Analysis

This week, I’m rerunning some popular posts while I prepare for this Friday’s video webinar: Drug Channels Outlook 2021.

Click here to see the original post and comments from October 2020.

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Last week, news broke that Prime Therapeutics is expanding its relationship with Cigna’s Express Scripts to include mail and specialty pharmacy dispensing. So far, there's been very little written about this transaction.

Below, I share my thoughts on the following topics arising from the deal:

• The mail and specialty pharmacy market

• The future of AllianceRx Walgreens Prime

• The emerging Express Scripts industry platform

• A reminder about why the Federal Trade Commission won’t challenge the relationship

Prime is becoming increasingly dependent on outsourcing to Cigna’s Express Scripts business. This new pharmacy contract furthers the industry’s move toward vertical consolidation and the disappearance of the independent PBM industry.

Once again, channel intermediaries continue to gain power and extract profits. More to come.

Posted by Drug Channels Institute, an HMP Global company on Monday, December 14, 2020

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

Today’s guest post comes from Sarah Alwardt, Vice President of Operations at Ontada.

Sarah describes how historical patient information can be used in current and future clinical trials, often eliminating the need for new trial participants. She also introduces us to Ontada, a new McKesson business that uses technology, real-world data, and research capabilities as a way to accelerate innovation and improve cancer therapies.

To learn more, visit the Ontada website.

Posted by Drug Channels Institute, an HMP Global company on Friday, December 11, 2020

Labels: Guest Post, Sponsored Post

Well, we are almost finished with 2020. Help us bid it good riddance with our final news roundup of the year:

• Quantifying the blockbuster 340 pharmacy profits of CVS, Walgreens, and Express Scripts

• An insider describes PillPack’s pre-Amazon origins

• Physicians vote to oppose copay accumulator adjustment

• Maine’s secret analysis shows that importation costs more

Plus, the first batch of humor about Pfizer’s COVID-19 vaccine.

P.S. Join the nearly 10,800 followers of my curated links published on @DrugChannels on Twitter. You can also join my nearly 14,000 followers on LinkedIn.

Posted by Drug Channels Institute, an HMP Global company on Thursday, December 10, 2020

Labels: 340B, Importation, Physicians, Pharmacy, Copay Accumulator Adjustment, PBMs, Pharmacy Economics

When Americans complain about “drug prices,” most are actually complaining about the share of costs they pay—and how those costs are computed. Addressing patient affordability issues therefore requires a deep understanding of the U.S. drug channel.

Today, I review four crucial issues that the new Congress could tackle to address affordability, patients' out-of-pocket obligations, and prescription prices. I also highlight some of the existing and proposed legislative efforts.

Our complex channel cannot be fixed with simplistic solutions. It may seem unlikely that we will get bipartisan legislation that sensibly addresses the distortions and challenges in our drug pricing system. But I can dream, can’t I?

Posted by Drug Channels Institute, an HMP Global company on Tuesday, December 8, 2020

Labels: Gross-to-Net Bubble, 340B, Costs/Reimbursement, Benefit Design, Copay Accumulator Adjustment, Specialty Drugs, PBMs, Medicare Part D

During 2020, the COVID-19 pandemic disrupted every aspect of the pharmaceutical channel—and our lives. Pharmacy and healthcare provider markets experienced unprecedented volatility. If all goes well, 2021 will begin our return to normalcy, as vaccines roll out across the country.

This year has demonstrated the underlying resilience of U.S. distribution channels for prescription drugs. Pharmaceutical wholesalers have maintained shipments and operational capacity. They are now poised to play a vital role in distributing COVID-19 vaccines and therapeutics as they become available. However, there are substantial uncertainties about the timing and level of financial impact on wholesalers’ economics.

Below, I highlight six trends that will affect the U.S. drug wholesaling industry. I hope you enjoy this summary as we look toward the new year.

Posted by Drug Channels Institute, an HMP Global company on Tuesday, December 1, 2020

Labels: COVID-19, Biosimilars, Hospitals, Buy-and-Bill, Wholesalers, Channel Management, Cell and Gene Therapies, PBMs

Medicaid and Government Pricing Congress
December 14-17, 2020 | Virtual
www.informaconnect/medicaidgov

Register Today and be sure to use promo code MDCDCBG to save $300*

With drug pricing and benefit coverage top of mind for many Americans, coupled with a volatile election and overall healthcare landscape, the stakes are incredibly high for bio/pharma manufacturers. Staying on the pulse of industry trends, policies and changing regulations has never been more crucial.

The 22nd Annual Medicaid and GP Congress delivers critical updates and industry best practices to effectively contract, report and comply with state and federal healthcare programs. Gain timely, up-to-the-minute insights on:

• CMS’ Proposed Rule
• 340B Program
• State Price Transparency
• Value-Based Contracts
• Dispute Resolution
• Bona Fide Service Fees
• Class of Trade
• FSS Contracts
• State Invoicing
• Policy Initiatives
• Election Implications
• And many other critical topics. Download the complete agenda

The robust, fully virtual agenda features 30+ CPE and CLE-accredited sessions and 50+ speakers representing leading bio/pharma companies, government organizations and law firms from Aimmune, Alvogen, AMAG, Apexus, Arent Fox, Arnold & Porter, Astellas, AstraZeneca, BMS, CMS, Covington & Burling, CSL Behring, Daiichi Sankyo, Eisai, Exelixis, Gilead, Granard, Hogan Lovells, Indivior, J&J, King & Spalding, Louisiana Department of Health, Maryland Department of Health, OIG, Oklahoma Health Care Authority, Pfizer, Regeneron, Sandoz, Sidley Austin, UCB and many more.

