Specialty Pharmacy Times Now Available on Line: Focus on Pharmacogenomics

Specialty Pharmacy Times launched to fill an important niche for one of the fastest growing markets in pharmacy. This new journal provides new concepts and deliverables to assist professionals who are interested in expanding their practice and keeping up to date with the field. We cover key topics for specialty pharmacists, providing valuable resources for this dynamic market.

Our articles are written by major thought leaders in the industry and we bring insightful commentaries to your inbox. We’ve welcomed experts on REMS, new product pipelines, Washington insights, and current trends. Our focus is on the business and practice of specialty pharmacy.

If you would like to subscribe to Specialty Pharmacy Times, it's easy to sign up for free! Sign up today by going to www.SpecialtyPharmacyTimes.com – and share the news about this new journal with your colleagues so they can also subscribe!

View the Spring 2011 issue here!


Bea Riemschneider
Editorial Director
Specialty Pharmacy Times
Dan Steiber, RPh
Specialty Pharmacy Times



Specialty Pharmacy Times New Edition Features Pharmacogenomics

Welcome to the second edition of Specialty Pharmacy Times. This month’s SPT features articles from several of the leaders from specialty pharmacy—from a pharmacist/owner in independent practice to one of the largest PBM-owned specialty pharmacies to related best of breed support organizations. Our SPT authors have taken note of key trends that will greatly affect the future of specialty pharmacy. You’ll be informed about pharmacogenomics, REMS, patient care, new regulations, reimbursement, excellence in staffing, what it takes to prepare your business for a potential sale, and more— all by industry experts.

In fact, this issue serves as a great reminder of our mission: Specialty Pharmacy Times is THE journal fully committed to setting the publication standard through peer-written and peer-reviewed articles which are focused on the “real world” of specialty pharmacy practice.

An emerging area that will greatly affect specialty pharmacy is molecular diagnostics and pharmacogenomic testing. Genomic testing predicts how effective therapies will be for specific patients and their diseases, allowing health care professionals to target the right drug for the circumstances. Product targeting optimizes the patient’s therapy, which in turn can drive treatment decisions. An excellent example is oncology patients, such as those treated for breast cancer with targeted products, who are screened for their HER-2 status. Pharmacogenomics testing assures that the right patient receives the right drug at the right time in the right dose, thereby improving patient outcomes while managing overall health care costs.

Other future disease states that can benefit from pharmacogenemomics include rheumatoid arthritis, multiple sclerosis, oral contraceptives, depression, and osteoporosis. Isn’t this much of what specialty pharmacy is all about?

Pharmacogenomics is here and now and is driving trends resulting in changes to our specialty pharmacy practice and businesses. The health care system can ill afford a one size fits all product selection model when the ability to personalize therapy exists. There will be challenges to overcome, among them, that the pharmaceutical industry is reluctant to potentially limit the use of its products, reimbursement for tests is still in flux, regulators and ethicists debate what the appropriate standards should be for testing, physicians are not certain what to do as clinical standards have yet to be determined, insurers have yet to see a strong ROI on the technology, and patients have not come together to demand access.

But new business models are emerging where specialty pharmacists are inserting themselves into a gatekeeper role in pharmacogenomics and product access. We invite our SPT readers to understand where these trends have placed us: at a dynamic crossroads from an ethics and standard of care perspective. Where does your business see pharmacogenomics working in your operation?


Cardinal Health Continues to Serve top Two Chains: CVS and Walgreens

Cardinal announced this week that they will continue to service Direct Store Delivery (DSD) to the 7,500 plus Walgreens retail pharmacy locations.  Cardinal is also the primary supplier of Walgreens multiple pharmacy warehouses.  Cardinal has a similar agreement with CVS and their 7,500+ locations and warehouse business.  It is the most common practice for drug wholesalers to supply rx products to the warehouses that primarily service the top volume chains such as CVS, Wagreens, WalMart (McK), RiteAid (McK) and Kroger (varies). 

D2 has lead the trade effort in over $1+BB in sales in 2010 with their various clients in 2010, let us know if we can "fine tune" your organization in 2011.  Contact dan.steiber@D2RX.com.

