Next week, Drug Channels Institute will release our updated 2017 Economic Report on Pharmacies and Pharmacy Benefit Managers (known in our previous editions as The Economic Report on Retail, Mail, and Specialty Pharmacies)

The exhibit below—one of 143 in our new report—provides a first look at the largest pharmacies, ranked by total U.S. prescription dispensing revenues for calendar year 2016. As you will see, the growth of specialty drugs is reshaping the pharmacy and PBM industries.

For a sneak peek at the complete report, download the free overview. Enjoy!

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The Centers for Medicare & Medicaid Services (CMS) just released a controversial and important new report: Medicare Part D – Direct and Indirect Remuneration (DIR).

The report shows mixed consequences of DIRs in the Medicare Part D program. For example, manufacturer rebates (the biggest part of DIRs) reduce plan costs and Part D premiums. However, beneficiaries pay higher out-of-pockets costs because coinsurance amounts are based on the undiscounted, pre-rebate retail price. Meanwhile, the government is paying a growing share of drug costs due to catastrophic coverage.

The CMS report has important implications for how we think about rebates, gross-to-net discounts, plan premiums, and patients’ out-of-pocket expenses. That’s why industry reactions have ranged from outrage to defensiveness. I encourage you to read the report and think about how it lays the groundwork for changing the Medicare Part D program.

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The weather may be chilly, but our monthly news update will keep you purring. Here are important new developments that will ignite your curiosity:

• A great new report that quantifies manufacturers’ gross-to-net discounts

• MedPAC targets Part B reimbursement

• Diplomat and CVS Health offer competing looks at the specialty drug pipeline

Plus, we here at Drug Channels have just released our 2017 media kit. Check it out and let us know how we can help you appear on the site!

P.S. I've been pretty active on the @DrugChannels Twitter  account. Follow along for my daily tweets on cool and intriguing stuff.

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CBI’s 4th Annual e-Rx and EHR Forum — ePrescribing and Electronic Health Records

March 15-16, 2017 | Philadelphia, PA

Exclusive Offer – Register by 2/24/2017 and save $400* (mention promo code ERXDC4)

CBI’s flagship e-Rx and EHR conference returns to Philadelphia in March for unparalleled learning and benchmarking opportunities. Benefit from the life sciences industry’s foremost event dedicated to the forward thinking strategies and tactics to streamline HCP workflow, drive customer education and facilitate access via e-Prescribing and EHR technologies.

Why e-Rx and EHR 2017? Here are just a few of the many exciting features of this year’s transformative program:

• A four-physician panel delivering first-hand accounts of HCP experiences with EHR systems
• An eye-opening Keynote from IBM Watson Health, providing a unique glimpse into the future of healthcare IT
• Industry insights and expertise from, among others: AstraZeneca, Celgene, Boehringer Ingelheim, NCPDP, Maine Coast Memorial Hospital, Intercept Pharmaceuticals
• Coverage of the hottest topics and key challenges keeping you up at night, including population health, innovations at the point of prescribe, ePrior authorizations, preventing opioid abuse and so much more

*Discount offer valid through 2/24/2017; 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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Yesterday, McKesson reported another quarter of disappointing financial results. Click here to read the press release.

CEO John Hammergren complained that the company was “unfavorably impacted in the third quarter by weaker branded pharmaceutical pricing than anticipated.”

On last night’s earnings call, the company echoed its threat to renegotiate agreements with manufacturers that don’t increase drug list prices at a rate that's acceptable to McKesson.

In What McKesson’s Profit Warning Means for Manufacturers and Pharmacies, I explained that McKesson and other drug wholesalers want drug list prices to rise. To help you interpret what’s going on, below is a brief excerpt from our 2016-17 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors that outlines precisely how wholesalers benefit from drug price inflation—even when they have fee-based agreements with manufacturers. File this post under “warped channel incentives.”

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Last week delivered significant announcements that will shake up the market for epinephrine auto-injector pens. CVS began promoting a lower-cost EpiPen alternative. Small pharma company Kaléo relaunched the AUVI-Q. Meanwhile, Mylan’s new generic EpiPen continued to gain traction.

It’s a good time to revisit the EpiPen situation and see what it tells us about U.S. pharmaceutical industry pricing. After last week’s announcements, there are now four key products, each with its own list price and rebate arrangements:

• An EpiPen with a $608 list price and rebates to pharmacy benefit manages (PBMs)

• An EpiPen with a $300 list price, but no rebates

• Adrenaclick, an alternative product with a $110 cash price at CVS pharmacies

• Auvi-Q, another alternative, with a $4,500 (!) list price

As I explain below, these variations wonderfully illustrate the warped incentives embedded in our crazy drug channel. Will we make progress in popping the gross-to-net bubble?

