Happy Thanksgiving, everyone! Before you stretch your stomach, stretch your mind with our extra-stuffed helping of food for thought. In this issue:

• The State of Specialty Pharmacy 2021

• How health plans profit—and patients lose—from insulin

• A fantastic new analysis of the gross-to-net bubble

• CVS acknowledges how its PBM profits from 340B

• Reconsidering Amazon

P.S. Please join the nearly 13,000 consumers of my daily commentary and links to neat stuff at @DrugChannels on Twitter. You can also find my daily posts on LinkedIn, where I have more than 21,000 followers.

Recent posts have covered: outcomes-based contracts, copay accumulators, hospitals’ drug profits, biosimilar interchangeability, managed Medicaid, DSCSA, CVS Health’s networks, unintended consequences of congressional drug pricing legislation, Walmart and TRICARE, McKesson’s European retreat, and more.

Please join me for my upcoming live video webinar, Drug Channels Outlook 2022, on December 17, 2021, from 12:00 p.m. to 1:30 p.m. ET. Hundreds of people from your competitors, customers, and suppliers have already signed up. Will you be there, too?

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Happy Thanksgiving, everyone! Before you stretch your stomach, stretch your mind with our extra-stuffed helping of food for thought. In this issue:

• How health plans profit—and patients lose—from insulin

• A fantastic new analysis of the gross-to-net bubble

• CVS acknowledges how its PBM profits from 340B

• Reconsidering Amazon

P.S. Please join the nearly 13,000 consumers of my daily commentary and links to neat stuff at @DrugChannels on Twitter. You can also find my daily posts on LinkedIn, where I have more than 21,000 followers.

Recent posts have covered: outcomes-based contracts, copay accumulators, hospitals’ drug profits, biosimilar interchangeability, managed Medicaid, DSCSA, CVS Health’s networks, unintended consequences of congressional drug pricing legislation, Walmart and TRICARE, McKesson’s European retreat, and more.

Please join me for my upcoming live video webinar, Drug Channels Outlook 2022, on December 17, 2021, from 12:00 p.m. to 1:30 p.m. ET. Hundreds of people from your competitors, customers, and suppliers have already signed up. Will you be there, too?

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Today’s guest post comes from Carolyn Zele, Senior Manager of Solution Enablement at MMIT.

Carolyn describes how oncology pathways were developed to help standardize treatment and ensure quality care. She argues, however, that these pathways often shut manufacturers out of the market.

Click here to learn more about MMIT's Pulse Analytics solution, which provides insight into payer- and pathway-driven barriers to access.

Read on for Carolyn’s insights.

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In my previous post, I highlighted the largest pharmacy chains that will participate in the 2022 Medicare Part D prescription drug plans (PDP).

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

As you will see here, the largest PSAOs are increasingly rejecting preferred networks. Below we provide details about the PSAOs owned by the three major wholesalers—AmerisourceBergen, Cardinal Health, and McKesson—along with information about AlignRx, the largest independent PSAO. There are some notable differences in strategy, as you will see from our handy scorecard below.

Smaller pharmacies’ rejection of Part D preferred networks shows that they are figuring out how to survive a highly challenging retail environment. Perhaps Part D is just a flesh wound?

Speaking of 2022, please join me for my upcoming live video webinar, Drug Channels Outlook 2022, on December 17, 2021, from 12:00 p.m. to 1:30 p.m. ET. Click here to learn more and sign up.

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In Consolidation and Preferred Pharmacy Networks in 2022’s Medicare Part D Plans, I highlighted how those networks have hijacked the world of stand-alone Medicare Part D prescription drug plans (PDP) and become a major presence in Medicare Advantage prescription drug (MA-PD) plans.

Today, I examine the largest retail chains’ participation in the 21 major 2022 Part D preferred networks that the eight largest plan sponsors will offer. Below, we offer you a handy table for scoring not only each chain’s participation, but also all changes from 2021 to 2022.

Narrow networks force pharmacies to trade volume for profits, due primarily to substantial pharmacy direct and indirect remuneration (DIR) payments. One unexpected bright spot has been pharmacies’ participation in the 340B Drug Pricing Program. As you review chains’ eager participation in the 2022 Part D networks, ponder whether a material change in the 340b contract pharmacy market might tarnish the attractiveness of being preferred.

Speaking of next year, please join me for my upcoming live video webinar, Drug Channels Outlook 2022, on December 17, 2021, from 12:00 p.m. to 1:30 p.m. ET. Click here to learn more and sign up.

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Dr. Adam J. Fein, CEO of Drug Channels Institute (DCI) and the author of Drug Channels, invites you to join him for a new live video webinar:

Drug Channels Outlook 2022

Broadcast live on December 17, 2021

12:00 p.m. to 1:30 p.m. ET

This page describes the event and explains how to purchase a registration.

This event is part of The Drug Channels 2021 Quarterly Video Webinar Series. Anyone who registered for the entire series should have received an email with a link to access the December event.

WHAT YOU WILL LEARN

Join Dr. Fein as he helps you and your team get ready for the year ahead by outlining key issues and uncertainties that will surely affect your planning. This event can be both a capstone of your annual learning and a touchpoint for the future. The Outlook 2022 marks our third annual outlook webinar.

