Employers Are Absorbing Even More Manufacturer Rebates from Their PBMs

The likelihood of a radical restructuring of the U.S. drug channel has never been greater. A serious effort exists to remove or decrease the role of rebates. Today, we shed light on one crucial aspect of the current rebate system: how employer-sponsored health plans access the billions of dollars in manufacturer rebates that are negotiated by their pharmacy benefit managers (PBMs). For this analysis, we rely on the Pharmacy Benefit Management Institute’s (PBMI) excellent new reports. As you will see, employers are receiving an increasing share of the rebate money collected by pharmacy benefit managers. However, employers’ rebate agreements with … Continue reading Employers Are Absorbing Even More Manufacturer Rebates from Their PBMs

NEW: The 2019 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers

I am pleased to announce our new 2019 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers, available for purchase and immediate download. Click here to download a free report overview (including the Table of Contents and a List of Exhibits) New Drug Channels Institute Study Analyzes U.S. Drug Pricing and Rebates, Predicts Further Shakeout and Consolidation (press release) We’re offering special discounted pricing if you order before March 22, 2019! The 2019 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers is the only resource of its kind available anywhere. With 180 proprietary charts, exhibits, and data tables, the … Continue reading NEW: The 2019 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers

Drug Channels News Roundup, February 2019: Diplomat’s Troubles, Sanofi’s Gross-to-Net Bubble, and the Legality of Accumulators

Winter—or at least February—is almost over! Celebrate the imminent return of spring with our selection of noteworthy news from around the drug channel. In this issue: My $0.02 on Diplomat’s failures and the new realities of specialty pharmacy Sanofi’s 2018 gross-to-net bubble Legal issues for copay accumulators Plus, The Onion reports a health insurance miracle! P.S. My @DrugChannels Twitter account now has more than 7,000 followers. Join the fun for my daily commentary on the industry’s news. Read more » Copyright © 2006-2019 Pembroke Consulting, Inc. d/b/a Drug Channels Institute. Drug Channels® is a registered trademark of Pembroke Consulting, Inc. … Continue reading Drug Channels News Roundup, February 2019: Diplomat’s Troubles, Sanofi’s Gross-to-Net Bubble, and the Legality of Accumulators

The Top 15 U.S. Pharmacies of 2018: M&A Reshapes the Market

Next week, Drug Channels Institute will release our 2019 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. It’s the tenth edition of our popular and comprehensive examination of the entire drug pricing, reimbursement, and dispensing system. The exhibit below—one of 180 in our new report—provides a first look at the 15 largest pharmacies, ranked by total U.S. prescription dispensing revenues for calendar year 2018. As you will see, vertical and horizontal mergers and acquisitions are reshaping the pharmacy and PBM industries—and enabling the big to get even bigger. I highlight some of the major transactions that affected our ranking. … Continue reading The Top 15 U.S. Pharmacies of 2018: M&A Reshapes the Market

How Health Plans Profit—and Patients Lose—From Highly-Rebated Brand-Name Drugs

My Wall Street Journal op-ed (Don’t Blame Drug Prices on ‘Big Pharma’) has received a lot of attention. Especially notable was a letter to the editor from American Health Insurance Plans (AHIP). It claims that “the savings that insurance providers negotiate are returned directly to consumers through lower premiums and out-of-pocket costs.” Don’t believe this misleading half-truth. It distorts the primary argument of my WSJ op-ed: Patients often pay full price for drugs that are sold to insurers at deep discounts. Below, to show you why, I follow the dollar for an expensive, highly rebated brand-name drug used by a consumer … Continue reading How Health Plans Profit—and Patients Lose—From Highly-Rebated Brand-Name Drugs

Preorder Now: Our 2019 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers

On March 5, 2019, Drug Channels Institute will release The 2019 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers. This new tenth edition is the most comprehensive, fact-based tool for understanding the entire U.S. drug pricing and distribution system. The 2019 edition has been significantly expanded and restructured since last year’s edition. We have added new industry data sources, deepened our coverage of many topics, and added more trending information. There are also 2 new chapters and many new exhibits. CLICK HERE to download a free pre-publication draft overview (including the Table of Contents and a List of Exhibits). … Continue reading Preorder Now: Our 2019 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers

Express Scripts Confirms It (Again): Minimal Growth in Drug Spending and Prescription Costs

Last week, Express Scripts released its 2018 Drug Trend Report. (Free download.) As you will see below, drug spending is not “skyrocketing” or “soaring.” All payer types experienced extremely low growth in pharmacy benefit spending. Average net (post-rebate) drug costs declined. These data also shed light on specialty drug spending. Greater use of specialty medications—not cost increases—was the most significant driver of spending. The latest Express Scripts data confirm the cost and spending slowdown that I have highlighted in previous Drug Channels articles. I’ll ask again: Can someone please alert the media and our elected officials? Meanwhile, the report dodges … Continue reading Express Scripts Confirms It (Again): Minimal Growth in Drug Spending and Prescription Costs

My Wall Street Journal Op-Ed: Don’t Blame Drug Prices on ‘Big Pharma’

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 … Continue reading My Wall Street Journal Op-Ed: Don’t Blame Drug Prices on ‘Big Pharma’

Drug Channels News Roundup, January 2019: Part D Plan Profits, Hospitals vs. Drugs, and BS in Healthcare

L.A. vs. New England! Youth vs. experience! Kale vs. chowdah! Yes, it’s time for a weekend of blow-out commercials, occasionally interrupted by a football game. Before you start training to gorge at your Super Bowl-party, tackle this month’s selection of notable news stories, intercepted for you from the Drug Channels gridiron. Touchdown: The little-known ways that plans profit from Medicare Part D Trick play: Hospital care vs. prescription drugs: My best tweet ever! Offensive lines: A must-read guide to BS in healthcare Plus, we here at Drug Channels have just released our 2019 media kit. Check it out and let … Continue reading Drug Channels News Roundup, January 2019: Part D Plan Profits, Hospitals vs. Drugs, and BS in Healthcare

Drug Prices Are NOT Skyrocketing—They’re Barely Growing at All

The IQVIA Institute for Human Data Science today released a new report that reveals important realities about U.S. drug pricing trends. Too many politicians and journalists remain committed to the false narrative of “skyrocketing” and “soaring” drug prices. By contrast, IQVIA data reveal that list prices for brand-name drugs grew by less than 6% in 2018. What’s more, net prices (after rebates and discounts) increased by only 1.5%. The 2018 figures mark the fourth consecutive year that net drug prices have grown by low-single-digit amounts. I recognize that relying on “facts” and “data” has become unfashionable. But I simply don’t … Continue reading Drug Prices Are NOT Skyrocketing—They’re Barely Growing at All