The Pharmacy Benefit

Welcome to The Pharmacy Benefit! Hosted by JC Scott, President and CEO of the Pharmaceutical Care Management Association, The Pharmacy Benefit talks about the latest trends, public policy developments, and political challenges impacting drug pricing and healthcare.

You'll hear the nation's top thought leaders, policy experts, and political analysts on a wide variety of topics from insulin affordability to advancements in gene therapy, biologics, other cutting edge therapies.

The Pharmacy Benefit will also analyze the latest news from inside the industry and give you an educated perspective on where things stand and where they're headed.
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November is National Diabetes Month. In this conversation, hosted by PCMA’s Angela Banks, we discuss the work that PBMs are currently doing to help millions of patients with diabetes manage their care. Express Scripts’ Chief Medical Officer Dr. Christine Gilroy joins us as our guest.

Host JC Scott speaks with Claire Winiarek, the VP for Policy of PCMA, about the increased use of mail delivery for prescriptions. Winiarek discusses the value of mail service for prescriptions both relative to the pandemic and beyond it.

PBM Mail Service Increases During the Pandemic: The top-line trend is increased mail delivery by 20 percent through July, year on year. At the tail end of the first quarter, early refills drove an increase, as well as at the end of the second quarter as people reached the end of their 90-day prescriptions.

PBM Response to Increasing Demand for Home Delivery: Part of the response was working with pharmacies to provide home delivery as well as mail delivery and to make consumers aware of the service. In addition, educating consumers about 90-day refills and arranging auto-ship through the mail has been an essential contribution to slowing the spread of the virus by making it possible for people to stay home.

PBMs and Pharmacies Working Together: PBMs and pharmacies worked together early in the pandemic to develop practical, common sense alternatives to delivery signature requirements.

PBMs and Delivery Challenges: Some PBMs are trying alternative carriers or changing when prescriptions are shipped to allow for potential delays. They’re also allowing for early refills and transition fills at local pharmacies. Behind the scenes, there are proprietary systems mapping the transit of prescriptions through the system so that delivery can be continuously fine- tuned. A well-funded Postal Service is critical for the affordability of this option.

Home Delivery Benefits Consumers: Prescription adherence rates improve from 77 percent for pharmacy pick up to 87 percent for mail delivery. This adherence, in turn, drives improvements to other outcomes such as emergency room utilization and rehospitalizations. Dispensation of medication is also safer when performed en masse in a factory setting as opposed to in local pharmacies. Of course, the scale also drives costs down for consumers, as does the convenience itself. Having 24/7 access to prescription counseling through PBMs can be another benefit both in terms of convenience and confidentiality. Data from IQVIA suggest that these increases in home delivery will be here to stay, along with telehealth and tele-pharmacy options.

COVID-19 Test Kits Via PBMs: UnitedHealth Group is beginning to send lower-nose tests that are as effective as the tests developed earlier in the pandemic. CVS is also sending out test kits.

Outlook for a Vaccine: Winiarek leads a stakeholder group with other drug supply chain partners, including pharmacies, manufacturers, grocers, and hospital pharmacists that has been discussing drug shortages and now plans for a COVID-19 vaccine. The discussion has centered around how the supply chain can support a scientific and evidence-based process of evaluation of vaccines. Planning ahead for the fact that supplies of the vaccine will be limited and developing policies for allocation, access, and safety are central to the group’s efforts.

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JC Scott speaks with Doug Long, Vice President of Industry Relations at IQVIA, about the impact of COVID-19 on the pharmaceutical market. Long discusses the data trends for pharmaceutical companies during COVID-19 and, most importantly, how these trends impact healthcare patients.

Prescription Stockpiling: With news of the impending pandemic, patients around the US began to stockpile 90-day prescriptions in March. As a consequence, the pharmaceutical marketplace experienced a major decrease in demand in the following two months. Long describes the effects of this “prescription rush” and subsequent demand decrease on the pharmaceutical industry.

Access Prescriptions and Shortages: JC and Long discuss methods by which patients are receiving their prescriptions during COVID-19. Mail-order and other socially distant methods (such as deliveries) have grown in popularity. Long also details how the pharmaceutical industry has responded to recent supply chain shortages. Overall, he is impressed by the resilience of the pharmaceutical supply chain (which includes manufacturing, PBMs, pharmacies, wholesalers, and logistics companies) during COVID-19.

Growth of TeleHealth: Long touches on the impact of telehealth on the healthcare marketplace and medical prescriptions. He notes the dramatic growth of telehealth in a matter of just a few months, and he believes that telehealth is here to stay. However, he cautions that telehealth may have a negative impact on prescription trends for patients.

You can subscribe to The Pharmacy Benefit on Spotify, Google Podcasts, Apple Podcasts, and all other major platforms.

Host JC Scott speaks with Tim Wentworth, the president of Cigna Express Scripts and Cigna Services, about how Cigna--along with the entire pharmaceutical industry--are addressing the COVID-19 pandemic. Wentworth is optimistic that the ingenuity of the US healthcare system can combat COVID-19 and that current industry-wide collaborations can survive beyond the current pandemic. Some key points from the conversation include:

Cigna Continues to Put the Patient First During COVID-19: Since the start of the outbreak in March, Cigna has focused on the safety of its employees, customers, and most of all, patients. Wentworth emphasizes that Cigna is dynamically managing the supply chain and acting flexibly and nimbly to ensure pharmaceutical access to the clients. It is also working with federal and state officials to ensure a balanced pharmaceutical policy.

The Pharmaceutical Industry is Collaborating To Address the Current Health Crisis: Wentworth is optimistic about the cooperation between industry members to ensure the patients continue to receive care. For example, Cigna is now collaborating with retail pharmacies to put in place a new program with deep discounts for uninsured patients. The entire industry is working to ensure that those suffering from healthcare and economic fallouts from COVID-19 are not forgotten. He believes that such collaboration can continue in the future.

US Health Sector Innovation Is the Best Bet Against COVID-19: US biotechnology and pharmaceutical companies are working in an unprecedented manner to find solutions to COVID-19. Wentworth believes that Cigna, and the entire industry, will find a way to ensure access to COVID-19 for its patients. He stresses that it is a public health decision more than it is a commercial decision.

You can subscribe to The Pharmacy Benefit on Spotify, Google Podcasts, Apple Podcasts, and all other major platforms.