Analysis

CBI’s Gross-to-Net Summit – GTN 2019
November 12-14, 2019 | Philadelphia, PA
www.cbinet.com/GTN

With drug pricing reforms looming and discounts/rebates under tremendous scrutiny, it is pivotal that pharmaceutical and biotech manufacturers stay on the forefront of gross-to-net management. The materiality of GTN deductions has increased in today’s competitive marketplace, and the forecasting, analytics, reporting and oversight of the related processes are paramount.

CBI’s GTN Summit, now in the 9th year, is designed to position your organization for success in the end-to-end management of GTN. You can download the complete agenda here.

Visit www.cbinet.com/GTN for further details and to register. Drug Channels readers will save $400 off the standard rate when they use discount code RZT477 and register prior to October 11th.*

The meeting is coming up on November 12-14 at the Hilton Philadelphia at Penn’s Landing and features expert perspectives from companies such as Adamas, Almirall, Amneal, Astellas, Daiichi Sankyo, Deloitte & Touche LLP, GSK, Impax, Incyte, Kala Pharmaceuticals, Lifestar Pharma, Paratek, Sandoz, Sunovion, Teva and more, all ready to share their insights into strategic forecasting, accounting estimates, analytics and finance reporting strategies, specifically for life science companies.

Whether you are a smaller/emerging company entering the market with a new launch or a company with existing products and more GTN experience, we will arm you with the strategies needed to advance in 2020.

Hot Topics on the Agenda Include:

• GTN and Strategic Finance in a Revolutionary Marketplace
• Product Pricing Pressures and Trends within the Payer Marketplace
• Leading Practices in GTN Management that Drive Success and Add Value
• End-to-End GTN Excellence – A Blueprint for Organizational Processes, GTN Estimation, Contracting, Transaction Processing and Reporting
• Right-Fitting a GTN Solution to Effectively and Efficiently Optimize GTN
• Robotics and Automation Realized
• Implementing Salesforce Initiatives to Maximize GTN
• GTN and Revenue Analytics Toolkit – Key Metrics, Standards of Practice and Solutions for Success

Customize Your Experience:

• Choose from Two Pre-Summit Breakout Seminars:
1. Industry 101 Boot Camp
2. Senior Executive Master Class
• Choose from In-Conference Summits:
1. Value-Based Contracting Summit
2. Patient Access Summit
3. Medical Summit and Industry Updates from HHS
4. Inventory Summit
5. Solution Summit
• Choose from Content Tracks:
1. Large Pharma
2. Small/Emerging Biotech
3. Generic Manufacturers

Download the agenda to plan your sessions and prepare to return to the office armed with critical updates and valuable takeaways.

Visit www.cbinet.com/GTN for further details and to register. Drug Channels readers will save $400 off the standard rate when they use code RZT477 and register prior to October 11th.*

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.

An interesting spat about biosimilars has emerged between two prominent policy-oriented physicians.

Dr. Peter Bach of Memorial Sloan Kettering and Mark Trusheim of MIT argues that we should “throw in the towel” on biosimilars and begin regulating drug prices.

On the other side, Dr. Scott Gottlieb, a former FDA commissioner, argues that we shouldn’t give up on biosimilars, but instead make structural and legislative changes that would increase competition.

To inform the debate, I share below the latest data on biosimilar adoption. As you will see, adoption rates for the most recently launched products—biosimilars of Neulasta and Epogen—are growing quickly, and prices are declining. These products are penetrating the market much faster than the biosimilars of Remicade did. Substitution rates for the upcoming wave of oncology biosimilars will likely penetrate even faster.

That’s why I concur with Dr. Gottlieb: Regulating prices at this stage of the market’s development is premature. This strategy may save some money in the short run, but it risks destroying a market that is finally beginning to fulfill its promise.

CBI’s Federal Pricing and Reporting
October 22-23, 2019 | Philadelphia, PA
www.cbinet.com/fedpricing

With legislation and regulation changes on the horizon, CBI’s Federal Pricing and Reporting Summit is a must-attend for bio/pharma manufacturers! You'll learn about best practices and future opportunities directly from government officials, including keynotes from the VA, DoD and PHS, and industry experts on pricing models and processes for complying with complicated rules and regulations.

Visit www.cbinet.com/fedpricing for further details and to register. Drug Channels readers will save $300 off the standard rate when they use code GDK898 and register prior to October 4th.

