One Last Thing Before that Out Of Office Goes Up…

Enjoy your day off AND extra savings! Register for any of the following IIR events and receive a 25% discount off the standard rate*

Mention code LABORDAYBLOG when registering for each or any of the following:

Register here for IIR’s Specialty Pharmacy Collaboration Summit event taking place September 15th-17th, 2014 in Boston, MA, visit the website for full details.

Register here for IIR’s 19th Annual Medicaid Drug Rebate Program Summit event taking place September 15th-17th, 2014 in Chicago, IL, visit the website for full details.

Register here for IIR’s FDA/CMS Summit for Payers event taking place December 11-12, 2014 in Washington D.C., visit the website for full details.


Have any questions? Email Jennifer Pereira.

*This promotion is only valid August 29- September 1st, 2014. Offer cannot be applied retroactively to confirmed paying registrants and cannot be combined with any other discounts or promotions. All registrants and guests are subject to IIR approval.

In the specialty pharmacy model, do all stakeholders win?

Welcome to the Specialty Pharmacy Collaboration Summit Podcast Series. Today we are speaking with Nick Calla, VP of Industry Relations, Community Specialty Pharmacy Network (CSPN)

Download the complete podcast & transcript here.

Is the specialty pharmacy model a win/win for all stakeholders? Basically, who wins and who loses as the industry grows?

Nick: That’s a very interesting question and sort of a future thought kind of question. When you think about specialty pharmacy, there are two wins, if you will. I think the patient ends up winning because they will get a higher degree of care in these higher touch models, whether it be through central fill – which is perfectly appropriate for some patients – or the community-based and even higher touch face-to-face model that we are working with and developing. I think the patient is a big winner in that space.

I think the provider is a big winner in this space. Again, the provider is a specialty. I’ll take a very specific example in the oncology community. As more and more products move away from infused therapy and move more into oral therapy, the provider needs an adjunct to the healthcare team in order to keep the patient on therapy and successful in their therapy. Side effect management, etc. Again, that’s where the specialist will win in using a specialty pharmacy as an adjunct to his practice.

I think the managed-care organizations are also quite honestly the winners in this space. The organization that ultimately is paying the bill --- well, the employer is paying the bill. But through the managed-care organization, they are winners as well because again you are getting patients compliant to therapy, staying on therapy and being successful on therapy. Ultimately, the goal is to reduce abandonment of therapy or short duration of therapy before you truly make a difference. Again, a very specific example of that would be in the Hepatitis B space where the duration of therapy is so important in achieving a response that can be sustained over time.

Finally, I want to mention the manufacturing community. Again, I think they win in this environment because they are able to promote their product, they have a higher degree of understanding that the patient that is on their therapy is going to be successful on therapy and compliant on therapy. Obviously, that means that they are marketing and selling the product that they have spent millions of dollars in getting to market in the first place. In my mind, everyone kind of wins in the specialty pharmacy model.

You say “Who loses?” I think the only way you lose in this model is if you don’t create a little bit more diversity in the model so that you don’t have as much fragmentation within the model and that the standard of care is consistent across all the different types of models, whether it is central fill or community based, etc. To keep that standard of care high and you basically maintain or retain the notion that specialty pharmacy was created as a high-touch model focusing in on intense counseling of the patient with the overriding goal of keeping the patient on therapy and managing their side effects.

As long you stay true to those basic tenets and don’t allow specialty pharmacy to turn into a quote/unquote “mail order” type of operation, then I think obviously all of the stakeholders I mentioned win. But, if you don’t maintain those, then I think really all the stakeholders end up losing in the end.

Click here to download the rest of the transcript and podcast.

To hear more from Nick, please join him at IIR's Specialty Pharmacy Collaboration Summit, September 15-17 in Boston. Also, you can save an EXTRA $100 off the current rate, $300 in total savings when registering by 8/22 with the code: XP1968BLOG - Register now.

How Can We Sustain the Innovation of Biopharmaceuticals?

Welcome to the Specialty Pharmacy Collaboration Summit Podcast Series. Today we are speaking with Robert Popovian, Senior Director, US Government Relations, Pfizer Pharmaceuticals.

Download the complete podcast & transcript here.

What needs to happen in the US to sustain the innovation initiative of biopharmaceuticals?

Robert: Well, biopharmaceuticals is a complex issue and a lot of people try to make it a very simple one by saying to do regulatory reform through the FDA or provide additional NIH funding to do research. Biopharmaceutical innovation policies are very complex and inter-dependent onto one another. There is no one magic bullet.

