Specialty Pharmacy Network Design Summit

August 17-18, 2017 | Philadelphia, PA

www.cbinet.com/specialtynetwork

Mark your calendar for August 17-18, 2017 and attend the Specialty Pharmacy Network Design Summit in Philadelphia!

Learn about the latest strategies to optimize specialty pharmacy networks, the role of data shaping the future of specialty pharmacy, and specialty drug pricing/contracting trends. This meeting focuses on all aspects of specialty pharmacy network design from a multi-stakeholder approach providing the ideal platform to discuss opportunities and decision-making criteria behind building and expanding your specialty drug networks.

Agenda Sneak Peek:

• Explore the Specialty Network Design Decision-Making Process – Critical Criteria to Consider for Network Design Success
• Patient Data Aggregation, Reporting and Interpretation Methods for Manufacturers to Better Understand the Complete Patient Journey
• Evaluate the Emerging Trend of IDNs/ACOs Role in Specialty Pharmacy – Network Design Strategies Tailored for IDNs/ACOs Partnerships
• Making the Connection with the Patient – Specialty Pharmacy Services Strategies, Consent Compliance and the Impact on Patient Access
• Utilizing Innovative Health Information Technology to Transform Network Design
• Specialty Pharmacy Oncology Case Study
• Interactive Scenario Planning – Discover the Best Network Design to Achieve Your Goals

Sign up to receive the complete agenda here, and visit www.cbinet.com/specialtynetwork for further details and to register. Drug Channels readers will save $400 off of the standard registration rate when they use discount code MXZ956.*

 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.

        

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Yesterday, I examined the magnitude of the gross-to-net bubble—the growing spread between a manufacturer’s list price for a drug and the net price to a third-party payer after rebates. See New Data Show the Gross-to-Net Rebate Bubble Growing Even Bigger.

The bubble directly affects patients’ out-of-pocket costs. Many patients now have benefit plans with deductibles and are therefore required to pay the full, undiscounted cost of their prescriptions. Patients taking specialty drugs face large coinsurance computed using the undiscounted list price.

One solution replaces formulary payments made to plan sponsors with prescription discounts for patients at the point of sale (POS). Last week, CVS Health became the first pharmacy benefit manager (PBM) to publicly embrace and explain this alternative benefit design. See below for details.

Which makes me wonder: Do point-of-sale rebates solve the patients’ problems that the gross-to-net bubble causes? And will this benefit design mark the beginning of the end for the PBMs’ traditional economic model?

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Despite a slowdown in brand-name drug list prices, the gross-to-net bubble is alive and well. The bubble reflects the growing spread between a manufacturer’s list price for a drug and the net price to a third-party payer after rebates.

According to the most recent QuintilesIMS report, the total value of pharmaceutical manufacturers’ off-invoice discounts, rebates, and other price concessions has more than doubled over the past five years, from $59 billion 2012 to an astonishing $127 billion in 2016.

Those payments offset more than half of the increase in list-price based spending. And though the gap between invoice and net prices shrank in 2016, the value of manufacturers’ discounts and rebates payments still grew last year, by $11 billion.

Below I delve into these data and share my observations. Tomorrow, I’ll examine how the bubble affects patients’ out-of-pocket costs and how CVS Health’s PBM business hopes to survive when the bubble pops.

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CBI’s Annual 340B Manufacturer Summit

August 22-23, 2017 | Alexandria, VA

www.cbinet.com/340B

With evolving regulations impacting 340B programs, pharmaceutical companies are faced with uncertainty on how to strengthen program compliance and integrity. CBI’s Annual 340B Manufacturer Summit breaks down and clarifies the impending regulations, provides strategies to develop comprehensive self-disclosure response and auditing processes, and establishes best practices to collaborate with contract pharmacies and covered entities.

Expert Perspectives Include:

• Conference Chairperson: Sabrina Aery, Director, Medicare FFS, National 340B Strategy, Bristol-Myers Squibb
• Compliance Spotlight: Chris Hatwig, President, Apexus
• Covered Entity Insights: Maureen Testoni, Senior Vice President and General Counsel, 340B Health
• Legal Spotlight: John Shakow, Partner, King & Spalding
• Manufacturer-Only Discussion: Hae Won Min Liao, Assistant General Counsel, Gilead Sciences
• And more!

Critical Updates, Interactive Discussions and Valuable Takeaways:

• Develop proactive techniques to improve new policy adoption and program compliance
• Determine impact of the Mega-Guidance withdrawal on diversion risk
• Review manufacturer ceiling prices and civil monetary penalties
• Reduce duplicate discount loss potential by working with intermediaries to conduct good faith dispute resolution
• Evaluate the evolving specialty bio/pharma landscape and discuss changes in decision-making autonomy, payment methodology and delivery system structure
• Discuss options to increase visibility into contract pharmacy operations and understand how claims adjudication has occurred
• Uncover best practices to respond to covered entities and initiate good faith financial remediation

Download the complete agenda here and visit www.cbinet.com/340B for further details and to register. Drug Channels readers will save $400 off of the standard registration rate when they use discount code GBZ697.*

*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.

        

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Today’s guest post comes from Kay Morgan, V.P. of Drug Products & Industry Standards and Clinical Solutions at Elsevier.