Register Today and be sure to use promo code MDCDCBG to save $300*

*Discount applies to standard rates only and may not be combined with other offers, categories, promotions or applied to an existing registration. Offer not valid on non-profit/government registrations.

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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.

Posted by Drug Channels Institute, an HMP Global company on Monday, November 30, 2020

Labels: Sponsored Post

Happy Thanksgiving, everyone! Before you stretch your stomach, stretch your mind with this extra-stuffed helping of food for thought. In this issue:

• Rebate rule redux

• Most Favored Nation and healthcare benchmarking

• Amazon’s pharmacy customer opportunity

• Drug spending realities updated

• GPO consolidation

Plus, I congratulate Dirk Rodgers of RxTrace on his retirement.

P.S. Join the more than 10,600 followers of my curated links published on @DrugChannels on Twitter. My recent tweets have highlighted: doctors against step therapy, distribution of COVID-19 therapies, biosimilar savings, copay accumulator data, prospects for smaller PBMs, the new transparency rule, specialty pharmacy profit metrics, the future of oncology practices, and an update on Diplomat founder Phil Hagerman. You can also join my more than 13,500 followers on LinkedIn.

Posted by Drug Channels Institute, an HMP Global company on Tuesday, November 24, 2020

Labels: Group Purchasing Organizations (GPOs), Gross-to-Net Bubble, Hospitals, Mergers and Acquisitions, International Drug Channels, Health Care Policy, Industry Trends, Physicians, PBMs

Informa Connect’s 16th Annual Commercial Contracts & Chargebacks
December 17-18, 2020 | Virtual Event
informaconnect.com/contracts-chargebacks

Excusive Offer for Drug Channels Readers

Register Now

To SAVE $300* using promo code CHR300

Informa Connect’s 16th Annual Commercial Contracts & Chargebacks, taking place virtually December 17-18, arms the industry with strategic approaches to improve contract operations, navigate class of trade complexities, streamline membership management and reduce revenue leakage to improve chargeback efficiency and the bottom line. Dynamic conference features include:

• Two Days of Live Content, Audience Polling, Speaker Q&As and Interactive Discussions
• View Our Library of On-Demand Content at Your Leisure, Available for 30 Days After the End of the Conference
• High Impact Topics Transforming the Market Include:
• Membership Eligibility and Classification — Tolmar Pharmaceuticals
• Strategic Contracting Playbook — Pfizer Inc.
• Expert Manufacturer/Trading Partner Exchange — McKesson
• Class of Trade Navigation — Health Industry Business Communications Council (HIBCC)
• EDI Think Tank — FFF Enterprises
• Scorecarding and Metrics — Zydus Pharmaceuticals USA
• Next-Gen Technology — Chronicled

Drug Channels readers are eligible for an exclusive savings of $300 off* the standard rate by using promo code CHR300, so download the complete conference agenda and reserve your seat today!

*Expires 12/16/2020; applies to standard rate only and may not be combined or applied to existing registrations; 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.

Posted by Drug Channels Institute, an HMP Global company on Monday, November 23, 2020

Labels: Sponsored Post

Amazon is getting more serious about pharmacy. ICYMI: Introducing Amazon Pharmacy: Prescription Medications Delivered.

This announcement is much less disruptive than it appears to be. Amazon is copying the GoodRx discount card model—including GoodRx’s partnership with Express Scripts. At the same time, Amazon is launching a mail pharmacy that will accept insurance and be in PBM pharmacy networks.

Amazon’s actions are another negative headwind for retail pharmacies, but not a fatal blow to the system. Perhaps Amazon will one day become a true disrupter. For now, Amazon is choosing to join the drug channel, not fundamentally change it.

Posted by Drug Channels Institute, an HMP Global company on Wednesday, November 18, 2020

Labels: Costs/Reimbursement, Benefit Design, Discount Cards, Pharmacy, PBMs

Almost three years ago, I warned about the emerging trend of copay accumulators and outlined the costly consequences for patients.

I’m sad to report that the latest data show a startling acceleration in the adoption of copay accumulator adjustment and the closely related copay maximizer.

Within the next year, more than 80% of commercially insured beneficiaries will be in plans with these benefit designs—although not all plan sponsors will have fully implemented them.

Accumulators, maximizers, and copay support programs are inefficient solutions to flaws in the U.S. drug channel system. That’s why patient groups and provider organizations are pushing back against them.

Alas, our divided Congress seems unlikely to provide any relief. Read on for the full details.

Posted by Drug Channels Institute, an HMP Global company on Tuesday, November 17, 2020

Labels: Co-pay Offset Programs, Costs/Reimbursement, Benefit Design, Copay Accumulator Adjustment, Specialty Drugs, PBMs