During the event, Dr. Fein will share his latest thinking on a wide range of topics, including:

• The prescription market in 2022

• Benefit design and plan sponsor strategies

• Federal and state drug pricing policy

• The 340B Drug Pricing Program

• Consolidation and vertical integration

• Specialty pharmacy trends

• Copay accumulators, maximizers, and utilization management tools

• Biosimilars

• Drug channel evolution and disruption

• And more!

PLUS: During the webinar, Dr. Fein will give participants an opportunity to unmute themselves and ask live questions.

As always, Dr. Fein will clearly distinguish his opinions and interpretations from the objective facts and data.

Read on for full details on pricing and registration.

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The Food & Drug Administration (FDA) recently approved the first interchangeable biosimilar insulin product: the insulin glargine-yfgn injection from Viatris. Read the FDA’s press release.

Alas, I’m sad to report that the warped incentives baked into the U.S. drug channel will limit the impact of this impressive breakthrough.

Viatris is being forced to launch both a high-priced and a low-priced version of the biosimilar. However, only the high-list/high-rebate, branded version will be available on Express Scripts’ largest commercial formulary. Express Scripts will block both the branded reference product and the lower-priced, unbranded—but also interchangeable—version. Meanwhile, Prime Therapeutics will place both versions on its formularies, leaving the choice up to its plan sponsor clients.

Consequently, many commercial payers will adopt the more expensive product instead of the identical—but cheaper—version. As usual, patients will be the ultimate victims of our current drug pricing system.

Below, I explain the weird economics behind this decision, highlight the negative impact on patients, and speculate on what this all could mean for biosimilars’ future. Until plan sponsors break their addiction to rebates, today’s U.S. drug channel problems will remain.

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Autumn is here! Curl up with your favorite pumpkin-spiced blog and savor these stories harvested from the Drug Channels patch:

• Fresh insights about hospitals’ specialty drug profits

• SSR Update: Drug prices keep dropping

• My $0.02 on international benchmarking goes viral

• Amazon is finally disrupting CVS—but not how you expected

Plus, the best article ever about Elizabeth Holmes’s Theranos trial.

P.S. Please join the more than 12,500 consumers of my daily commentary and links to neat stuff at @DrugChannels on Twitter. You can also find me on LinkedIn, where I have more than 20,000 followers.

My recent social media topics have included: the ASPE report, biosimilar reimbursement, non-profit hospital shenanigans, HRSA’s reorganization, MTM in Part D, PBMs’ GPOs, pharmacy GPOs, channel strategy, white bagging, and the soothing sounds of pills being counted.

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Informa Connect’s Trade & Channel Strategies

Delivered as a Hybrid Event

In-Person: December 13-14, Hilton Philadelphia at Penn’s Landing, Philadelphia, PA

Virtual: December 16-17

www.informaconnect.com/trade-channel/

Year after year, the life science industry marks Informa Connect’s Trade and Channel Strategies as the “go-to” event for trade, channel, market access, account strategy and brand professionals. Join hundreds of your industry counterparts this December to unravel the complexities of the channel, navigate high-impact topics transforming trade and benchmark winning pharmacy and distribution frameworks.

Drug Channels readers will save 10% off the current rate when they register and use code 21DC10*.

Live Keynotes Delivering Timely Updates and Insights on High-Impact Topics:

• Analyze Market Dynamics and Trends Impacting the Channel in an Ever-Changing Environment
• Unpack Emerging Product Specific Trends in 3PL, Distribution and Pharmacy
• Break Down Evolving Regulatory Reform Driving Innovation and Access
• Navigate Major Market Mergers and Forecast Future Evolution in the Industry
• Discover Pharmacy-Level Innovations Redesigning Care and Driving eCommerce

Customize Your Experience with Tailored Content:

• Benefit from sessions covering the full product mix
• Build your own agenda with focused breakouts on critical topic areas
• Hear from key stakeholders along the supply chain continuum
• Attend the Diversity, Equity and Inclusion Summit taking place December 14th

Drug Channels readers will save 10% off the current rate when they register and use code 21DC10*.

Be sure to sign up today and save your seat!

*Offer applies to current 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. To find out how you can promote an event on Drug Channels, please contact Paula Fein (paula@drugchannels.net).

       

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This week, I’m rerunning some popular posts while I prepare for today's live video webinar: Drug Channels Update: Buy-and-Bill Market Trends.

Click here to see the original post and comments from June 2021.

The Bureau of Labor Statistics (BLS) has recently released its employment and salary data for 2020. That means it’s time to update Drug Channels Institute’s (DCI) annual analysis of pharmacist salaries and employment.

We have found that the share of pharmacists who work at hospitals reached a new high. What’s more, average base salaries for retail pharmacists have dropped, while salaries have risen for pharmacists employed by hospitals, physician offices, and other non-retail settings. 

A word of caution: These data were collected during the peak of last year’s pandemic shutdowns. I suspect that 2020 will turn out to have been a much more challenging year for retail-employed pharmacists.

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