Download the full report from Kalderos.

---

The content of Sponsored Posts does not necessarily reflect the views of Pembroke Consulting, Inc., Drug Channels, or any of its employees.

Posted by Drug Channels Institute, an HMP Global company on Monday, April 26, 2021

Labels: Guest Post, Sponsored Post

Today’s guest post comes from Erica Conroy, Vice President of Specialty at CoverMyMeds.

Erica discusses four technology areas that the healthcare network can embrace to increase speed to therapy, affordability, and adherence.

To learn more about CoverMyMeds' specialty medication access solutions, download their new whitepaper: Helping Patients Access Specialty Therapies: Autoimmune Conditions. (Free download)

Read on for Erica’s insights.

Posted by Drug Channels Institute, an HMP Global company on Friday, April 23, 2021

Labels: Guest Post, Sponsored Post

Cigna’s Evernorth business has recently released its 2020 Drug Trend Report. The results, which reflect the Express Scripts PBM business, are presented as a series of animated webpages. As you can see, Chief Innovation Officer Dr. Glen Stettin is newly cartooned.

For commercial plan sponsors, pharmacy benefit spending grew by 4.0%. However:

• More than three-quarters of this spending growth was due to the growth in utilization—the number of people being treated and the number of prescriptions being dispensed.
• The net, post-rebate costs of drugs rose by only 0.9%.

Details and comments about some therapeutic classes below.

SaveonSP, the secretive copay maximizer partner of Express Scripts, apparently again drove big specialty savings for some plans in 2020. I wonder how many plan sponsors have probed the profits and operations of this business?

Posted by Drug Channels Institute, an HMP Global company on Tuesday, April 20, 2021

Labels: Costs/Reimbursement, Industry Trends, Copay Accumulator Adjustment, Specialty Drugs, PBMs