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SPECIALTY PHARMACY TIMES-Sets the new standard for Specialty journalism.

Pharmacy Times Launches New Journal on Specialty Pharmacy. 


 Pharmacy Times publishes a new journal for the growing specialty pharmacy market with prestigious editorial board and industry leaders.  PLAINSBORO, NJ (November 2, 2010)‹Pharmacists serving the growing field of  specialty pharmacy now have a new resource from the leading pharmacy  publication. Pharmacy Times has launched a quarterly publication focused on the key areas surrounding specialty pharmaceuticals and the enhanced practice needs of pharmacists and other key personnel in this field. The inaugural issue of Specialty Pharmacy Times brings together insights from leading voices in the specialty pharmaceuticals industry, and introduces Dan Steiber, RPh, Principal of D2 Pharma Consulting LLC, as the new Editor-in-Chief.

In the cover article, David M. Suchanek, RPh, discusses Fair Market Value (FMV)‹an issue that is ³one of the hottest topics in the industry,² according to the author. The article offers an in-depth analysis of FMV, including Obama administration regulatory mechanisms and their impact on the commercial marketplace. In his feature article, ³What Will Drive the Specialty Pharmacy Models of Tomorrow?² editorial board member Randell J. Correia, PharmD, looks to the future of specialty pharmacy with a focus on chronic disease. ³There¹s a tsunami of specialty pharmaceuticals headed our way,² wrote Dr. Correia, Senior Vice President of Mail Service and Specialty Pharmacy at Prescription Solutions.

The Fall 2010 issue of Specialty Pharmacy Times also introduces a roster of regular contributors who are well-regarded in the field. In the first Washington Insights column, contributor Jayson Slotnik, JD, unravels key elements of the Affordable Care Act that define Average Manufacturer Price. A former Director of Medicare Reimbursement and Economic Policy at the Biotechnology Industry Organization in Washington, DC, Slotnik provides a true insider¹s perspective.

³We are thrilled to include many important industry thought leaders in our journal, which will be the leader in peer-written articles covering significant aspects of the industry,² said Tighe Blazier, President of Pharmacy Times. ³We¹ve welcomed experts on REMS, new product pipelines, and current trends with this first issue, and we are focused 100% on the business and practice of specialty pharmacy.²  

 Specialty Pharmacy Times fills a much needed niche for one of the fastest growing markets in pharmacy. ³As a leader in health care publishing, Pharmacy Times is in the perfect position to launch an industry-specific journal such as Specialty Pharmacy Times, which is rich in content, insight, and scope,² said Mike Hennessy, President and CEO of MJH & Associates, the parent company of Pharmacy Times.  Pharmacists can subscribe to Specialty Pharmacy Times by going to www.SpecialtyPharmacyTimes.com <http://www.specialtypharmacytimes.com/> and register for a free subscription. For more information on the first issue, also visit www.PharmacyTimes.com <http://www.PharmacyTimes.com> .

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New Federal Update on Group Purchasing Organization Contracting Ethics

The Government Accountability Office (GAO) has updated its 2003 report on the services provided to customers by Group Purchasing Organizations (GPOs). The original report examined reported anti-competitive business practices (such as unusually high administrative fees), as well as the steps GPOs were taking to address these issues.

The updated report found varying codes of conduct and other initiatives among GPOs that impacted varying components of their business model. The GAO also reported varying opinions of GPO initiatives by representatives of customers. The focus appears to be more hospital based but a good review for all GPO functions.

We thought you’d find it of interest, the scope of the study is below.

 To describe the types of services that GPOs provide and how GPOs fund these services, we used a structured data collection protocol that included two parts—(1) we collected written responses to structured questions from the six largest national GPOs based on their reported 2007 purchasing volume (a measure of the amount of money that customers spend through GPO contracts), and (2) we conducted interviews with representatives from each of the six GPOs to clarify their written responses and obtain additional information.8 In 2007, these six GPOs accounted for almost 90 percent of the total GPO purchasing volume.9 We obtained information from the six GPOs about their services and funding in 2008, the most recent full year available at the time of our review. We also interviewed representatives from six GPO customers—hospitals—that varied in size, the GPOs with which they did business, and whether they had an ownership stake in a GPO. In addition, we interviewed representatives from five medical product vendors of various sizes that do business with GPOs. We judgmentally selected these GPO customers and vendors in order to provide a variety of viewpoints on GPOs; however, the information they provided is not generalizable to other GPO customers or vendors. In addition, we interviewed representatives of organizations representing GPOs, vendors of medical products, and hospitals.

