Analysis

The Centers for Medicare & Medicaid Services (CMS) has recently released its 2021 data on enrollment in Medicare Part D prescription drug plans (PDPs). Our exclusive analysis of these numbers finds that for 2021, an astounding 99% of seniors are enrolled in PDPs with preferred pharmacy networks.

Below, we use the new enrollment data to examine the major pharmacy chains’ position within the 27 major Part D plans that have preferred networks. As you will see, the big supermarket chains—Albertsons, Kroger, and Publix—outpaced the big three drugstore chains and Walmart.

Pharmacies continue to sacrifice margin for store traffic. Don’t expect that to change—especially given the notable failure of the independents-only Indy Health Part D plan.

Let’s melt away this foul February with our monthly selection of scorching news from around the drug channel. In this issue:

• Payers confess: Patients lose from copay accumulators

• Humana joins the Express Scripts GPO

• Hospitals vs. PBMs over specialty pharmacy white bagging

• Let’s all follow the Buy-and-Bill Dollar!

Plus, entrepreneurial pharmacy owner Dave Marley demonstrates the power of innovation.

P.S. Join the more than 11,000 followers of my daily links to neat stuff at @DrugChannels on Twitter. You can also join my more than 15,000 followers on LinkedIn.

Does pharmacy need to be disrupted?

Venture capitalists clearly think so, judging by the billions they have put behind technology-enabled digital pharmacies. Below, you’ll find our list of 14 leading contenders along with funding levels. These companies have not gained significant pharmacy industry market share, but their revenue growth rates are impressive.

Alas, many of these digital pharmacies seem to have misdiagnosed their relative advantage versus today's pharmacies.

On March 16, 2021, Drug Channels Institute will release The 2021 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. This report—our twelfth edition—remains the most comprehensive, fact-based tool for understanding the entire U.S. drug pricing, reimbursement, and dispensing system.

We are providing you with the opportunity to preorder this thoroughly updated and revised 2021 edition at special discounted prices. This means that you can be among the first to access our new report. Those who preorder will receive a download link before March 16.


You can pay online with all major credit cards (Visa, MasterCard, American Express, and Discover) or via PayPal. Click here to email us if you would like to pay by corporate purchase order or check.

Special preorder and launch pricing discounts will be valid through March 31, 2021.

Time to update Drug Channels' exclusive look at independent pharmacy owners’ business economics.

Our analysis reveals that despite what you may have heard, many independent pharmacies have figured out how to survive a highly challenging environment.

Today’s guest post comes from David Holladay, President of CoverMyMeds.

David highlights the value of empathy in patient care. He also shares crucial findings from CoverMyMeds’ new 2021 Medication Access Report. This report provides a wealth of data about medication access, while also highlighting patients’ own stories and experiences.

Read on for David’s insights.

For my first Drug Channels news roundup of 2021, I focus on two remarkable, must-read reports that provide extraordinary details about the hidden economics of our drug channel:

• The Center for Medicare & Medicaid Services’ new transparency rule discloses how much major insurers overpay hospitals for outpatient drugs.

• A new Senate report reveals unprecedented information about PBMs, manufacturers, and the gross-to-net bubble for insulin.

Plus, a 2021 update to my all-time favorite chart.

P.S. Join the nearly 11,000 followers of my daily links to neat stuff at @DrugChannels on Twitter. You can also join my nearly 15,000 followers on LinkedIn.

Today’s guest post comes from Jason Coles, Senior Product Manager for Clinical Effectiveness at Wolters Kluwer, Health.

Jason discusses the benefits of accessing patient information across clinical contexts. He introduces us to the Wolters Kluwer drug data solutions. These solutions promote interoperability and help healthcare businesses meet regulations related to health information exchange.

To learn more, download the Wolters Kluwer interoperability stories ebook.

Read on for Jason’s insights.

ICYMI: The econowonks at the Centers for Medicare & Medicaid Services (CMS) recently dropped the latest National Health Expenditure (NHE) data, which measures all U.S. spending on healthcare. Links below.

Today, I highlight the surprising insights from the latest figures. I examine the growth rates of major spending categories, break down costs vs. utilization, and highlight the unfavorable out-of-pocket dynamics for prescription drugs compared with hospital care.

Bonus: I also debrief you on CMS’s quinquennial comprehensive revision to the national spending data.

Regular readers know the unofficial motto of Drug Channels: "Everyone is entitled to their own opinion, but not their own facts." For 2021, I hope the drug pricing flat earthers (#DPFE) finally start to follow the data and acknowledge what’s really going on.

17th Annual Life Sciences Accounting & Reporting Congress
March 16-18, 2021 | Virtual Event
www.informaconnect.com/accounting-reporting-congress

The 17th Annual Life Sciences Accounting & Reporting Congress, an important event for finance, accounting and business leaders within life sciences, provides in-depth CPE education and networking with nearly 600 professionals. Join us for a Spring Virtual Update on March 16-18, 2021 as we navigate regulatory reform, increased complexity, dynamic risk environment, COVID industry impacts and more.

Visit www.informaconnect.com/accounting-reporting-congress for further details and to register. Drug Channels readers will save $100 off the current lowest rate when they use code DRCH100 and register prior to February 12, 2021.*

With Expert Keynotes, In-Depth Workshops and Live Q&A Opportunities and other virtual features, you’ll end your week ready to advance your organization to stay ahead in 2021.

Here’s a snapshot of what to expect:

Valuable Virtual Networking, Career Development, and Educational Opportunities:

• Pre-Congress Offerings including Technology Solution Summits, Controller’s Think Tank, 101 Foundational Course, Talent Acquisition and Team Optimization Summit
• CEO Fireside Chat – A Candid Conversation on Key Business and Industry Priorities in 2021 and Beyond
• CFO Keynote Panel – Leading in Finance and Navigating the Course of Change
• CAO Panel and Q&A – Critical Issues in Technical Accounting and Financial Reporting
• Healthcare Policy Fireside Chat – Pricing, Policy and Healthcare Outcomes
• SEC Keynote Address – Oversight, Management and Performance
• FASB Address – Standards Update and Initiatives
• Advancement Course – Future Finance: Strategies to Empower the Team, Elevate Talent, Inspire Inclusion and Cultivate a Winning Culture
• Plus – Hot Topic Workshops focusing on AI and Robotics Automation, IPO Readiness, Clinical Trials and Vendor Study Management, Divestiture Strategies, M&A Integration, New Product Commercialization, ESG Metrics and Disclosures, Cyber and Data Security, Corporate Tax Reform Implications

Visit www.informaconnect.com/accounting-reporting-congress for further details and to register. Drug Channels readers will save $100 off the current lowest rate when they use code DRCH100 and register prior to February 12, 2021.*

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rate or non-profit rates. 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.