Kay reviews specialty drug pricing and discusses strategies to manage spending on these therapies. For more, download Managing the Costs of Specialty Drugs, a free whitepaper from Elsevier.

Read on for Kay’s insights.

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Time to update our exclusive annual analysis of pharmacist salaries. As always, we rely on the latest Occupational Employment Statistics (OES) data from Bureau of Labor Statistics (BLS).

In 2016, the average gross base salary for a pharmacist at a retail, mail, and specialty pharmacy topped $120,000—up 0.6% from the 2016 figure. Retail employment expanded, with the greatest growth at drugstores.

Meanwhile, the share of pharmacists who work at hospitals grew again. Pharmacists who work at hospitals also had salary increases that exceeded those of the average pharmacist. As I explain below, the specialty boom and generic plateau continue to drive the pharmacy industry’s evolution.

Though pharmacist salaries are growing, they are not keeping pace with those of other healthcare practitioners. That disparity should be troubling to every pharmacy school dean.

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QuintilesIMS recently released Medicines Use and Spending in the U.S.: A Review of 2016 and Outlook to 2021. The report is an excellent, albeit often misinterpreted, resource for understanding the pharma market.

Below, I analyze the latest data on how pharmacy dispensing channels have changed over the past five years. Key insights:

• Retail chains now dispense nearly 6 out of 10 prescriptions. 
• Mail pharmacies have experienced declining prescriptions, but have soaring purchases of specialty drugs. 
• Contrary to popular belief, independent pharmacies continue to grow.

Just about every media story inaccurately reported the QuintilesIMS data as “drug spending.” To tickle your inner wonk, I also provide a primer on how to interpret and understand what the QuintilesIMS data really mean.

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Reimbursement and Access 2017

August 16-17, 2017 | Philadelphia, PA

www.cbinet.com/reimbursement

The market access, pricing and reimbursement landscape is rapidly evolving as stakeholders shift to a value-based healthcare system. This transition coupled with increasing drug pricing scrutiny and mounting uncertainty related to potential repeal/replacement of the Affordable Care Act creates tremendous challenges for bio/pharma manufacturers to overcome.

Join CBI in Philadelphia this August 16-17 at Reimbursement and Access 2017. Hundreds of leaders in Access, Reimbursement, Managed Markets and Commercial Operations have benefited from this highly-acclaimed event which arms attendees with best practices and practical strategies during a time of unprecedented uncertainty on complex issues.

Powerful Programming and Compelling Content on Topics Including:

• The current state and direction of the healthcare landscape
• Evolution and trends in drug pricing transparency
• Value-based contracting and rebating strategies
• Policy, trends and initiatives around Medicare benefit design
• Updates and real-time analysis on the Healthcare Exchange Marketplace
• Payer insights on utilization management strategies
• Recent advancements in value-based care models in oncology
• Emerging pathways for pricing assessment framework
• Patient assistance and reimbursement support programs

Dynamic Dialogue Driven by a Multistakeholder Speaking Faculty Representing:

AbbVie • Apobiologix • Aralez Pharmaceuticals • AssistRx • Avalere • BIO • Boehringer Ingelheim • Celgene • Center for Medicine in the Public Interest • Chiesi USA • Churchill Pharmaceuticals • Covance • CSL Behring • Gilead • Harvard Pilgrim Health Care • Johnson & Johnson Health Care Systems • Maxor National Pharmacy Services • Magellan Health • NASP • Pacira Pharmaceuticals • Pfizer • Pharming Healthcare • PhRMA • Sunovion Pharmaceuticals • UPMC Health Plan • Walgreens • And More!

Visit www.cbinet.com/reimbursement for more information. Drug Channels readers will save $500 off the standard registration rate when they use discount code EXH946.*

*Discount expires 06/30/2017 and may not be combined with other offers, category rates, promotions, or applied towards an existing registration. Offer not valid on workshop only or academic/nonprofit registrations. 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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Ronny Gal, Ph.D., a senior analyst at the investment bank Sanford C. Bernstein & Co., recently published a fascinating report on the size of pharmaceutical manufacturers’ charitable foundations. Ronny has graciously agreed to let me share the high-level results below.

Ronny and his team found that pharmaceutical manufacturers’ patient assistance programs (PAPs) account for 10 of the largest 15 U.S. charities and provided $6.5 billion of support in 2014. (See table below.) On average, the manufacturers’ financial support accounts for 8% of their operating expenses.

PAPs are controversial and closely monitored. As I argue below, their growth is linked to pharmacy benefit designs that shift prescription costs to patients. Many insured patients face economically-debilitating coinsurance—in some cases with no limit on out-of-pocket expenses. The programs are an imperfect, but necessary, fix to our imperfect drug channel system. Ronny has provided some valuable facts that show how important these programs have become.

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Summer is unofficially here! Before you break out the grill, check out these officially noteworthy items:

• My $0.02 on the new Express Scripts-Walgreens alliance

• CMS wants more details on pharmacy-paid DIR fees

• JAMA discovers the drug channel

Plus, revisit Asembia’s 2017 Specialty Pharmacy Summit with an awesome photo gallery. You’ll find two of my favorites lurking below.

P.S. My @DrugChannels twitter feed now has an astounding 4,100 followers. Join them and see why!

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