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The surge in vertical integration in the healthcare industry has created "an oligopoly of integrated healthcare companies controlling nearly all aspects of the healthcare and pharmacy supply chain," said the National Community Pharmacists Association in comments submitted today to the Federal Trade Commission and the US Department of Justice Antitrust Division..."These vertical mergers have allowed a handful of massive companies to exercise enormous power over patients and the marketplace. In many cases, we believe they are creating for themselves unfair advantages that are driving up patient costs and killing local businesses," said B. Douglas Hoey, NCPA CEO...READ MORE

Finding quality cancer treatment is a life-altering pursuit, but too often financial challenges force patients to decide whether they can afford a potentially life-saving treatment...This month, the State of Ohio Board of Pharmacy changed its policy on drug donations, allowing patients to donate unneeded oral cancer therapy drugs to others fighting cancer. Drugs that were opened and in possession of one patient can now be used to help those in need, reducing waste and cutting costs...Thanks to that policy change, the OSUCCC (Ohio State University Comprehensive Cancer Center)...has created a drug repository program that will provide patients in financial need with drugs donated by patients who no longer require them...READ MORE

Although control measures are applied, falsified medicines are present in the supply chain in Niger, with solutions requiring cross-country collaboration, says the country’s Ministry of Health...The spotlight was put on the topic of falsified medicines earlier this month with the signing of the Lomé Initiative​, a political declaration under which the governments of seven African countries agreed to act to fight the issue, and improve access to quality medicines for African populations...the smuggling of fake drugs occurring at the country’s borders is the main weak point in the supply chain...harmonization of the legislation...can and needs to be achieved with the establishment of the African Medicines Agency, which would be the African equivalent of the European Medicines Agency, in charge of the evaluation and supervision of medicinal products...READ MORE

CEOs from the world’s largest pharmaceutical companies pitched ideas for lowering drug prices at the J.P. Morgan Healthcare Conference in San Francisco this week. None, however, offered to cut prices on any of their own drugs...Some of the executives, like Regeneron CEO Leonard Schleifer, suggested making changes to Medicare, the federal government’s health insurance plan for the elderly, by adding an out-of-pocket maximum for beneficiaries. Others, including Pfizer CEO Albert Bourla, supported passing rebates paid to pharmacy benefit managers through to consumers, arguing the current system drove up list prices and out-of-pocket costs...They also faulted hospitals and insurers. During a panel on drug pricing reform...Bristol-Myers Squibb CEO Giovanni Caforio and Roche CEO Bill Anderson blasted hospitals for marking up the price of medicines, sometimes by triple-digit percentages...READ MORE

Two new reports quantify the problem that community pharmacists have experienced firsthand: direct and indirect remuneration fees are skyrocketing, causing some pharmacies to go out of business...DIR fees have skyrocketed by 1600% in the last 5 years, totaling $8.5 billion since 2013, according to a new policy analysis...Pharmacy benefit managers are profiting from DIR fees in excess of 500% per prescription, compared with the average PBM administration fee...A loophole in the program allows health plans and PBMs to pocket an excessive amount of pharmacy DIR fees rather than offset prescription costs for seniors...READ MORE

The Food and Drug Administration and Federal Trade Commission have drawn a line on anticompetitive practices in the complex biosimilar market...The agencies have announced their intent to enforce false or misleading claims about biosimilars and their reference products. They also plan to educate consumers and doctors about biosimilars…the FDA...released a draft guidance this week, advising the industry how to properly label and promote biosimilars and reference products...The guidance focuses on how biologic and biosimilar labels and promotions should reference the other product. The agency is particularly intent on ensuring that biologic makers don’t suggest their product is safer, more effective or clinically different than its biosimilar...READ MORE

It might not come as a surprise for many pharma watchers, but a new GlobalData survey found drug pricing and reimbursement remain the industry's top concern for 2020. In the survey, 49% of respondents said pricing and reimbursement is their top worry for the year...Behind drug pricing, 14% of respondents said they're concerned about the U.S. political divide, while other threats included Amazon and biologics patent expirations...READ MORE

Christina Mattina, welcome to This Week in Managed Care from the Managed Markets News Network

The Centers for Medicare & Medicaid Services has issued a proposed rule and the Advance Notice Part II to further advance the agency’s efforts to strengthen and modernize the Medicare Advantage and Part D prescription drug programs. These changes would lower the beneficiary cost sharing on more expensive prescription drugs, promote the use of generic medications, and allow beneficiaries to know in advance and compare their out-of-pocket payments for different prescription drugs...The proposed rule would require Part D plans to offer real-time drug price comparison tools to beneficiaries starting January 1, 2022 so that consumers can buy lower-cost alternative therapies under their prescription drug benefit plan...READ MORE

With tens of billions of dollars in sales pumping into their coffers each year, the world's largest publicly traded pharmaceutical companies can be extremely profitable investments for shareholders...But impressive profits––and the welcome return on investment that comes with them––don't always translate into more innovation or long-term value. Megapharmas spend a lot of money each year investing in short-term returns for their shareholders—including executives—instead of investing more of those profits into R&D...How can publicly traded companies best return value for investors?... A premium must be placed on new products and novel launches because if you don’t do that and you invest in buying back your stock instead of buying for your future, then you have satisfied the short term need for some shareholders but you have, in the long term, lost value...READ MORE

1. Johnson & Johnson
2. Pfizer
3. Merck & Co.
4. AbbVie
5. Bristol-Myers Squib
6. Gilead Sciences
7. Amgen
8. Eli Lilly