{"id":32848,"date":"2025-07-30T16:31:16","date_gmt":"2025-07-30T16:31:16","guid":{"rendered":"https:\/\/www.newsbeep.com\/au\/32848\/"},"modified":"2025-07-30T16:31:16","modified_gmt":"2025-07-30T16:31:16","slug":"340b-vs-patients-humira-whiplash-accumulator-fallout-and-pharmacy-struggles","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/au\/32848\/","title":{"rendered":"340B vs. Patients, Humira Whiplash, Accumulator Fallout, and Pharmacy Struggles"},"content":{"rendered":"

\"\"<\/a>Let\u2019s cut through the steamy summer haze with a refreshing breeze of industry insights from Drug Channels\u2014perfect for pondering while you float in your favorite pool:<\/p>\n

Plus, a shout-out to three talented journalists<\/a>.<\/p>\n

P.S. Want more real-time insights? Join my more than 64,000 LinkedIn followers<\/a> for daily links to neat stuff, along with sharp and thoughtful commentary from the DCI community.

\n<\/p>\n

Do Patients Receive 340B Drug Discounts at the Contract Pharmacy Counter?<\/a>, IQVIA
\n
Sigh. Yet another study finds that 340B covered entities continue to fall short in passing discounts to the patients who need them most.<\/p>\n

According to this new IQVIA study, only 3% to 5% of branded 340B prescriptions at retail and mail-order contract pharmacies were filled using a 340B drug discount card. That\u2019s shockingly low\u2014especially in a country where (per the report) 32% of the population is uninsured or underinsured.\n<\/p>\n

As you can see below, Disproportionate Share Hospitals (DSHs) had the biggest discrepancy between 340B prescriptions (74.7%) and card usage (42.8%). Perhaps not coincidentally, many of these contract pharmacies were situated in higher-income neighborhoods\u2014raising further questions about equitable access.\n<\/p>\n

[Click to Enlarge]<\/p>\n

\"\"<\/a>
\n
This study reveals yet another massive disconnect between the program\u2019s benefits and patient access. It also echoes less robust government studies<\/a>. Transparency and accountability are long overdue.<\/p>\n

As usual, the Drug Channels community engaged in a lively debate over these data<\/a>.<\/p>\n

Biosimilar use is on the rise\u2013but 1 in 8 patients return to Humira<\/a>, Truveta
\n
New patient-level data uncover a curious trend in the Humira-to-biosimilar journey:
\nMore than 1 in 8 patients who switched to a Humira biosimilar ended up switching back to the original product.
\nSwitching back was more common among older adults, women, and patients with rheumatoid arthritis and ankylosing spondylitis.<\/p>\n

[Click to Enlarge]<\/p>\n

\"\"<\/a>
\n
These findings raise important questions about what\u2019s driving patients to return to Humira, despite having used lower-cost biosimilars.<\/p>\n

I’d like to see the study replicated with much more detail about formularies, copay support, and other factors. In the meantime, the Drug Channels community provided multiple possible explanations on my LinkedIn post<\/a>. <\/p>\n

Close Loophole Allowing Insurers, PBMs to Profit Off Patients<\/a>, RealClearHealth
\n
Consider this troubling case involving a patient with psoriatic disease.<\/p>\n

As he explains, his patient support funds\u2014intended to help afford a specialty medication\u2014were absorbed by his health plan. This left him with unexpected and unaffordable costs.\n<\/p>\n

IMHO, Congress should eliminate the “non-essential drug” loophole that allows copay accumulators to function. If you\u2019re not familiar with how Affordable Care Act (ACA) Essential Health Benefit requirements enable copay maximizers, check out Section 6.2.2. of DCI\u2019s 2025 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers<\/a>. <\/p>\n

What Options Do Retail Pharmacies Have to Become Profitable?<\/a>, Spotlight on Market Access
\n
Community pharmacies are being squeezed from every direction: plummeting generic margins, relentless PBM pressure, intense front-end competition, and limited access to 340B pricing. Closures are increasing, profitability is elusive, and the entire industry is being reshaped.<\/p>\n

In June, Antonio Ciaccia of 46brooklyn Research and I unpacked these dynamics in a live video webinar,\u00a0What\u2019s Next for Retail Pharmacy: Data, Debate, and Disruption<\/a>.\n<\/p>\n

Angela Maas at AIS Health provides some highlights of our discussion in the above article.<\/p>\n

A farewell to AIS Health’s publications
\n
I was saddened to learn that AIS Health is discontinuing its market access publications: Health Plan Weekly, Radar on Drug Benefits, Radar on Medicare Advantage, and Radar on Specialty Pharmacy.<\/p>\n

They consistently featured knowledgeable journalists and high-quality content. In addition to Angela Maas<\/a>, I want to give a well-derserved shout outs to Lauren Flynn Kelly<\/a> and Leslie Small<\/a>. \u00a0If you’re looking for top-tier talent, any of these three outstanding professionals would be a fantastic hire.<\/p>\n

<\/p>\n","protected":false},"excerpt":{"rendered":"Let\u2019s cut through the steamy summer haze with a refreshing breeze of industry insights from Drug Channels\u2014perfect for…\n","protected":false},"author":2,"featured_media":32849,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[33],"tags":[64,63,137,490],"class_list":{"0":"post-32848","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-medication","8":"tag-au","9":"tag-australia","10":"tag-health","11":"tag-medication"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/32848","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/comments?post=32848"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/32848\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media\/32849"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media?parent=32848"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/categories?post=32848"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/tags?post=32848"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}