Analysis

Today’s guest post come from Heather Morel, Senior Vice President and General Manager of Access and Adherence at RxCrossroads by McKesson.

Heather discusses how to overcome barriers to patient adherence. To learn more about RxCrossroads by McKesson’s patient support programs, download their free white paper: The Impact of Behavioral Coaching on Adherence.

Read on for Heather’s insights.

Cell and gene therapies are poised to transform the treatment of many serious and previously untreatable conditions.

As this new market develops, payers and PBMs are laying the groundwork for disruptive channel models. Below, I examine how Cigna’s Express Scripts business has begun to shape this channel’s development. Its new models show the promise of private market innovation for the financing and commercialization of novel therapies.

These approaches will also shake up existing channels. If payers rub this magic lamp, these innovative channel models would: 1) enhance the role of the vertically-integrated insurer/PBM/pharmacy companies, 2) reduce or eliminate buy-and-bill by providers, and 3) minimize the role of the largest wholesalers. Consider the examples below to be early warnings of change.

FYI: Today’s post is an excerpt from Chapter 6 of our new 2019–20 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors.

I am pleased to announce our new 2019–20 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors, available for purchase and immediate download.

• Click here to download a free report overview (including the Table of Contents and a List of Exhibits)

• Click here to read the press release

We’re offering special discounted pricing if you order before October 18, 2019!

The 2019–20 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors—our 10th edition—is the most comprehensive, fact-based tool for understanding and analyzing the U.S. pharmaceutical distribution industry.

This 2019-20 edition contains the most current financial and industry data along with detailed information about the strategies and market positions of the largest companies: AmerisourceBergen, Cardinal Health, and McKesson. It updates our annual analysis of each wholesaler’s business segments and underlying business profitability, based upon our proprietary economic models. An intriguing new section reviews the financial factors that determine executive compensation at each of the public companies. See page vi of the free report overview for a summary of key changes and updates in this 2019-20 edition.

See below for more info and some behind-the-scenes tidbits. Happy reading!

P.S. If you would like to pay by corporate purchase order or check, please email Tamra Feldman. If you preordered the report, you should have already received an email with download instructions. Please contact us if you did not receive the email.

CBI’s 3rd Nurse Educator Programs
November 20-21, 2019 | Philadelphia, PA
www.cbinet.com/nurseeducator


During a time with advanced therapy regimens and complex reimbursement models, Nurse Educators are pivotal to address the knowledge gap and simplify the path forward for patients, from clinical interactions to commercialization. CBI’s Nurse Educator Programs tackles emerging challenges and provides the tools and strategies to optimize patient adherence and uncover best practices for improving the overall patient experience.

Download the complete agenda here.

Join your compliance, medical affairs and access peers November 20-21 in Philadelphia, PA, and hear expert perspectives from U.S Attorneys, Johnson & Johnson, Lexicon Pharmaceuticals, Alnylam, Janssen, Otsuka and many more.

Cutting Edge Topics on the Agenda Include:

• Compliant Patient Interactions Workshop:
• Patient Assistance and Copay Programs
• Foundation Support
• Hub Services
• Risks Associated with Field Reimbursement Teams
• Patient Spotlight — Elevate Meaningful Patient Engagement Programs to Advance Education and Outcomes
• Enforcement Oversight — Gain Insight into Federal Enforcement of Patient Assistance and Nurse Educator Programs
• Ready for Launch? Critical Considerations, Objectives and Decision-Making when Developing and Implementing Nurse Educator Programs
• Explore Innovative Partnership Opportunities between Industry and Patient Advocates
• Risk Avoidance in the Patient Journey — Make Privacy a Priority

Register today and save $400 — Be sure to mention promo code “400NEP”.

*Offer valid through 11/1/2019; applies to standard rates only and may not be combined with other offers, promotions or applied to an existing registration. Offer not valid on academic or workshop only 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.

Next week, Drug Channels Institute will release our 2019–20 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. It’s the 10th edition of our comprehensive and highly-regarded examination of U.S. prescription drug distribution channels. It will be released on October 8, but is available now for preorder at discounted pricing.

The exhibits below—2 of the 136 in our new report—provide a look at the revenues and market share of the Big Three wholesalers: AmerisourceBergen Corporation, Cardinal Health, Inc., and McKesson Corporation.

As you will see below, the Big Three wholesalers’ revenues continue to grow faster than those of the overall pharmaceutical industry. This growth has increased the wholesale share of the U.S. drug distribution channel and enabled the big to get even bigger. In the report, we document that gross profits have not kept pace with revenues.

For a sneak peek at the complete report, click here to download a free pre-publication draft overview (including the table of contents and a list of exhibits).

CBI’s Contracts & Chargebacks Critical Update Summit
November 14-15, 2019 | Philadelphia, PA
www.cbinet.com/chargebacksupdate

CBI’s Contracts & Chargebacks Critical Update Summit offers an important opportunity to connect with key stakeholders on timely updates in this evolving contracting landscape.

Benefit from tremendous networking opportunities and forward-thinking content addressing strategies for process implementation and collaboration excellence among key stakeholders. Experience an interactive dialogue, best practices and innovative models in a rapidly changing market to maximize stakeholder relationships, improve chargeback processes, navigate class of trade complexities and streamline membership management.