Take a deep dive into the latest innovations and challenges in federal reporting and contracting, especially as issues surrounding transparency and compliance evolve and offer opportunities for growth. The conference agenda covers the below and more:

• Review Federal Supply Schedule (FSS) compliance rules post-Acetris Health case with updated knowledge on transparency expectations
• Examine the possibilities around outcomes-based contracts and other strategies for better compliance and negotiations with the Big Four Federal Programs
• Managing Refunds of 340B Overcharges and Mitigating Compliance Risk
• Hear directly from the VA OIG regarding FSS contract compliance and audit expectations
• Review leading strategies and best practices for coordination with the Department of Defense with new budgeting changes
• Discuss the impact of drug shortages and limited distribution with an eye towards opportunities for growth and collaboration

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

Visit www.cbinet.com/fedpricing for further details and to register. Drug Channels readers will save $300 off the standard rate when they use code GDK898 and register prior to October 4th.

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.

On October 8, 2019, Drug Channels Institute will release The 2019–20 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors.

This new tenth edition is the most comprehensive, fact-based tool for understanding and analyzing all aspects of the U.S. pharmaceutical distribution industry. It also contains detailed information about the largest companies: AmerisourceBergen, Cardinal Health, and McKesson.

For the 2019-20 edition, we have added 19 additional exhibits and interesting new material, such as a look at the factors that determine executive compensation at the public wholesalers. I’ll share more details when we release the full report.


We are providing you with the opportunity to preorder this thoroughly updated and revised 2019-20 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 October 2.


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.

Preorder and launch pricing discounts will be valid through October 18, 2019.

If you have any questions before purchasing a license to the report, please email me. As always, thank you for your support of our work.

P.S. The launch date has been updated from October 2,2019, to October 8, 2019.

Time for our review of the Inc. 5000 list, the magazine’s annual ranking of the fastest-growing private companies in the United States. The list—based on revenue growth from 2015 to 2018—offers a valuable snapshot of the dynamic specialty pharmacy industry. Today’s article marks our eighth annual analysis of the list.

The specialty pharmacy industry slowdown meant that fewer specialty pharmacies than ever before were eligible for the Inc. 5000 list. We have identified eight specialty pharmacies in this year’s edition. Annual revenues range from $15.5 million to $726.1 million. For the four companies returning from last year’s list, 2018 sales-weighted average revenues grew by 48%.

This year’s Inc. roster signals that the shakeout is beginning. Fewer new specialty pharmacies are starting up, the bigger companies are getting acquired, and market share is concentrating further with the biggest players. Look for other dramatic changes in the coming year.

The specialty pharmacy industry outlook will be a hot topic at next week’s 2019 NASP Annual Meeting & Expo. I’ll be there, so please share your thoughts with me if you see me there.

CBI’s 4th Annual Outcomes-Based Agreements & Innovative Payer Contracting Summit
October 2-3, 2019 | Sheraton University City | Philadelphia, PA
www.cbinet.com/OutcomesContracting


The shift from volume to value-based care presents an opportunity for payers and bio/pharma and device manufacturers to explore innovative contracting methods, while demonstrating a commitment to improving clinical outcomes and patient access.

CBI’s 4th Annual Outcomes-Based Agreements and Innovative Payer Contracting Summit, taking place October 2-3 in Philadelphia, is the ideal platform for cross-industry stakeholders to discuss critical strategies on how to navigate the continuous changing policy and regulatory landscape, structure value-based agreements and measure outcomes with real world data. Featured speaking faculty include those representing Titan Spine, Highmark Inc., Sanofi, Avalere Health, Pfizer, Pernix Therapeutics, Curant Health, Ferring Pharmaceuticals and more!

Forward-Thinking Topics of Discussion Include:

• Evaluate how to target the best opportunities for an integrated delivery and financing system
• Understand which therapeutic areas payers are looking into and at what level of investment
• How do you define and derive value from real-world evidence?
• Identify how Real-World Evidence and Health Economics Outcomes Research coalesce into actionable data generation platforms for internal and external collaboration
• Examine how drug leasing models for curative cell and gene therapies [CAR-T] work
• Explore the drug subscription model for direct contracting between employers and life sciences

PLUS! Join us for the pre-conference workshop Change Management for Value-Based Contracting with workshop leaders Nick Merryfield, CEO, Verpora and Omar Ali, Visiting Lecturer, Value-Based Pricing and Innovative Contracting of New Medicines, University of Portsmouth; Former Adviser, NICE.