So, there are three distinct environments that need to be addressed to really sustain the biopharmaceutical innovation marketplace in the US and that is the investment environment, which is basically appropriate and electoral property protection. For example, tax policy, ability to price medicines according to the marketplace.

There is the regulatory environment, which is the second environment, which requires that we do a better job of streamlining not only the FDA, but other regulatory bodies like the Centers for Disease Control. And then, more importantly, within the regulatory policy framework is how to better do clinical trials and clinical trial recruitment. That needs to be addressed.

Finally, it is the access, which in my opinion is the one that is short shifted a lot of times because unless you address the access environment for biopharmaceutical, no matter if you are investing a lot of money in it or you have a very deregulatory process to get the product out, if the patients are unable to access those medicines because they are too high cost regarding out-of-pocket costs or there is no meaningful way to get access to it because there is no way to communicate that information to the providers, innovation will suffer and patients will suffer long term with that.

Click here to download the rest of the podcast.

To hear more from Robert, please join him at IIR's Specialty Pharmacy Collaboration Summit, September 15-17 in Boston. Also, you can save an EXTRA $100 off the current rate, $500 in total savings when registering by 7/25 with the code: XP1968BLOG - Register now. 

See you in Boston!

What is the Future of Specialty Pharmacy?

Welcome to the Specialty Pharmacy Collaboration Summit Podcast Series. Today we are speaking with Nick Calla, VP of Industry Relations, Community Specialty Pharmacy Network (CSPN)

Download the complete podcast & transcript here.

What is the future of specialty pharmacy and the impact on the key stakeholders?

Nick: When you look at specialty pharmacy, in my mind it is still an evolving area of pharmacy. Specialty pharmacy really came into being, I would say, at least 20 years ago where it was the very beginning of specialty pharmacy with products like betaseron in the Multiple Sclerosis space, as well as products like Crixivan in the HIV space back in the mid-80s.

The model has evolved and has evolved dramatically over the last 10 years or so. At this point in time, it is really quite dominated by the Big 4, Big 5 large PBMO and health plan owned specialty pharmacies. Therefore, when you look at a model like the one that I represent or CSPN – quite honestly the smaller pharmacies are being shut out of a number of opportunities.

Now, there are a number of good reasons for that. Many retail-based or community-based pharmacies simply have not developed the infrastructure to support a specialty product which, as I mentioned earlier, is a high-touch model. Many of these pharmacies have not developed the benefit investigation needed, the reimbursement support infrastructure needed and really the clinical support needed to truly manage dictation. However in our model, for example, there are a number of community players – smaller, independent pharmacies – that have developed all of these resources. They have also developed accreditation through some of the accrediting groups like URAC and ACHC. As well, they’ve become members of organizations like NASP – National Association of Specialty Pharmacies. So, they have truly developed the model over time.

As I said, the industry is still dominated by the Big 5 and Big 6 and again, I think what’s going to happen over time as this model starts to develop is that you are going to need more pharmacies with the capabilities to handle the special dictation. There are many, many products. Development on the oncology side, for example, on the Multiple Sclerosis side and the Rheumatoid Arthritis side that I think will require a larger group of pharmacies that truly have the capability to manage that patient.

So, that’s where I see it. I see the future of specialty pharmacy really expanding and creating opportunities for stakeholders beyond the few that have truly taken advantage of this space up to this point.

Click here to download the rest of the transcript and podcast.

To hear more from Nick, please join him at IIR's Specialty Pharmacy Collaboration Summit, September 15-17 in Boston. Also, you can save an EXTRA $100 off the current rate, $500 in total savings when registering by 7/25 with the code: XP1968BLOG - Register now.

See you in Boston!

Obamacare May Raise Patient Costs for Specialty Drugs

Via Specialty Pharmacy Continuum

According to specialty pharmacy experts, patients who rely on specialty drugs to treat their rare and complex conditions may be forced to pay a large percentage of the drug’s cost instead of a traditional fixed copay, if they are in an Affordable Care Act (ACA) exchange health plan.

Despite some of the exchange plans having the draw of lower monthly premiums, people should prepare themselves for higher deductibles and unpredictable out of pocket costs. Even though the cost structures do vary between the exchange plans, patients may face this issue no matter what exchange plan they are enrolled in.

