CBI’s Medicare Pricing & Contracting Congress

February 25-26, 2020 | Hilton Alexandria Old Town | Alexandria, VA

www.cbinet.com/medicare2020

The current Medicare and drug pricing landscape is facing the potential for seismic changes in the year ahead. CBI’s Medicare Pricing & Contracting Congress expands in 2020 to convene stakeholders representing bio/pharma manufacturers, health plans, PBMs and leading policy advisors to provide critical updates and analysis on the impact of changing legislation.

Visit www.cbinet.com/Medicare2020 for more information. Drug Channels readers will save $500 off the standard registration rate when they use promo code RDU698*.

Benefit from In-Depth Discussions on High-Impact Issues:

• Political and legislative trends impacting coverage & access
• International Pricing Index Model (IPI) and Most Favored-Nations Clause updates
• Changes to Part B and ASP reporting requirements
• Trends and insights into Medicare Part D drug spending
• Considerations for balancing care and quality while delivering patient-centric outcomes
• Approaches for value-based contracting and alternative payment models

PLUS! Choose Between Two Tracks of Content:

1. Pricing & Contracting — for manufacturers
2. Part D Plan Strategies —for health plans and PBMs

Distinguished Speakers Driving the Dialogue:

• Mike Anderson, Pharm.D., CEO, Part D, UnitedHealthcare Medicare & Retirement
• Dan Wygal, Executive Director, Contract and Channel Strategy, AstraZeneca Pharmaceuticals
• Laura Crawn, Senior Director, Government Programs Market Strategy & Support, Express Scripts
• Steve Phillips, Senior Director, Health Policy Worldwide Government Affairs & Policy, Johnson & Johnson
• Michelle Drozd, Executive Director Reimbursement Policy, Gilead Sciences
• Kendra Martello, Executive Director, Public Policy & Corporate Social Responsibility, Government Affairs & Public Policy, Mallinckrodt Pharmaceuticals
• John Gorman, Founder and Chairman, Nightingale Partners
  
• And more!
REGISTER TODAY!

Visit www.cbinet.com/Medicare2020 for more information. Drug Channels readers will save $500 off the standard registration rate when they use promo code RDU698*.

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

The content of Sponsored Posts does not necessarily reflect the views of Pembroke Consulting, Inc., Drug Channels, or any of its employees.

        

Source: Post feed

For retail clinics, is it the best of times or the worst of times?

Walgreens  retail clinic business has been floundering. Last week, Walgreens announced that it would shut the last of its in-house retail clinics and in favor of outsourcing clinic operations to hospitals and health systems.

Other retailers are investing in more expansive healthcare services to realize the promise of store-based healthcare. That’s one reason why CVS Health is rolling out its HealthHUBs, while Walmart is phasing out its traditional retail clinics in favor of a more comprehensive Walmart Health offering.

Below, I review the retail clinic market in 2019. Many large retail chains operate clinics, but their strategies and growth rates differ. I expect the traditional retail clinic model to fade in favor of locations with broader healthcare services. This new direction will put pharmacies in more direct competition with urgent care clinics and primary care providers.

Pay close attention to how CVS Health leverages its Aetna business to manage site-of-care costs. Investors, payers, and patients will soon determine whether this has been the age of wisdom or the age of foolishness.

Read more »

        

Source: Post feed

Last week, McKesson released its earnings for the third calendar quarter of 2019. (See the links below.) The company revealed unexpectedly high revenue growth in its distribution business—but little incremental profit from these new revenues. Its stock dropped sharply on the news..

The thief that burgled the missing profits: CVS Health, McKesson’s largest customer. McKesson’s financial results reflected the challenges of an ultra-low profit customer that unexpectedly started growing much faster than the overall industry.

Consolidation and concentration in the pharmacy and pharmacy benefit management (PBM) industries continue to pressure wholesalers’ profits. Manufacturers and smaller customers should get ready for the fryer. Robble robble!

Read more »

        

Source: Post feed

Pharmaceutical Drug Pricing Strategies and Copay Summits

December 11-12, 2019 | Alexandria, VA

World Congress invites you to the Pharmaceutical Drug Pricing Strategies and Copay Summits where experts will share their solutions for critical issues.

Join your peers to learn from 35 speakers and enjoy 5 hours of networking at The Westin, Alexandria, VA. Drug Channels readers save $200 off the standard rate when you use promo code DC200 and register by November 8th.* To register your team, contact World Congress at 800-767-9499.

