This week, I’m rerunning some popular posts while I prepare for this Friday’s live video webinar: Drug Channels Quarterly Update: Patients, Payers, and PBMs.

Click here to see the original post and comments November 2020.

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.

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This week, I’m rerunning some popular posts while I prepare for this Friday’s live video webinar: Drug Channels Quarterly Update: Patients, Payers, and PBMs.

Click here to see the original post and comments from January 2021.

It was another year of unexpected drug price developments.

In 2020, brand-name drug net prices dropped for the third consecutive year. Meanwhile, brand-name drug list prices grew at their slowest rate in at least 20 years. See our updated analysis below.

I also review the factors behind declining brand-name drug prices. These factors are firmly in place for 2021.

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Our new Congress may try tackle drug prices in the new year. Let’s hope that their policy perceptions catch up to today’s realities.

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This week, I’m rerunning some popular posts while I prepare for this Friday’s live video webinar: Drug Channels Quarterly Update: Patients, Payers, and PBMs.

Click here to see the original post and comments from January 2021.

Once again, the three largest pharmacy benefit managers (PBMs)—Caremark (CVS Health), Express Scripts (Cigna), and OptumRx (United Health Group)—have increased the number of drugs they have excluded from their standard formularies. 

Today, I update our annual tracking of the number of exclusions by each PBM. I also highlight the expansion of exclusions into major specialty therapy classes. The 2021 formulary exclusion lists are available below for your downloading pleasure.

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Today’s guest post comes from Brian Haenni, Vice President of Hub Solutions at ConnectiveRx.

Brian discusses the benefits of digital patient support services. To learn more about ConnectiveRx’s patient support capabilities, register for their April 14, 2021 webinar, Transforming the Patient Support Experience.

Read on for Brian’s insights.

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Pharmacy pricing and benefit design are fundamentally broken.

For proof, look at GoodRx’s 2020 financial results for its discount card business. The company accounted for an estimated $3.4 billion in U.S. prescription revenues—and earned nearly $500 million in fees from PBMs.

Incredibly, three out of four consumers who used GoodRx already had commercial, Medicare, or Medicaid insurance. This means that someone—the consumer, their employer, and/or the government—paid insurance premiums for a pharmacy benefit managed by a PBM. Yet it was still worthwhile for people to bypass their plan’s out-of-pocket costs and PBM network rates in favor of a different PBM’s rates. As I explain below, such arbitrage creates potent conflicts between PBMs and their plan sponsor clients.

Don’t blame GoodRx for this mess. I give it credit for helping consumers navigate a crazy system that incentivizes people to bypass their own insurance plans. But it’s hard not to dislike a system that enables these games. Read on and let me know what you think.

The unusual alliance between PBMs and discount card vendors is among the many topics that I’ll address in DCI’s upcoming live video webinar, Drug Channels Quarterly Update: Patients, Payers, and PBMs , on March 26, 2021, from 12:00 p.m. to 1:30 p.m. ET. CLICK HERE TO LEARN MORE AND SIGN UP.

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I am pleased to announce our new 2021 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers, available for purchase and immediate download.

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

• New Drug Channels Institute Study: The Latest Trends for U.S. Drug Pricing, Reimbursement, and Patient Costs (press release)

We’re offering special discounted pricing if you order before March 28, 2021.

The 2021 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers is a truly unique resource. With 211 proprietary charts, exhibits, and data tables, this 12th edition provides a comprehensive, fact-based, and non-partisan tool for understanding the entire U.S. drug pricing, reimbursement, and dispensing system.

The full document clocks in at 412 pages. I can confidently say there is nothing else available that comes close to this report.

The chart below illustrates the depth and breadth of the 2021 edition. The numbers indicate the report chapter that corresponds to, explains, and analyzes each channel flow.

Below, you can read more info and some behind-the-scenes tidbits.

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.

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Today's guest post comes from Carolyn Zele and Ritupriya Yamujala, Senior Solution Consultants at MMIT.

Carolyn and Ritupriya discuss the challenges that manufacturers face in getting payer coverage for new drugs. They argue that a manufacturer can use analogs to improve messaging to payers, identify coverage challenges, and accurately predict payer uptake.

To learn more about these techniques, register for MMIT’s April 6, 2021 webinar: Predicting Payer Uptake With Precision.

Read on for Carolyn’s and Ritupriya’s insights.

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Next week, Drug Channels Institute will release our 2021 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. It’s the 12th edition of our popular and comprehensive examination of the entire drug pricing, reimbursement, and dispensing system. (You can preorder at special discounted prices.)

The exhibit below—one of 211 in our new report—provides a first look at the 15 largest organizations, ranked by total U.S. prescription dispensing revenues for calendar year 2020.

U.S. prescription dispensing revenues reached a record $465 billion in 2020. The largest players all had bigger slices of the revenue pie, due to the growth at specialty pharmacies and multiple transactions that shifted market share among the vertically integrated companies.

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). We’re offering special discounted pricing if you order before March 28, 2021.

Join me for DCI’s upcoming live video webinar, Drug Channels Quarterly Update: Patients, Payers, and PBMs , on March 26, 2021, from 12:00 p.m. to 1:30 p.m. ET. I'll review key PBM-related findings from our new report. Plus, I'll take live audio questions from the audience. (Yes, really.)  CLICK HERE TO LEARN MORE AND SIGN UP.

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Join Dr. Adam J. Fein, CEO of Drug Channels Institute (DCI) and the author of Drug Channels, for his latest exclusive live video webinar:

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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.

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