This week, I’m rerunning some popular posts while I attend Asembia’s 2019 Specialty Pharmacy Summit.

Click here to see the original post and comments from January 2019.

Let’s kick off 2019 with a quick review of last year’s specialty pharmacy mergers and acquisitions (M&A). Our list (below) includes only deals that were publicly announced in 2018.

Pharmacy benefit managers (PBMs) were especially busy. CVS Health bought five specialty pharmacies. UnitedHealth’s OptumRx bought Avella Specialty Pharmacy, the largest independent specialty pharmacy.

Diplomat Pharmacy was uncharacteristically quiet during 2018, though it had been one of the most active acquirers in previous years.

The specialty pharmacy industry is rapidly maturing, so I expect many more exits in the coming years. Looking to pick up a fast-growing specialty pharmacy? Click here for your post-holiday shopping list.

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This week, I’m rerunning some popular posts while I attend Asembia’s 2019 Specialty Pharmacy Summit.

Click here to see the original post and comments from.

Time for Drug Channels’annual look at independent pharmacy owners’ business economics, drawn from the recently released 2018 National Community Pharmacists Association (NCPA) Digest, Sponsored by Cardinal Health. Here's the press release: NCPA Releases 2017 Digest.

Below, I update our estimates on pharmacy economics and margins. Our analysis reveals that independent pharmacy owners have faced another year of deteriorating finances.

What's more, we estimate that in 2017, the average pharmacy owner’s salary fell to a level comparable to that of an employed pharmacist. Owning a pharmacy, with all of its hassles and additional obligations, now brings the same reward as being an employee. I wonder how many owners will conclude that it’s barely worth the risk and effort.

Read on for our look at pharmacy profits and some comments on the industry’s competitive dynamics, including the financial impact of direct and indirect remuneration (DIR) fees.

The pharmacy consolidation endgame is getting closer. The next time you see a pharmacy owner, offer your condolences.

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This week, I’m rerunning some popular posts while I attend Asembia’s 2019 Specialty Pharmacy Summit.

This is an especially timely rerun. Believe it or not, Express Scripts' 2019 formulary prefers Eli Lilly's high-list/high-rebate Humalog insulin over the authorized generic version that is being sold at a 50% lower list price. The authorized generic will be preferred only on Express Scripts' Flex Formulary, which has very low adoption. 



Bottom line: Many plans still crave rebate dollars. Sorry, patients with deductibles and coinsurance. The gross-to-net bubble lives on! 



Click here to see the original post and comments from November 2018.

Express Scripts has just announced its National Preferred Flex Formulary, a new option that favors drugs with lower list prices over the high-list/high-rebate versions of these products. Click here to read the press release.

This new formulary signals that Express Scripts is trying to prepare its plan sponsor clients for a world without rebates. The formulary also provides a way for Express Scripts to prepare itself for such a world.

As I explain below, many plan sponsors embrace the warped incentives of the gross-to-net bubble—the ever-growing pile of money between a manufacturer’s list price for a drug and the net price after rebates and other reductions. I outline two crucial payer and PBM factors that make it difficult for manufacturers to cut list prices and pop the gross-to-net bubble.

Express Scripts’ new formulary challenges plan sponsors that are addicted to rebate dollars. Let’s see how many plan sponsors will prefer a low list-price over a high-list/high-rebate product—and how many more manufacturers will respond with lower list prices.

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This week, I’m rerunning some popular posts while I attend Asembia’s 2019 Specialty Pharmacy Summit.

Click here to see the original post and comments from February 2019.

Yesterday, The Wall Street Journal published my op-ed: Don’t Blame Drug Prices on ‘Big Pharma’. The article text is pasted below for those who don't subscribe.

I wrote this piece for a general business audience, though my arguments about rebates and patient out-of-pocket costs will be familiar to regular readers of Drug Channels. Alas, I had to omit such insider terms as gross-to-net bubble, direct and indirect remuneration, and SpongeBob SquarePants.

A personal note: I have been reading the WSJ daily since I was 18 years old. It’s a genuine thrill to see my byline on an op-ed in this newspaper. Another item off my bucket list!

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Financial Strategies and Accounting for Bioscience Companies

June 11-12, 2019 | San Francisco, CA

www.cbinet.com/financialstrategies

Expectations have never been higher as more small and mid-sized life science companies prepare to launch new and innovative products in a competitive marketplace. Gross-to-Net remains a top risk, especially after a launch, and it is pivotal to achieve accuracy in GTN forecasts to avoid large adjustments.

Ensure success by gaining proven pre-revenue commercialization strategies, frameworks for managing gross-to-net estimates and mitigating risk, models to scale the business and grow a best-in-class finance function, hearing, timely updates on tax and legal matters, and industry expertise for communications and investor relations at CBI’s Financial Strategies and Accounting Summit for Bioscience Companies.