Download the conference agenda for the complete speaker and session lineup, then register using promo code OUT400 to take advantage of $400 off* the standard rate!

*Discount expires 10/1/19; 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.

This week, I’m rerunning some popular posts while I work on the forthcoming 2019-20 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. Click here to see the original post and comments from May 2019.

This article was the first of my 2019 series exploring the hidden economic mysteries of the 340B Drug Pricing Program. You can read the full series here: https://drugch.nl/340B

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The 340B Drug Pricing Program continues to expand at double-digit rates. According to our government contacts, discounted 340B purchases hit a record $24.3 billion in 2018. That figure is an astonishing 26% higher than its 2017 counterpart.

What’s more, we have found that since 2014, purchases under the program have grown at an average rate of 28% per year. By comparison, manufacturers’ net drug revenues have grown at an average rate of below 5% over the same period. Consequently, the 340B program has grown to account for at least 7% to 8% of the total U.S. drug market.

Nearly all of the billions in 340B discounts have accrued to hospitals. Yet hospitals' charity care has dropped amid the 340B program’s growth. The charts have the details.

So where did the money go? We have no idea, because hospitals and their lobbyists fight any call for them to disclose or account for how they use their 340B profits—while consistently misrepresenting the program's size and growth. Be skeptical when you read random stories about the generosity of a 340B covered entity. As always, the plural of anecdote is not data.

Read on for the latest details and ponder who really benefits from the 340B program's size—and how much longer this shocking growth can continue.

This week, I’m rerunning some popular posts while I work on the forthcoming 2019-20 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. Click here to see the original post and comments from May 2019.

This article was written before the rebate rule was withdrawn. That's why the PBMs Reborn scenario described below remains relevant.

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Over the next week, CVS Health and Cigna will hold their annual investor days. (Links below.) They will offer business and financial overviews of their diverse companies, including an update on the outlook for their pharmacy benefit managers (PBMs).

It’s a tough time to be a PBM. Compensation models are shifting, due to increased scrutiny by payers, regulators, and politicians. Plan sponsors are more sophisticated and seek greater pass-through of rebates, admin fees, and other manufacturer-provided revenues. Network spreads are under pressure, while specialty pharmacy dispensing accounts for a growing share of profits. Plus, the entire drug channel system could move toward a world without rebates.

Below, I update Drug Channels Institute’s look at PBM market share and reflect on four crucial areas in which PBMs’ compensation will be evolving. No PBM discloses detailed information about the sources and composition of its profits, so consider my observations as general guidelines for evaluating the upcoming investor day commentary from management.

This week, I’m rerunning some popular posts while I work on the forthcoming 2019-20 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. Click here to see the original post and comments from May 2019.

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Last week, Paula and I had the pleasure of attending Asembia’s 2019 Specialty Pharmacy Summit at the wonderful Wynn Las Vegas.

The Specialty Pharmacy Summit remains the most important forum for learning, networking, and conducting business throughout the entire specialty marketplace.

Today marks the ninth year that I will violate Vegas code and tell you what happened there.

Below, I offer reflections on the meeting, share my experiences during the featured session, and highlight four crucial specialty industry trends. You’ll also find a link to the conference’s Featured Session slides and cool photos—including two of the many selfies for which I posed during the meeting. Enjoy!

This week, I’m rerunning some popular posts while I work on the forthcoming 2019-20 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. Click here to see the original post and comments from June 2019.

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Time to dive into our 12th (!) annual review of the Fortune 500 list. Every year, this is one of my most popular posts, because it helps us follow the dollar and understand how drug channel intermediaries make money.

Fortune’s 2019 list contains only six drug channel companies: AmerisourceBergen, Cardinal Health, CVS Health, McKesson, Rite Aid, and Walgreens Boots Alliance.

Consolidation and vertical integration have transformed the channel—and the Fortune rankings. Below you will see our list of the companies that disappeared from the roster. We therefore have added to our analysis the four managed care and insurance companies on the list that operate PBMs.

Using the Fortune data, I explore the profitability and shareholder returns of the largest drug channel and managed care companies. I compare these companies with the Fortune 500’s eleven pharmaceutical manufacturers and with a separate survey of independent pharmacies.

These data remind us that many multi-billion-dollar businesses profit as drugs move through the U.S. reimbursement and distribution system. Enjoy our swim through this crazy complexity.