The price of prescription drugs and affordability of treatments is at the center of the health care debate. These Summits address the critical juncture of price and affordability, by showcasing strategies, innovations, and best practices across the bio/pharmaceutical industry to share how to be a part of the solution.

Given the recent news headlines, Senate finance hearings, and the introduction of drug pricing transparency laws, drug pricing is under the national spotlight. Hear both perspectives at the Pharmaceutical Drug Pricing Strategies Summit which brings pricing and reimbursement leaders together to discuss the future of federal and state pricing requirements, transparency regulations, and strategic drug pricing models.

The 2nd Annual Copay Summit convenes multiple stakeholders together, from manufacturers, payers, states, government, advocacy, and foundational groups, to examine regulations and innovations around the use of Copay and Coupon programs, and Copay Accumulator and Maximizers in an evolving health care landscape.

The Summits’ in-depth sessions will help you attain solutions for issues your organization faces in drug pricing and copay strategies.

• Develop strategic drug pricing models to meet federal and state pricing requirements and ensure transparency
• Examine the changes regarding copay accumulator adjustments, state copay legislation, and compliant assistance programs
• Explore multi-stakeholder insights from manufacturers, and insurers, on the future of drug price transparency and patient affordability

Our distinguished speaking faculty will share their insights:

• Mike Mason, Vice President, Lilly Diabetes, Senior Vice President, Connected Care and Insulins Eli Lilly and Company; he recently testified before the U.S. House of Representatives
• Robert Popovian, Vice President, US Government Relations, Pfizer; he has published and presented extensively on the impact of biopharmaceuticals and health policies on health care costs and clinical outcomes
• Peter Pitts, President of the Center for Medicine in the Public Interest; he is a former member of the United States Senior Executive Service and was FDA’s Associate Commissioner for External Relations

Join your peers to learn from 35 speakers and enjoy 5 hours of networking at The Westin, Alexandria, VA. Drug Channels readers save $200 off the standard rate when you use promo code DC200 and register by November 8th.* To register your team, contact World Congress at 800-767-9499.

*Cannot be combined with other offers or prior registrations.

The content of Sponsored Posts does not necessarily reflect the views of Pembroke Consulting, Inc., Drug Channels, or any of its employees.

        

Source: Post feed

Today’s guest post comes from Ben Stormer, Vice President of Specialty Product Development and Strategy at CoverMyMeds and Regina Murphy, Vice President of Product Strategy, Access and Adherence at RxCrossroads by McKesson.

Ben and Regina describe AMP: Access for More Patients™, a new technology-based hub service solution from CoverMyMeds and RxCrossroads by McKesson. To learn more about AMP, visit go.covermymeds.com/specialty.

Read on for Ben’s and Regina’s insights.

Read more »

        

Source: Post feed

Eeek! Time for my Halloween roundup of Drug Channels news stories.

In this issue:

• Creepy! Express Scripts invests in 340B

• Shocking! What Americans really think about government drug price negotiations

• Scary! A terrifying tale of compounding pharmacies and the Cats movie

Plus, the best take on nutrition research I have ever read.

P.S. Join the more than 8,300 people who follow @DrugChannels on Twitter. My recent tweets have highlighted biosimilars, Part D in 2020, generic drug approvals, H.R.3 and its effects, 340B hypocrisy, ICER, Jamaican monetary policy, billionaires, and more.

Read more »

        

Source: Post feed

Last week, I highlighted the largest pharmacy chains that will participate in next year’s Medicare Part D prescription drug plans (PDP).

Today, I examine how independent pharmacies will participate as preferred cost sharing pharmacies via the pharmacy services administrative organizations (PSAOs) that that represent these pharmacies in negotiations with plans.

For most independent pharmacies and their PSAOs, the profit sacrifices of Medicare Part D preferred networks are apparently no longer worth the incremental volume. As I predicted last year, they are starting to reject preferred networks:

• McKesson’s Health Mart Atlas will be the only PSAO whose members’ level of participation in preferred Part D networks will be comparable to that of the big chains.

• Pharmacy members of AmerisourceBergen’s Elevate network will again skip preferred status in the major Part D networks.

• Members of Cardinal Health’s PSAOs and the independent Arete Pharmacy Network will be preferred in many fewer 2020 networks compared with 2019.

