The State of Specialty Pharmacy 2018: Reflections from #Asembia18 (rerun)

This week, I’m rerunning some popular posts before the Labor Day weekend. Click here to see the original post and comments from May 2018. Last week, Paula and I had the pleasure of attending Asembia’s 2018 Specialty Pharmacy Summit. The Specialty Pharmacy Summit remains the most important forum in the specialty marketplace. This year, a record 6,500 people learned, networked, and connected in Las Vegas. It was another year of record attendance. (Here’s the official press release.) Drug Channels again salutes Larry and Robert Irene for sustaining and growing an annual event that unites the entire industry. Today marks the … Continue reading The State of Specialty Pharmacy 2018: Reflections from #Asembia18 (rerun)

Reflections from #Asembia18: The State of Specialty Pharmacy 2018

Last week, Paula and I had the pleasure of attending Asembia’s 2018 Specialty Pharmacy Summit. The Specialty Pharmacy Summit remains the most important forum in the specialty marketplace. This year, a record 6,500 people learned, networked, and connected in Las Vegas. It was another year of record attendance. (Here’s the official press release.) Drug Channels again salutes Larry and Robert Irene for sustaining and growing an annual event that unites the entire industry. Today marks the eighth year that I will violate Vegas code and tell you what happened there. Below, I offer reflections on the meeting and highlight key … Continue reading Reflections from #Asembia18: The State of Specialty Pharmacy 2018

New Data: Pharmacy Owners’ Profits Fall As Industry Competition Rises

Time for my annual look at independent pharmacy owners’ business economics, drawn from the recently released 2017 National Community Pharmacists Association (NCPA) Digest, Sponsored by Cardinal Health. Here’s the press release: NCPA Releases 2017 Digest. Below, I review our latest estimates on pharmacy economics and margins. Our analysis reveals that independent pharmacy owners are now performing poorly. In 2016, we estimate that the average pharmacy owner saw their salary decline by more than 20%, to about $156,000. The number of independent pharmacies and gross margins also are trending downwards. It’s the third consecutive year in which owner’s compensation declined. Read … Continue reading New Data: Pharmacy Owners’ Profits Fall As Industry Competition Rises

Will CMS Pop the Gross-to-Net Bubble in Medicare Part D With Point-of-Sale Rebates?

Last week, the Centers for Medicare & Medicaid Services (CMS) released its 713-page proposed policy changes and updates for the Medicare program. See the links below. Buried in this document is a radical concept: Part D plans would be required to recognize the value of manufacturer rebates and pharmacy payments in retail prescription prices. These amounts are two key components of Direct and Indirect Remuneration (DIR) that are currently paid to plans. CMS is asking for feedback for future rulemaking but did not propose any specific changes. Any program modifications would not occur until at least 2020 or later. However, … Continue reading Will CMS Pop the Gross-to-Net Bubble in Medicare Part D With Point-of-Sale Rebates?

How Independent Pharmacies Will Participate (Or Not) in 2018’s Part D Preferred Pharmacy Networks

In a previous analysis (CVS Bets Big: Our Exclusive Analysis of Pharmacy Chain Participation in 2018’s Part D Preferred Pharmacy Networks), I highlighted how the largest pharmacy chains will participate in next year’s Medicare Part D prescription drug plans (PDP). Today, I examine independent pharmacies’ participation in 22 major 2018 Part D preferred networks. Our analysis focuses on the pharmacy services administration organizations (PSAOs) that represent these pharmacies in negotiations with plans. As you will see below, the profit pressures from narrow networks have made smaller pharmacies much choosier about contracting for preferred status. For three of the four largest … Continue reading How Independent Pharmacies Will Participate (Or Not) in 2018’s Part D Preferred Pharmacy Networks

2016’s Fastest-Growing, Private Specialty Pharmacies (From the Inc. 5000)

Time for our annual review of the latest Inc. 5000 list, the magazine’s annual ranking of the fastest-growing private companies in the United States. The list offers a valuable snapshot of the dynamic specialty pharmacy industry. This marks our sixth annual review of the list. We have identified 15 specialty pharmacies on the 2017 list, which is based upon revenue growth from 2013 to 2016. Annual revenues range from $6.4 million to $1.3 billion. The pharmacies and key stats are listed below. For the nine companies returning from last year’s list, median revenues in 2016 sped ahead by 24%—impressive but … Continue reading 2016’s Fastest-Growing, Private Specialty Pharmacies (From the Inc. 5000)

The State of Specialty Pharmacy 2017: Reflections from #Asembia17 (rerun)

This week, I’m rerunning some popular posts while I work on the forthcoming 2017-18 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors. Click here to see the original post and comments from May 2017. FYI, Asembia’s 2018 Specialty Pharmacy Summit will be held on April 29 to May 2, 2018. Last week, Paula and I had the pleasure of attending Asembia’s 2017 Specialty Pharmacy Summit in Las Vegas, itself the summit of spectacle. We even met a new friend, as you can see from the photo on the right. The Specialty Pharmacy Summit remains the most important forum for conducting … Continue reading The State of Specialty Pharmacy 2017: Reflections from #Asembia17 (rerun)

Diplomat Sees Declining DIR Fee Impact—and Perhaps Readies a PBM Strategy

Last week, Diplomat Pharmacy released its quarterly earnings, which included new details about the financial impact of Direct and Indirect Remuneration (DIR) fees. I provide some background on DIR fees below. Diplomat, as a public company, is the only entity that is obligated to publish truthful information about DIR fees. While reviewing its data, let’s recall our Drug Channels philosophy, courtesy of the late senator Daniel Patrick Moynihan: “Everyone is entitled to his own opinion, but not his own facts.” As you will see below, Diplomat’s exposure to DIR fees remains relatively modest. DIR fees as a share of its … Continue reading Diplomat Sees Declining DIR Fee Impact—and Perhaps Readies a PBM Strategy

Drug Channels News Roundup, June 2017: Amazon, Whole Foods, 340B, DIR Fees, Provider-Sponsored Health Plans, and Kaiser

Happy 241st birthday, America! Before you launch your July 4 festivities, please enjoy these Drug Channels fireworks: My $0.02 on how Amazon-Whole Foods affects Amazon’s pharmacy ambitions Congress starts to get serious about the 340B program CMS finalizes reporting on pharmacy-related DIR fees A reality check on provider-sponsored health plans Plus, Kaiser provides a hilarious look at the hospital of the future…as seen from the 1950s! P.S. Follow @DrugChannels on Twitter for my daily curated selection of news and commentary. Read more » Copyright © 2006-2017 Pembroke Consulting, Inc. and Copyright © 2006-2017 Drug Channels. This Feed is for personal … Continue reading Drug Channels News Roundup, June 2017: Amazon, Whole Foods, 340B, DIR Fees, Provider-Sponsored Health Plans, and Kaiser

Will CVS Health’s Point-of-Sale Rebates Deflate the Gross-to-Net Bubble—and Disrupt the PBM Business?

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 … Continue reading Will CVS Health’s Point-of-Sale Rebates Deflate the Gross-to-Net Bubble—and Disrupt the PBM Business?