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D2 REVIEW: APHA and AMCP introduce MTM Connections a fantastic site for new professional opportunties

Medication Therapy Management or MTM is the focal point for today’s professional practice of pharmacy.  MTM continues to evolve and pharmacy, payers, patients and health care providers collaborate in improving outcomes.  Recently, APHA introduced MTM Connections.  D2 Pharma Consulting has carefully reviewed this site which was developed jointly by the Academy of Managed Care Pharmacy (AMCP) and the American Pharmacists Association (APhA) to advance the implementation and delivery of medication therapy management and other clinical services by pharmacists and ultimately enhance patient care through improved medication use.


 The site has many features including the MTM Locator .  MTM Locator is a self-reported and searchable directory of MTM provider and payer program profiles to facilitate identification, establishment and availability of pharmacist MTM and other clinical services. 

Other features include:


The site also features an MTM Resource Library.  MTM Resource Library is an annotated and searchable bibliography of medication therapy management and pharmacist clinical services resources to enhance understanding and provide access to the most relevant information supporting the delivery and value of MTM and other clinical services provided by pharmacists.

D2 is a multidiscipline organization focused on the health care supply chain and specialty pharmacy.  For more information about D2 please go to www.d2rx.com

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The EU Becoming a tougher Pharma Market

European governments have now embarked on a cycle of levying higher rebates from drug companies amid fiscal tightening across EU nations. Greece announced a 20-27% rebate increase in early May. There is now a state of confusion, with some drug companies saying that they will stop supplying drugs in protest at unilateral imposition of drug purchasing prices. On May 21, Spain announced a 7.5% cut in list prices, in what now looks to be a widening trend toward lower pricing across the EU. Europe is a limited source of earnings for Japanese drug makers.   Already announcement have been made by some manufacturers that life saving meds with be witheld from the entire population if positions do not change.  Free market pricing as we know it is a thing of the past.  Your strategy development plan has never been more important.  Stay tuned for more.

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Health Care Council Panel: Investors Ready with Capital, Seeking Opportunities

The Nashville Health Care Council (NHCC) held it’s “Financing the Deal: Strategic Issues for Health Care Companies” panel luncheon May 12 at the Loews Vanderbilt Hotel.  “This event is always one of the most widely attended in the Council’s program series,” said NHCC president Caroline Young.  Approximately 500 local and national attendees heard comments on the how health care reform legislation -- adding about 30 million new patients to the mix -- is being viewed favorably by the investment community. 

Robert Fraiman, President and CEO, Cain Brothers & Company, Inc. told attendees he believes the capital freeze is over and companies like his have underinvested in the health care sector.  New partnerships and structures between hospitals and service providers, he said create a platform ripe for investors.  Citigroup Managing Director Toby King supported that opinion saying buyers are buoyant and more aggressive, even than sellers.  He stressed that it’s important for health care firms to understand and be able to respond to the question of what reform means for your organization.  “The answer to that question can really impact deal opportunities,” King said.   He further suggested that prepping for the bundling of care between hospitals and post-discharge firms, like home health or skilled nursing, represents a strategic opportunity.  King said hospitals are going to want to own, rent or somehow control care after the inpatient treatment episode ends, “…they need to find ways to limit those re-admissions as that can negatively affect their reimbursements.”  With one IPO in the Q1 of 2009 and 27 in Q1 of 2010, it’s clear the fiscal landscape is changing.

Timothy Sullivan, Founder and Managing Director, Madison Dearborn Partners, cautioned health care providers and service providers in the space not to get ahead of themselves as many details of the new reform bill remain to be defined and most changes won’t take effect until the 2014 time frame.  He said his firm is interested in firms that “keep quality high, but are innovative in providing that at a lower cost of care.”  “Healthcare companies are up 50-100% over the last 12 months,” Sullivan said.  He urged firms to think about how they will be structured and provide services in 2015 to 2018 when the changes are more fully in play.