You’ll find details and a handy scorecard below.

With independents fleeing preferred networks, will the Centers for Medicare & Medicaid Services (CMS) take a closer look at the market? And are independents really ready to say that they are never ever, ever, ever getting back together with preferred networks?

Read more »

        

Source: Post feed

CBI’s Specialty Therapies and Biosimilars Congress

January 22-24, 2020 | Miami, FL

www.cbinet.com/specialtytherapies

Kick off 2020 in Miami at the Specialty Therapies and Biosimilars Congress! Come together with colleagues from across the industry to tackle the challenges involved in managing the cost and quality of innovative therapies that are controlling or conquering diseases that were once considered untreatable.

Visit www.cbinet.com/specialtytherapies for further details and to register. Drug Channels readers will save $400 off the standard rate when they use promo code SPT400 and register prior to November 22nd.*

The quest to drive better outcomes, ensure access and manage costs is more vital than ever. Don’t miss the chance to be part of the conversation. Sign up to see the agenda here.

Experts from Blue Cross Blue Shield of Michigan, MedImpact Healthcare System, Fairview Specialty Pharmacy, Ochsner Health System, Boehringer Ingelheim, AHIP, Hemophilia Alliance, BBCIC, Mayo Clinic, Sunovion Pharmaceuticals and more will lead robust discussions on topics such as:

• Biosimilar Litigation and Patent Law
• Cell and Gene Therapy Reimbursement and Funding Strategy
• Medicare Report 2020
• Barriers to Entry – Challenges and Solutions for Entering the Marketplace
• Collaboration in a Complicated Landscape – The Role of Specialty Pharmacies in Controlling Cost
• Managing the Patient’s Journey – Payer Contracts, Points of Care and Formulary
• Real World Data and Demonstrated Value – The Care for Biosimilars and Expensive Therapies
• The Evolving Role of the Specialty Pharmacy in Oncology Management

Visit www.cbinet.com/specialtytherapies for further details and to register. Drug Channels readers will save $400 off the standard rate when they use promo code SPT400 and register prior to November 22nd.*

CBI will see you there!

*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.

The content of Sponsored Posts does not necessarily reflect the views of Pembroke Consulting, Inc., Drug Channels, or any of its employees.

        

Source: Post feed

In Preferred Pharmacy Networks Rebound in 2020 Medicare Part D Plans, I highlighted how those networks will again dominate next year’s Medicare Part D prescription drug plans (PDP).

Today, I examine chain pharmacies’ participation in the major 2020 Part D preferred networks that the nine largest plan sponsors offers. Some highlights:

• CVS will retain its position as a preferred pharmacy in many 2020 networks, while Walgreens will pull back on its preferred pharmacy participation. 

• For the first time in years, Rite Aid will expand its participation in plans that are independent of its EnvisionRx subsidiary.

• Walmart will regain its position as the chain most committed to preferred networks. Kroger and Albertsons will maintain the strong positions that they have established over the past few years.

Below, we provide you with a handy table for scoring each chain’s participation and all changes from 2019 to 2020.

The winners will gain and/or retain Part D prescription volume, but profits will suffer due to direct and indirect remuneration (DIR) price concessions, a.k.a., DIR fees. The retail chains have never clearly disclosed how they tradeoff prescription volume for profits. Remember: you can’t spell “pyrrhic victory” without victory.

Read more »

        

Source: Post feed

The Centers for Medicare & Medicaid Services (CMS) has released its data on the 2020 Medicare Part D plans.

Our exclusive analysis of these data reveals that preferred cost sharing pharmacy networks will maintain their dominance as an established component of Part D benefit design. For 2020, 95% of Medicare Part D regional prescription drug plans (PDP) will have a preferred network. In 2019, 92% of plans had such a network.

Below, I provide historical data on preferred networks’ growth and then discuss the top nine companies offering the 2020 plans. Humana is the only major plan sponsor to offer a national plan with an open network for 2020.

The prominence of preferred networks will again pressure pharmacy profits. That’s because pharmacies must pay direct and indirect remuneration (DIR) price concessions, a.k.a., DIR fees. In my next post, I’ll examine chain pharmacies’ participation in these plans and what it means for pharmacy profits.

P.S. Today’s post is brought to you by the letter D.

Read more »

        

Source: Post feed