This event will kick off on Thursday, November 14 at 3pm with two inclusive summits for operational excellence and re-convene the next day for a full day of benchmarking, learning and networking on the topics that matter most to your organization.

Inclusive, Interactive Workshops on November 14th:

1. Implement and Operationalize Complex Contracts
2. Manage Membership and Chargeback Administration

Main agenda topics include:

• Mitigate Challenges Through Stakeholder Collaboration and Operational Excellence
• Wholesaler Playbook for Process Optimization in a Shifting Market
• Navigate Class of Trade Assignments–Maximizing GPO Alignment for Streamlined Workflow
• Valuable Strategies for Payer Cost Control Approaches
• Technology Innovation – Advance Data Exchange Through EDI and Blockchain
• Keep a Pulse on Regulations for Contract Compliance— Chargeback adjudication for 340B Pricing

Request the agenda here and prepare to return to the office armed with critical updates and valuable takeaways.

Visit www.cbinet.com/chargebacksupdate for further details and to register. Drug Channels readers will save $300 off the standard rate when they use code ZAB852 and register prior to October 25, 2019.

CBI will see you there!

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

Autumn is here! Curl up with your favorite pumpkin-spiced blog and savor these stories plucked from the Drug Channels patch:

• Amazon targets 340B

• UnitedHealthcare shows how providers increase drug prices

• Another 340B hospital behaves badly

• The downsides of deflating generic drug prices

Plus, upscale hotel or hospital: Can you tell the difference? (I couldn’t.)

P.S. Join the nearly 8,200 people who follow @DrugChannels on Twitter. My recent tweets have highlighted Amazon’s formulary, Walmart Health, PBM regulation, uninsured, drug price forecasts, CBO scoring, and more.

CBI’s Strategic Medicare Contracting Forum
November 20-21, 2019 | Alexandria, VA
www.cbinet.com/Medicare

CBI’s Strategic Medicare Contracting Forum, taking place November 20-21 in Alexandria, VA, provides bio/pharmaceutical manufacturers with an update on the seismic changes occurring within Medicare. The expert faculty provides insight into the current state of new and proposed regulations, explores what lies ahead and breaks down how these changes will impact your organization. Join colleagues and expert speakers to stay ahead of the curve on Medicare.


You and your team members will benefit from this opportunity by gaining insights from industry experts on the complex changes occurring within Medicare, walking away with critical perspectives and robust knowledge on key topics.

In-Depth Discussions on High-Impact Issues Include:

• Political and Legislative Trends Impacting Healthcare Coverage and Access – Goldwater Institute
• Discuss State Efforts on Drug Pricing Transparency for 2020 – Mallinckrodt Pharmaceuticals and Bristol-Myers Squibb
• Navigate Legislative Proposals to Lower Drug Pricing – U.S. House of Representatives
• Update on the International Price Index (IPI) Model and the Favored-Nations Clause – Bristol-Myers Squibb and PhRMA
• Strengthening Medicare Part D for Patients – Pfizer Inc.
• Assess the Future of Medicare Part D 2.0 – American Action Forum
• And much more!
  

Visit cbinet.com/Medicare to view the complete speaker and in-depth session lineup, then register using promo code TZJ345 for this exclusive savings of $400 off!

*Discount expires 11/19/19; cannot be combined or applied to 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.

Third-party payers' benefit designs remain a significant barrier to addressing drug costs. Many continue to use the ever-growing rebate dollars of the gross-to-net bubble to offset overall plan costs rather than reducing patient’s out-of-pocket spending.

Point-of-sale (POS) rebates are one possible benefit design solution. POS rebates directly share with patients the discounts that PBMs negotiate with manufacturers.

A recent survey of large employers by the National Business Group on Health (NBGH) suggests this change may be coming. The survey found that about one in five large employers is using point-of-sale (POS) rebates in their pharmacy benefit plans. The survey found that a further 40% of employers are considering POS rebates for 2021 and 2022.

Pharmaceuticals are the only part of the U.S. healthcare system where the difference between list and net prices is monetized as rebates and redistributed by intermediaries to payers. But we’ve seen that moving to a world without rebates may not be possible, given the drug channel’s entrenched interests and payers’ established economics.

POS rebates may therefore be our most realistic chance for addressing the drug costs of patients trapped in the gross-to-net bubble. Commercial payers and Congress (for Medicare Part D) should get started ASAP with POS rebates for insulin—a highly rebated and massively distorted therapeutic category.

Five of the largest pharmaceutical manufacturers—Eli Lilly, Janssen, Merck, Novartis, and Sanofi—have now publicly reported the 2018 gross and net price changes for their U.S. product portfolios, along with average discounts from list price. You can find links to the reports below.

These reports shed light on the heated political rhetoric and policy proposals that focus on drugs’ list prices. The reality: brand-name drug makers sold their products at half of those list prices. As you will see, the five companies discounted their average list prices by 44% to 55%.

Four of the five companies experienced a year-over-year decrease in average net prices.

This disparity continues to inflate the gross-to-net bubble. More than half of insured patients’ out-of-pocket prescription costs are tied to the list price, not the post-rebate net cost. That’s why rebate reform is needed. I’ll address the state of point-of-sales rebates in my next post.