Bello! The hot and hazy days of summer are here. Go for a swim to cool off and then enjoy this refreshing selection of articles chosen by Drug Channels para tu.

• Did the FTC’s compelling interim report prove its case?

• GoodRx joins the Humira biosimilar price war with Boehringer Ingelheim

• Averon revealed to be a new buying group for biosimilars for CVS Health and Cardinal Health

• Why the IRA will be bad news for 340B hospitals

Plus, the June 2024 update to my all-time favorite chart. Muak muak muak!

P.S. Join my more than 57,000 LinkedIn followers for daily links to neat stuff along with thoughtful and provocative commentary from the DCI community.

Have you requested an invite to the inaugural Drug Channels Leadership Forum? Attendance will be highly limited, so apply now. Full agenda coming in early September!

Informa Connect’s Medicaid Drug Rebate Program Summit
September 23-25, 2024 | Chicago, IL
Drug Channels readers save 10% with code 24DRCH10*

Experts from across the US come together each year to conquer the complex, ever-evolving MDRP regulatory guidelines and accelerate their careers by sourcing world-class content alongside everyone who matters in Medicaid. 

Today’s guest post comes from Joshua Guinter, Vice President of Channel Strategy and Product Access at Cencora.

Josh discusses the importance of a customized channel strategy for manufacturers. He outlines four key considerations that will ensure a successful strategy.

Click here to learn more about Cencora’s manufacturer solutions.

Read on for Josh’s insights.

It’s time for Drug Channels’ annual update on pricing at the largest pharmaceutical manufacturers.

This year’s review includes the following 10 companies: Bristol Myers Squibb, Eli Lilly and Company, Genentech, GlaxoSmithKline, Merck, Novo Nordisk, Sanofi, Takeda, Teva, and UCB. You can find links to each company’s data below.

These data remain inconvenient for drug pricing flat earthers (#DPFE):

• When rebates and discounts were factored in, brand-name drug prices again declined—or grew slowly—in 2023. For the companies that experienced net price gains in their portfolios, net prices grew more slowly than—or only slightly faster than—the overall inflation rate.

• Rebates and discounts reduced the selling prices of brand-name drugs at the biggest drugmakers to less than half of their list prices.

• For the eight companies with multiple years of data, the gross-to-net difference in price changes remained sizable. See the second chart below.

As I noted last week, multiple forces are poised to pop the gross-to-net bubble for high-list/high-rebate products. Insulin has been the first to deflate—and the Humira biosimilar market may be next. Journey with me to Bikini Bottom as we delve into the murky waters of gross-to-net drug pricing at the biggest drugmakers.

Today’s guest post comes from Greg Skalicky, President, EVERSANA; Krista Pinto, President, Deployment Solutions, EVERSANA; and Faruk Abdullah, President, Professional Services & Chief Business Officer, EVERSANA

Greg, Krista, and Faruk explain how and why integrated delivery networks (IDNs) have become crucial stakeholders for drug commercialization. They outline a two-pronged strategy to help brand teams thrive in today’s IDN landscape.

To learn more, read EVERSANA’s free report: IDN Trends and Engagement Strategies Every Drug Manufacturer Needs to Know.

Read on for Greg, Krista, and Faruk’s insights.

Last week, the Federal Trade Commission (FTC) released its interim report on pharmacy benefit managers (PBMs). The report’s unsubtle subtitle revealed how the agency views PBMs: The Powerful Middlemen Inflating Drug Costs and Squeezing Main Street Pharmacies. ICYMI, the FTC's report relied extensively on the Drug Channels Institute's (DCI's) 2024 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers.

PBMs’ negotiating leverage against pharmaceutical manufacturers has been a key factor inflating the gross-to-net bubble—the ever-growing dollar gap between sales at brand-name drugs’ list prices and their sales at net prices after rebates, discounts, and other reductions.

For 2023, DCI estimates that the total value of manufacturers’ gross-to-net reductions for all brand-name drugs was $334 billion. (As we describe below, our latest estimates make a crucial change in the presentation of these figures compared with previous editions.)

Multiple forces are poised to pop the gross-to-net bubble for high-list/high-rebate products. This will force PBMs to further evolve their business models, while challenging plan sponsors and the FTC to follow the dollars.

Alas, patients remain caught in the drug channel's murky waters. I still can’t predict when SpongeBob SquarePants departs from Drug Channels—although I wish him a happy 25th birthday!

Today’s guest post comes from Gavin Magaha, Senior Director of External Affairs and Policy at Kalderos.

Gavin discusses the three key reasons for duplicate discounts between the 340B Drug Pricing Program and the Medicaid Drug Rebate Program. He then explains Oregon’s novel approach to fixing the problem.

To learn more, register for Kalderos’ August 21, 2024, webinar: Revolutionizing Government Discount Programs: Why Traditional Methods Fail.

Read on for Gavin’s insights.

The econowonks at the Centers for Medicare & Medicaid Services (CMS) recently released the latest projections for U.S. spending on healthcare. (See links below.) These data provide the latest official look at how the Inflation Reduction Act (IRA) will affect U.S. healthcare spending.

As you will see below, CMS projects that outpatient prescription drugs dispensed by retail and mail pharmacies will remain a small share of total U.S. healthcare spending. The Inflation Reduction Act’s changes to the Medicare Part D program, along with coming demographic shifts, will have a significant impact on future spending by government programs and consumers.

Nonetheless, taxpayers—primarily via Medicare and Medicaid—will continue to dominate the employer-sponsored insurance market. Like it or not, vertically integrated insurers, PBMs, specialty pharmacies, and providers will continue to prosper.