The American Society of Hospital Pharmacists (ASHP) has just released its latest national survey of pharmacy practice in hospital settings. Download it here. (Available for purchase.) I always enjoy this annual treasure trove of insights.

This year’s survey updates our understanding of hospitals’ and health systems’ all-out pursuit of specialty pharmacy dispensing revenues. In 2018, more than 75% of the largest hospitals operated a specialty pharmacy. Check out the data below.

The 340B Drug Pricing Program has—and will continue to—encourage even more specialty pharmacy growth at hospitals. It is also providing a new way for Walgreens Boots Alliance to profit from 340B.

Amidst this growth, hospital-owned specialty pharmacies find themselves competing for prescriptions against pharmacy benefit managers (PBMs). These PBMs have built benefit networks that shift prescriptions away from hospitals in favor of the PBMs’ own specialty pharmacies.

Hospitals can fight PBMs for network access—or they can befriend a PBM-owned 340B contract pharmacy and still earn super-size profits. As you’ll see below, the odd combination of narrow networks and 340B is creating unexpected frenemies in the drug channel.

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Last week, I documented how the biggest independent and PBM-owned specialty pharmacies participate as contract pharmacies within the 340B program. These specialty pharmacies are owned by CVS Health, Cigna (Express Scripts), OptumRx (UnitedHealth Group), Walgreens Boots Alliance/Prime Therapeutics, and Diplomat Pharmacy.

Today, let’s follow the prescription dollar to expose how specialty pharmacies and covered entities profit from 340B prescriptions. We rely on confidential disclosures made to the U.S. Government Accountability Office (GAO).

You’ll see the indisputable prescription math that permits large specialty pharmacies to share in the 340B discounts that covered entities earn. These pharmacies’ profits can be $1,000 per prescription—far exceeding their typical profits from dispensing a third-party-paid prescription.

No wonder PBMs and specialty pharmacies are racing to become 340B contract pharmacies!

For years, hospitals and their lobbyists have been claiming that discounts from the 340B program support care for low-income and uninsured patients. What they don’t say: These discounts are also supporting some of the largest public companies in the U.S.

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CBI’s 7th Annual Coupon and Copay Forum

October 2-4, 2019 | Sonesta Rittenhouse Square | Philadelphia, PA

www.cbinet.com/coupon

These continue to be turbulent times for life sciences manufacturers, as the drug pricing debate shows no signs of wavering, state legislation to ban copay accumulator programs intensifies, and rebate reform gets replaced by Trump’s push for ‘most favored nation” drug pricing policy. Staying on the pulse of the patient affordability landscape and overcoming patient access barriers by leveraging strategic copay programs is more paramount than ever.

CBI’s flagship Coupon and Copay Conference, taking place October 2-4 in Philadelphia, is an important event devoted exclusively to designing (and re-designing) copay programs aimed at driving patient access and affordability to offset high-cost therapies and deductibles.

By popular demand, the 2019 agenda includes an all-new programming feature with one day of content devoted to the pressing topic of copay accumulators. Don’t miss three full days of jam-packed content on coupons, copays and accumulators covering:

• State and federal progress regulating copay accumulator programs
• Alternative copay strategies to respond to the rise of copay accumulator and maximizer programs
• Shifts in benefit plan design today and over the next 2-5 years
• Drug pricing legislation and potential impact on patient access
• Innovative copay program designs
• Impact of copay assistance programs on overall healthcare costs
• Potential effect of the price transparency debate and consumerism on patient adherence rates
• Performance metrics to justify the cost of copay programs
• And so much more!

Register today and save $500 or learn more at www.cbinet.com/coupon.

*Discount offer valid through 8/23/2019; applies to standard rates only and may not be combined with other offers, categories, promotions or applied to an existing registration.

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

        

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I recently documented the astounding growth in the number of pharmacies participating in the 340B Drug Pricing Program.

Below, we turn our attention to specialty pharmacies and PBMs in the 340B program. We have updated our exclusive analysis of how the biggest independent and PBM-owned specialty pharmacies participate as contract pharmacies within the 340B program.

The five largest specialty pharmacies are owned by CVS Health, Express Scripts, OptumRx, Walgreens Boots Alliance/Prime Therapeutics, and Diplomat Pharmacy. As you will see below, these specialty pharmacies account for more than 20% of total contract pharmacy relationships with 340B hospitals and other covered entities. Yet they represent only 1% of 340B contract pharmacy locations.

We also review 340B participation by other large independent pharmacies.

Large, multi-billion-dollar, for-profit companies don’t participate in government programs unless there is money to be made. So next week, we’ll follow the prescription dollar to explore how specialty pharmacies and covered entities profit from 340B prescriptions.

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Let’s cut through the steamy summer haze with our refreshing selection of articles and insights. In this issue:

• New details about Amazon’s PillPack deal

• Novo Nordisk’s CEO on the gross-to-net bubble

• Fresh data on adherence problems with copay accumulators

• My all-time favorite chart!

Plus, I am dazed and confused by a Specialty Pharmacy Times article.

P.S. Stay current with my daily links to cool stuff at @DrugChannels on Twitter.