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PAP 2017 – CBI’s 18th Annual Patient Assistance & Access Programs

March 16-17, 2017 | Baltimore, MD

CBI’s PAP Summit continues the tradition of uniting manufacturers, co-pay foundations, non-profits, free clinics, advocacy organizations, hospitals and more to analyze the legalities, intricacies and best practices for these vital programs at a time of unprecedented need. As pricing pressures, politics, regulatory scrutiny and “under insurance” converge, now is the time to gather, discuss and plan the path forward.

2017 Program Highlights Include:

• Marketplace trends impacting patient access, affordability and adherence
• The prospect of Obamacare reversal and what it means for patient access
• Emerging market-based and political initiatives to control drug utilization
• New waves of patients and evolving models of assistance
• Trends and insights in co-pay program assistance and utilization
• Program best practices to optimize the patient journey
• Advocate and manufacturer relations to enhance patient access

Plus – Choose from Three Content Streams:

• Technology and Innovation – Paving a Path to Improve Outcomes
• Affordability and Access – Streamlining Financial Support and Access to Care
• Legal and Compliance – Oversight and Frameworks for Compliance

For more information, please download the complete agenda or visit www.cbinet.com/pap. Drug Channels readers will save $400 off of the standard registration rate when they use discount code FDH399.*

*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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Just-released data from the Centers for Medicare & Medicaid Services (CMS) confirms that preferred cost sharing networks will continue to dominate Medicare Part D. Our exclusive analysis finds that for 2017, 73% of seniors are enrolled in Prescription Drug Plans (PDPs) with preferred pharmacy networks. The three biggest companies—Humana, UnitedHealthcare, and CVS Health's SilverScript—now account for 69% of enrollment in stand-alone Part D plans.

Below, we use the enrollment data to analyze the major pharmacy chains’ position within the 17 major multi-regional Part D plans with preferred networks. As you will see, Walgreens and Walmart are the big winners, while CVS and Rite Aid lag far behind.

As long as pharmacies are willing to accept lower reimbursements in exchange for increased store traffic, preferred networks will continue to grow. For 2017, Walgreens’ aggressive partnering strategy looks likely to result in significant prescription market share gains.

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PBMI 22nd Annual Drug Benefit Conference

March 6 – March 8, 2017 | Orlando, Florida

Location: Loews Portofino Bay Hotel at Universal Orlando

The conference will kick off with an opening speech by Scott Gottlieb, M.D. Dr. Gottlieb is a practicing physician and Resident Fellow at the American Enterprise Institute. A leading expert in health policy, Dr. Gottlieb’s work focuses on providing insights into the economic and technological forces driving the transformation of healthcare.

Attendees will benefit from hearing from thought leaders and innovators who will provide insight into practical and proven strategies for effectively managing the drug benefit. The conference includes three educational tracks and continuing education credit (CE) for pharmacists, is available. Check out the conference program to see who will be there.

Conference attendees can get a head start on their conference learning experience by selecting one of two FREE pre-conference workshops to attend. Workshops will be held Monday, March 6th from 10:30 am to 12:45 pm.

• Workshop A: Trust But Verify: A Case Study on the Value of Auditing Your PBM Sponsored by Pharmaceutical Strategies Group

• Workshop B: Improving Patient’s Safety and Outcomes with Innovative Solutions Sponsored by Surescripts, LLC

Note: Conference registration is required to attend a workshop.

Drug Channels readers will save $255 off conference rates when they register online and use discount code PEM17.

If you have questions or need information about exhibiting or sponsorship at the conference, please contact Linda DeChant at ldechant@pbmi.com.

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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ICYMI: CVS drugstores were booted from the pharmacy networks of Blue Cross and Blue Shield of Alabama. It's more evidence for preferred and limited pharmacy networks in commercial plans. But how many payers are adopting these new narrow network models?

As far as I know, the only public answer comes from the Pharmacy Benefit Management Institute’s (PBMI) new 2016 Trends in Drug Benefit Design report. (Free download with registration.) Drug Channels again thanks Takeda Pharmaceuticals U.S.A. for having sponsored the research.

According to the PBMI’s survey data, almost half of all employers have a narrow pharmacy network. The chart below tracks the growth in different network designs. Many interrelated factors support the continued adoption of narrow networks. The savings to payers from narrow networks come primarily from pharmacies, which offer or must accept lower per-prescription margins. That’s what makes narrow networks so controversial—but also highly pro-competitive. Caveat venditor!

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