Author: Peter

...most pharma companies have begun to use data to make marketing decisions, one healthcare agency data veteran sees a recurring problem in the way that data is typically utilized...Pharma marketers too often only use data after the fact, said Kevin Troyanos...Saatchi & Saatchi Wellness. While post-campaign ROI analysis is important to find out what worked and what didn’t for the next effort, it can also lead to confirmation bias...That’s when data is used to validate the HiPPO—Highest Paid Person’s Opinion..True data-driven companies use information dynamically to inform decisions, identify what works and what doesn’t work and to make changes on the fly...Pharma typically puts a lot of research into one tactic, one channel or one creative and are almost locked in to it. What happens then is that teams are leveraging data in a defensive way, essentially using it to say that the decision they made was the right one and this is why,” he said. “Pharma needs to begin to use data as a driver, not as a defense mechanism.”...

Laura Joszt, Managing Editor at The American Journal of Managed Care. Welcome to This Week in Managed Care from the Managed Markets News Network

Price increases accounted for roughly 60% of recent sales growth recorded in the U.S. for many of the pharmaceutical industry's top-selling drugs...Between 2014 and 2017, U.S. sales for 45 leading products increased by 28%, or about $23 billion. More than $14 billion of those newly won dollars stemmed from price increases during that span...the findings highlight just how reliant drugmakers have been on price hikes to drive growth. Without the boost from higher prices, eight of the drugs examined...would have posted revenue declines...While scrutiny on the industry has remained close since 2014, there are signs that government pressure could change the calculus for larger pharmaceutical firms...Growth is already a key question for many large-cap pharmas and biotechs, a number of which also face competition from biosimilar rivals to their top drugs in the coming years. Removing price increases from the equation could reveal just how precarious a position some companies are in...

A recent memo from Centers for Medicare and Medicaid Services clarifies why many Americans aren’t getting the medications they need. The wrong person is choosing your prescription drug, and it isn’t your doctor...starting in 2020, Medicare Part D health plans can implement “indication-based drug therapy.”...Doctors do not treat indications; we treat patients, one at a time, each with his or her own name, unique medical history, and individual reactions to specific medications, whether good or bad...In other words, the person choosing your medications has no medical training, no license to practice medicine, and does not even know your name...Prescribing the wrong Rx for you occurs throughout health care. It is not limited to Medicare...Most health plans require doctors in their panels to use the “fail first” approach, also known as step therapy. When starting treatment, the treating physician can only prescribe the most “cost-effective, medically sound” medication. “Cost-effective” means cheapest drug for the health plan. “Medically sound” means lowest risk of side effects, which often means least likely to be medically effective. After the first drug fails to help the patient, the doctor is then allowed to take the next step with a second drug also chosen by the health plan. Eventually, when all the cheap alternatives fail, the doctor may be allowed to special order the right drug. The bottom line? An insurance actuary, not your doctor, chooses your Rx..

USP is launching a new program, Impurities for Development (IfD), to assist manufacturers in their drug development efforts and help them meet quality standards and regulatory requirements to control impurities that may be harmful to patients...Characterizing and controlling impurities in drugs under development can present significant challenges to manufacturers because they can occur for several reasons: arising naturally within the source materials, being added as part of a product’s synthesis, occurring inadvertently during processing and manufacturing, or forming during the shelf life of the product...The new IfD program aims to help pharmaceutical manufacturers with custom-designed services to identify, isolate, synthesize and characterize impurities in medicines under development, allowing manufacturers to focus on other development processes...

Nicole Grassano, PTNN, Pharmacy Week in Review, this weekly video program provides our readers with an in-depth review of the latest news, product approvals, FDA rulings and more.

The Justice Department’s approval of the $69 billion merger between CVS Health and Aetna...caps a wave of consolidation among giant health care players that could leave American consumers with less control over their medical care and prescription drugs...The approval marks the close of an era, during which powerful pharmacy benefit managers brokered drug prices among pharmaceutical companies, insurers and employers...The two companies say that they will be better able to coordinate care for consumers as the mergers help tighten cost controls...critics worry that consumers could end up with far fewer options and higher expenses...Just last month, the Justice Department also approved the takeover of Express Scripts, a major CVS rival, by the big insurer Cigna...This type of consolidation in a market already dominated by a few, powerful players presents the very real possibility of reduced competition that harms consumer choice and quality...Facing the prospect of competition from outsiders like Amazon, whose tentative forays into the pharmacy business have already shaken up the industry, established players have also been looking for ways to stay relevant to their customers and enlarge their share of the health care market...The companies “are feeling pressure to do something different or it will be done to them,”...

In the run-up to next month’s midterm elections, the country’s three largest distributors alone have given nearly $3 million to congressional campaigns. Key lawmakers from both parties — including many of the ones who publicly shamed the companies for their role in the crisis — have accepted the contributions eagerly...analysis of the current cycle’s campaign finance disclosures, two of the three largest distributors are on pace to exceed their campaign donations from 2016 — a notable increase, since campaign spending tends to stagnate in years without a presidential election...the largest contributions have gone to lawmakers who oversee investigations into those distributors or who play key roles in determining health care and drug policy...From drug companies to insurers, lawmakers routinely accept campaign contributions from the companies across the health care industry that they are tasked with regulating...Sen. Claire McCaskill, who has not accepted campaign cash from distributors, has spoken of the pharmaceutical industry’s ability to sprinkle cash “like fairy dust” around the Capitol — and to use their curried favor to stall legislation that isn’t industry-friendly...

A political action committee backed by the national pharmaceutical lobby is again getting directly involved in key legislative races...The Healthy Nevada PAC — almost entirely funded by the Pharmaceutical Research and Manufacturers of America, or PhRMA — is running a series of ads on Facebook boosting nine Republican and Democratic legislative candidates with slightly more than a week to go before the start of early voting. The group ran a series of similar ads on Facebook ahead of the state’s June primary election...The ads appear on a page called “Healthy Choice for Nevada” and include no mention of health care or drug pricing issues on the corresponding ad text...PhRMA spokeswoman Priscilla VanderVeer said the group is focused on supporting candidates willing to work with them on healthcare and medicine cost issues...

One way that community pharmacies can improve how well they care for their patients and their bottom line is to provide enhanced services. These include services that can help keep patients out of the emergency room or hospital and, for which, in some instances, the pharmacist can be reimbursed by a third-party payer or by the patient...These services can be revenue streams that can help local pharmacies compete with big-box stores and mail-order...There are nine ways that community pharmacies can profitably implement enhanced services...If you don’t do this, other healthcare providers will...Other pharmacies, nursing services, and telephone-based providers are already on board with these things...The nine services are:

1. Enhanced delivery
2. Immunizations
3. Medication therapy management (MTM)
4. Medication synchronization
5. Adherence or convenience packaging
6. Medicare plan selection
7. Point-of-care testing
8. Nutrition
9. eCare capability