ON SALE! We are offering our 2018–19 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors at discounts up to 30% off. Sales prices valid thru 9/3/19. The updated 2019-20 edition will be available in early October 2019.

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CBI’s 5th Annual Life Sciences Compliance Congress for Specialty Products

September 12-13, 2019 | Hyatt Regency | Cambridge, MA

www.cbinet.com/SpecialtyCompliance

CBI’s 5th Annual Life Sciences Compliance Congress for Specialty Products conference, taking place September 12-13 in Cambridge, MA, is tailored to the distinctive business needs and compliance challenges of specialty biotech and pharmaceutical manufacturers.

This CCB, CPE, CLE accredited conference provides numerous interactive sessions, panel discussions and networking events, optimizing face-to-face engagement with fellow compliance and legal industry professionals, including:

• Create your own tailored conference experience with 4 comprehensive breakout sessions
• Gain insights into the government perspective with a keynote panel featuring U.S. Attorneys from the District of Massachusetts, District of New Jersey and Southern District of New York
• Deep dive into patient support and assistance with 3 focused afternoon sessions highlighting compliant patient interactions, nurse educator programs and copay assistance
• Hear about the successes and letdowns of building compliance programs from the ground-up during the closing fireside chat with senior thought leaders
• PLUS! This year will include the inaugural, invitation-only Legal & Compliance Leadership Summit, designed to encourage an open exchange of ideas and strategies surrounding some of the most critical issues facing compliance leaders across the industry

Hear valuable content on high-impact issues for breakthrough therapies from 40+ industry leaders including Acceleron Pharma, Sobi, Vertex Pharmaceuticals, EMD Serono, Radius Health, Sanofi Genzyme, Sarepta Therapeutics, Sunovion, Strongbridge BioPharma, TherapeuticsMD, Avanir Pharmaceuticals, TESARO, Servier Pharmaceuticals, Alexion, Akebia Therapeutics, Takeda, Sage Therapeutics, Boehringer Ingelheim, Boston Biomedical, Blueprint Medicines and more!

Visit www.cbinet.com/SpecialtyCompliance to view the complete speaker and in-depth session lineup, then register using promo code TXF846 for this exclusive savings of $400 off!*

*Discount expires 9/11/19; cannot be combined or applied to existing registration. 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.

        

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Today’s guest post comes from David Holladay, President of CoverMyMeds.

David discusses the obstacles and frustrations patients experience as they navigate the patient journey. He describes CoverMyMeds’ technology solutions that have helped solve medication access and adherence challenges for patients.

To learn more about technology-enabled patient support, download this new case study: Comprehensive Prior Authorization Support to Help Impact More Patients.

Read on for David’s insights.

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STAT recently published our op-ed: State drug importation laws undermine the process that keeps our supply chain safe.

I co-authored this op-ed with Dirk Rodgers, an independent consultant and author of the excellent RxTrace blog.

As we see it, there is no legal or operational way of transforming a drug packaged for a foreign market into a drug that meets the U.S. requirements of our in-progress track-and-trace system. What’s more, there is no way to alter the law to enable importation without undermining the law’s purpose and value.

States can't wish away the requirements of a significant federal law. Either we have a secure drug supply chain or we don’t.

Note that our op-ed was published before Canada announced that it would resist drug exportation.

Full text below. Read on and let us know what you think.

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CBI’s 13th Hub and SPP Model Optimization

September 26-27, 2019 | San Diego, CA

www.cbinet.com/hubswest

With mounting cost pressures and increased demands for affordable, value-based treatment options, our industry faces an increasingly competitive market, for both specialty and non-specialty products. Increasingly, companies must strategize to manage the most critical challenges associated with product and patient services. CBI’s 13th Hub and SPP Model Optimization provides executives with strategies for developing and integrating hub programs and other patient-centric services to ensure product access and maximize reimbursement.

Visit www.cbinet.com/hubswest for further details and to register. Drug Channels readers will save $300 off the standard rate when they use discount code YZN462 and register prior to August 9th.*

Just a few highlights from the program include:

• Current litigation/court rulings that impact Hub and SP Models
• Integration of medical and pharmacy benefits
• AI across patient access programs to improve conversion and adherence
• Key learnings on aligning patient services and market access for rare disease launch success
• Examining EHR data to generate claims data and understand care episodes to see the effectiveness of a therapy
• Evaluating key patient and therapeutic traits that influence hub model design
• Best practices for combining data sources to provide a complete picture of the patient journey
• Tips to prepare for the hubs of the future and designing patient-centric hub models

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

Visit www.cbinet.com/hubswest for further details and to register. Drug Channels readers will save $300 off the standard rate when they use discount code YZN462 and register prior to August 9th.*

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 or other offers. 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.

        

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Today’s guest post comes from Pritesh Patel, Commercial Segment Director of Clinical Effectiveness at Wolters Kluwer, Health.

Pritesh presents a case study of how technology improved patient engagement, which translated into better patient health outcomes. To learn more, download their complete ebook: Patient Engagement in Commercial Health.

Read on for Pritesh’s insights.

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