The Winner of Biosimilars vs Incumbents in 2017: Competition

Summary While 2017 has been bad for biosimilar entrants, it has been good for competition as prices for incumbent drugs such as Remicade have dropped significantly for the first time.  Rather than argue for more legal and legislative protection for biosimilars, we argue for a rethinking of competitive strategy on the part of the entrants. […]

Hepatitis C Formulary Choices for 2018: Will CVS Risk Looking Bad?

Summary: AbbVie’s aggressive list pricing for its new Hepatitis C Virus (HCV) drug Mavyret is disruptive to the current PBM business model.  It essentially asks PBMs to align with client interests by adding a cost-effective drug to their national formularies despite little to no possibility for retained rebates. On September 15, 2017 Express Scripts (ESRX) […]

Pharmacy Benefit Managers

CURRENT PAPERS ON PBMs A Position Auction Demonstration Project for Lowering Reference + Biosimilar Rx Drug Prices in Medicare Part B  (8/19) Off-Target: Pelosi’s Binding Arbitration Proposal to Reduce Medicare Part D Drug Prices (04/19) Quantifying a Pharmacy Benefit Manager (PBM) Fee-For-Service Business Model   (03/19) CVS’s Negligent Handling of Its 2019 Formulary Change In Coverage […]

Pharmacy Benefit Manager Rx Drug Rebates – PBMs

A Position Auction Demonstration Project to Lower Reference + Biosimilar Rx Drug Prices in Medicare Part B (8/19)  Pharmacy Benefit Managers as Conflicted Countervailing Powers (01/07) Who is Best at Negotiating Pharmaceutical Rebates? (12/05) The Role of Pharmacy Benefit Managers in Formulary Design: Service Providers or Fiduciaries? Journal of Managed Care Pharmacy Vol. 10 No. […]

The Pharmacy Benefit Manager (PBM) Business Model

CURRENT PAPERS: Quantifying a Pharmacy Benefit Manager (PBM) Fee-For-Service Business Model (03/19) The Problem with CVS’s “Guarantee Net Cost” PBM Business Model (12/18) Three Phases of the Pharmacy Benefit Manager Business Model (09/17) Will Amazon’s Online Pharmacy Display Therapeutic Equivalents (12/17) Blame PBMs (Not Pharma) For Driving Drug Price Inflation (09/17) Merck Data Discredits PBM-Sponsored Study of […]