Visit www.cbinet.com/financialstrategies for further details and to register. Drug Channels readers will save $400 off the standard rate when they use discount code NHA949 and register prior to May 17th.*

Sign up for the agenda and speaker announcements here. Here’s a sneak peek into who you’ll be hearing from:

• Alan Fuhrman, Chief Financial Officer, Amplyx Pharmaceuticals
• Laurie Stelzer, Chief Financial Officer, Halozyme
• Marc Belsky, Chief Financial Officer, Kezar Life Sciences
• Robin Washington, Chief Financial Officer, Gilead Sciences
• Mark Kaufmann, Chief Financial Officer, Ardelyx
• Murray Kay, former Commercial Controller, Abbvie
• Jennifer Sharpe, Executive Advisor, Life Sciences Revenue Analytics, IntegriChain

Visit www.cbinet.com/financialstrategies for further details and to register. Drug Channels readers will save $400 off the standard rate when they use discount code NHA949 and register prior to May 17th.*

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 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 Ben Stormer, VP of Product Development and Strategy for Specialty at CoverMyMeds.

Ben discusses how automatic, streamlined electronic enrollment in patient hub services will improve patients' adherence to specialty medication.

To learn more, connect with CoverMyMeds at the Asembia Specialty Pharmacy Summit next week in Las Vegas.

Read on for Ben’s insights.

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April is over, and now, come what May, it’s time for our monthly roundup of news stories highlighting key trends for U.S. drug channels. In this issue:

• My $0.02 on the Cigna/Express Scripts’ $25 insulin program

• Amazon starts marketing PillPack to Prime customers

• Surprise! Magellan drives major biosimilar adoption.

• Prime Therapeutics shows the power of formulary exclusion

Plus, read media coverage of our recent webinar: Preparing for a World Without Rebates.

P.S. Join the more than 7,400 people who follow my daily updates and links to neat stuff at @DrugChannels on Twitter.

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It’s time for Drug Channels Institute’s annual update of the number of U.S. specialty pharmacies.

As always, I had outstanding research assistance. (See photo at right.) But even we can’t count the total number of pharmacies dispensing specialty drugs, since any pharmacy can designate itself a specialty pharmacy.

We therefore counted every pharmacy location that had achieved accreditation by an independent organization.

Our exclusive findings:

• As of the end of 2018, more than 900 unique pharmacy locations had achieved specialty pharmacy accreditation from one or more of three major independent accreditation organizations. The 2018 figure marks a 25% increase over the 729 locations in 2017 and is more than double the 2015 figure.

• Pharmacy locations owned by healthcare providers—hospitals, health systems, physician practices, and providers’ group purchasing organizations—now account for more than one-quarter of all accredited specialty pharmacy locations.

Enjoy more of our arithmomania below. It will help explain why you’ll count more people than ever at next week’s Specialty Pharmacy Summit 2019. Drug Channels Institute will be there, so please say hello, e.g. “Greetings, it is I, a Drug Channels reader.”

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CBI’s 15th Annual Commercial Contract & Chargeback Excellence

June 25-26, 2019 | Philadelphia, PA

www.cbinet.com/chargebacks

Heading into Year 15, CBI’s Commercial Contract & Chargeback Excellence conference has become a must-attend for pricing and contracting professionals, offering interactive dialogue and best practices to guide you through a rapidly changing market.

Visit www.cbinet.com/chargebacks for further details and to register. Drug Channels readers will save $400 off the standard rate when they use discount code ZKE535 and register prior to May 10th.*

Our esteemed speaking faculty, made up of companies such as Pacira Pharmaceuticals, Premier, Celgene, McKesson, Chiesi USA, Zydus Pharmaceuticals and more, will collaborate and offer perspectives on chargeback efficiency, class-of-trade, GPO membership management, contract administration, and everything in between.

Download the agenda here and see in-depth coverage on critical topics, such as:

• Key trends and drivers of change impacting the commercial contracting landscape and market access
• New strategies for risk-share agreements and value-based contracting
• Optimize data exchange between trading partners from the wholesaler perspective
• GPO Best practices for streamlined membership management and accountability
• Valuable strategies for payer cost control approaches in the contracting space
• Impact of HHS Proposed Rule to eliminate prescription drug rebates on contracting stakeholders

Plus! New for 2019!

• In-Conference Workshops on the following topics: Class-of-Trade Membership Management, Value-Based Contracting Agreements, Pricing, Contracting and GTN Considerations at Launch, EDI Data Exchange, and 340B Pricing and Chargeback Reconciliation
• Tracked programming diving into the strategies and best practices for both complex contracts management and GPO and chargeback administration

Visit www.cbinet.com/chargebacks for further details and to register. Drug Channels readers will save $400 off the standard rate when they use discount code ZKE535 and register prior to May 10th.*

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 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 Scott Dulitz, Chief Strategy Officer at TrialCard.

Scott discusses the evolution of pharmaceutical manufacturer hub programs. As he explains, crucial industry trends are changing how patients and healthcare providers interact with and evaluate support services.

To learn more about TrialCard’s patient management solution, view TrialCard's recent video: Emerging Market Trends Shape Hub/Market Access Services, or email Scott at scott.dulitz@trialcard.com.

Read on for Scott’s insights.

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