Avalere examined 603 unique plan designs offered by 60 different carriers in 19 states to assess whether specialty medications are being put in a higher tier with a larger percentage of coinsurance, said Jenna Stento, a senior manager at Avalere. The analysis found that 59% of silver plans on exchanges across the country use coinsurance on the specialty tier instead of a fixed copay. It also found that 23% of silver plans charged coinsurance rates of at least 30% more than the cost of the drugs on the highest formulary tier, and 60% of lower-premium bronze plans apply specialty tier coinsurance greater than 30% of the drug price.

“This examination highlights the fact that patients relying on specialty medications are going to have to lay down significant finances up front until they hit the out-of-pocket cap, which is $6,350 for most people and $2,250 if that person is 200% below the federal poverty rate,” said Ms. Stento. “The fact that patients will be paying an unknown percentage will make it harder for some to plan financially, and will raise questions about access and availability.”

With the number of underinsured and strained patients continuously growing, how can these concerns be corrected?

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To learn more about Specialty Pharmacies, Specialty Drugs, the Affordable Care Act, and much more, join us in Boston this September for the Specialty Pharmacy Collaboration Summit. 

Register by 7/25 with the code XP1968BLOG and take an extra $100 off the current rate - that is $500 in total savings! Register here.

See you in Boston!

4 Key Challenges in the Specialty Pharmacy Ecosystem

 Is the Specialty Pharmacy Model Sustainable?

At IIR's all-new Specialty Pharmacy Collaboration Summit on September 15-17, 2014 in Boston, join leading pharmaceutical manufacturers, health plans, and specialty pharmacies as they participate in in-depth sessions, roundtables and panel discussions to address the four key challenges in the specialty pharmacy ecosystem:

1. Adherence

Excellus, Bluecross Blueshield, Denver Health Medical Plan, Tufts Health Plan

Hear from experts in a payer specific panel as they shed light on commercial plan strategies and priorities.

2. Managing Costs and Determining Value of Specialty Drugs

 Pfizer

Robert Popovian, Senior Director, US Government relations of Pfizer will address the optimal methodologies to assess the value and cost proposition of specialty drugs in the evolving payment policy environment 

3. Distribution of Specialty Drugs and Channel Management

 Sanofi + Dana-Farber Cancer Institute, Harvard University

Develop distribution strategies to sustrain commerical success and learn how to postition withing the channel to gain a competitive adcantage with Richard Peters, MD, PhD, Division Medical Officer, Sanofi and Sylvia Bartel, VP Pharmacy, Dana-Farber Cancer Institute, Harvard University

4. Sustainability of the Specialty Pharmacy Model

National Association of Specialty Pharmacy + Independent Health

Gary Cohen, BSPharm, RPh, CSP, CEO, National Association of Specialty Pharmacy and Mike Reilly, President, Pharmacy Benefit Dimensions, Independent Health join together to discuss what the future holds for specialty pharmacy

Download the brochure for the full agenda and speaker details

Don't miss out! Register now to save up to $600! Plus take an EXTRA $100 off when you use the code XP1968LINK - $700 in total savings! Click here to register.

See you in Boston!

Announcing IIR’s All New Specialty Pharmacy Collaboration Summit

IIR is proud to introduce the all-new Specialty Pharmacy Collaboration Summit taking place September 15-17, 2014 in Boston, MA.

This collaborative summit is designed to facilitate networking and integration between all key stakeholders in the evolving specialty pharmacy value chain, including the leading pharmaceutical manufacturers, health plans, and specialty pharmacies.

Register now to save $600! Plus take an EXTRA $100 off with the code: XP1968BLOG - That is $700 in total savings! Register today!    

To see how you can expand distribution, increase patient adherence and improve your bottom line, download the brochure.

Develop consistency and clarity around the integration of all specialty pharmacy stakeholders through:

• Never-Before-Heard Case Studies on accountable care Impact on payer provider relations from:
• Aetna
• BCBS
• Tufts Health Plan
• Denver Health Medical Plan
• And more!

• URAC Accreditation Workshop to improve operations and enhance compliance.
• Facilitate more face-to-face meetings to foster meaningful engagement and build relationships across 3 days than in your entire year with partnering360.

Remember, to save an EXTRA $100 off the current rate, use the code: XP1968BLOG when registering.
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Connect with Potential Partners and Clients

To learn more about how to sponsor or exhibit, please contact Patricia Rose at 508-614-1406 or prose@iirusa.com.