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Insights from the 2016 edition of the largest gathering in specialty pharmacy.
Late spring signals the top conference in specialty pharmacy every year, the Asembia Specialty Pharmacy Summit, previously known as the Armada Specialty Pharmacy Summit.
Here are four of my takeaways from Armada, nay, Asembia 2016.
1. The absence of the PBMs was noticeable and curious.
Typically Express Scripts and Aetna have a presence at the show that is impossible to overlook. This year I saw or heard very little from these two large PBMs. This is surprising given the arrival of pharma’s day at risk and the significant interest manufacturers expressed in at-risk contracts during the event. Adam Fein, with Drug Channels wrote that three Express Scripts representatives were in attendance, while Aetna sent two.
From my perspective their lack of participation amounts to a wasted opportunity for PBM representatives and healthcare stakeholders in general. The shift to risk-based procurement methodology is going to require absolute alignment between PBMs, payers, manufacturers and pharmacies. The PBM perspective is critical in getting this alignment right.
2. The conference is growing fast.
Asembia 2016 was easily double the size it was four years ago. Officials put the number at over 4,500 registered attendees. This should not come as a surprise given the growth in the specialty pharmaceutical industry as a whole.
According to a recent report from The Pew Charitable Trusts, less than 1% of all prescriptions were written for specialty drugs in 2014, yet they accounted for approximately 32% of total drug expenditures. The Pew report further states, “Utilization rose by 5.8% in 2014 because of increased use of existing drugs and the introduction of new pharmaceuticals. In 1990, only 10 specialty drugs were on the market. Currently, approximately 300 such drugs are on the market, 19 of which became available in 2014 alone. And nearly 700 specialty drugs are under development.”
I believe the term “specialty pharmacy” may slowly disappear and everything will be “pharmacy.” This seems logical given the increasing ubiquity of specialty medications. There was a time when specialty medications meant more than “expensive.” That time, and fee-for-service healthcare, may well be behind us.
Next: Two more lessons
3. Someone turned up the volume on patients and adherence.
At Asembia 2016 discussions on the patient and medication adherence finally reached a pitch that was not entirely drowned out by the business of healthcare conversations. Sessions led by such disparate pharmacy stakeholders as Anthem, Johns Hopkins, Florida Cancer Specialists, AmerisourceBergen and Asembia touted adherence as a central component to the future success of the industry. The direct cost of medication non-adherence, estimated at upwards of $300 billion annually, was recited repeatedly.
4. The payers sound worried.
One highly attended presentation at the conference, “Managing Specialty Pharmaceuticals, a Payer’s Point of View,” was given by Lisa Morris, Staff VP, Clinical & Specialty Pharmacy at Anthem. Everyone wants to know what the payers are thinking.
As it turns out, they’re thinking, “How are we going to pay for all this?” While specialty pharmaceuticals like the new breakthrough cures for hepatitis C haven’t bankrupted the system, and while it appears a responsible, stepped approach to PCSK9 inhibitors has tamped down the flames of the $1,000 per month for life headlines, what happens when improvements in oral oncolytics and eventually oral immunotherapeutics turn cancer from a death sentence to a manageable chronic condition?
Read: Top ways to tap value from specialty drugs for chronic care
Will “at risk” contracts be more than value-based window dressing? Will payers and manufacturers be closer to a relationship in which everyone benefits through improved adherence and patient outcomes? What will limited distribution networks look like 12 months from now? Those are questions for which we will seek answers at Asembia 2017.
Marc O’Connor is chief operating office forCurant Health, a provider of enhanced medication therapy management and specialty pharmacy services proven to improve patient adherence, outcomes and reduce overall healthcare spending. Marc is also a board member of the Team Type 1 Foundation, an organization whose mission is to “instill hope and inspiration for people around the world affected by diabetes.”