Summing up the positive outlook, Riley Sweat, Head of Healthcare Investment Banking, Raymond James & Associates, said the passage of the legislation and market changes have removed a level of uncertainty and that’s restarting health information technology interests along with strong activity in mergers and acquisitions.  Panel moderator Brent Turner, Executive Vice President Finance and Administration, Psychiatric Solutions, asked Sweat for his thoughts on “winners” in the space.  Sweat felt the reform would be good for Medicaid Managed Care Plans, PBMs and service providers.   He cautions the value in the legislation for Managed Care, Medicare Advantage Plans and home health/hospice.  While there is strong interest in the home health/hospice space by investors, “They were not necessarily beneficially treated by the health care reform legislation.”

-        Posted by Rena K. Goins

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Armada Health Care Summit: D2 Addresses Specialty Pharmacy Opportunities in Retail

D2 Pharma Consulting is  attending the  Armada Health Care  Summit  at The Wynn, Las Vegas as a speaker.  Well over 1,000 executives, including specialty pharmacy providers, pharmaceutical and biotech manufacturers, payers, managed care companies and various other affiliated healthcare organizations are on hand for the three-day meeting. 

Some of the biggest names in Specialty Pharmacy have been speaking to the audience including presentations from CVS Caremark VP biotech and specialty industry relations Albert Thigpen, who discussed the state of the specialty pharmacy business — where the market is today and where it’s going in the future — and a presentation by Christopher Goff, CEP and general counsel, Employers Health Coalition of Ohio, on current trends in large employer benefit strategies for managing specialty pharmacy. Goff, who also oversees the organization’s subsidiary, Employers Health Purchasing Corp. — which includes employers in Ohio as well as 11 other states, representing more than 2 million covered lives in all — talked about the chief concerns that employers have as it relates to managing specialty pharmacy spending. Chief among those concerns, Goff noted:

•Specialty pharmacy spending is growing 3.5 times faster than traditional pharmacy spending

•Specialty pharmacy costs run 6-11 times more than traditional pharmacy costs

•Total drug costs are running $15 to $110 thousand/year

•61% of imployers are using exclusive specialty pharmacy networks to control costs

 •41% are employing methods to reduce inappropriate utilization by following evidence-based guidelines

•40% carve out specialty drugs from the medical benefit.

CVS Caremark’s Thigpen shared growth estimates in excess of $112 billion by 2014, with a robust pipeline of approximately 145 to 150 biocompounds in phase-3 development. Thigpen believes the specialty pharmacy market “is not well-defined or organized,” he said, with a message to all attendees: “If you don’t create change, change will create you.” Among the key trends Thigpen believes will continue in the near future, is the continued merger and acquisition activity between large pharmaceutical companies and small biotech companies with rich R&D pipelines; the continued shift in reimbursement models including a shift to more fee for service — fee for service contracts increased more than 50% over the last three years, he said; and the continued contraction of specialty pharmacy networks — since 2005 the number of plans that use just one specialty pharmacy provider has increased significantly while the number of plans using three or more has decreased.

The keynote speaker was  Mitt Romney.  Who spoke on many issues affecting the American public with a focus on pharmacy and health care.

Dan Steiber R.Ph. will be addressing Opportunities in Specialty Pharmacy for Retailers.  If you are interested in receiving a transcript of his presentation, contact Dan at dan.steiber@d2rx.com.


D2’s Dan Steiber to Present at the Armada Sixth Annual Specialty Pharmacy Summit

The healthcare industry’s Sixth Annual Armada Specialty Pharmacy Summit will return to the Wynn Hotel in Las Vegas, NV on May 4 – 7, 2010.  This year’s event is expected to draw over 1,000 specialty pharmacy stakeholders and attendees.  Dan Steiber R.Ph. and Principal for D2 Pharma Consulting will be presenting on the role that Community Pharmacy can play in Specialty Pharmacy.  His full talk can be provided to those that request it by emailing Dan at Dan.Steiber@d2rx.com

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