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Articles

Shift focus in orphan and ultra-orphan messaging to clinical benefit.

The Payer Value Deficit in Orphan Drugs

Supporting health plan clinical preparation and financial modeling.

Payer Key Business Factors for Orphan Product Launches

 interview, Vibhu Tewary, project director, IQVIA Institute for Human Data Science, discusses:

Highlights of the company’s report surrounding the “Long-term Market Sustainability for Infused Biosimilars in the US: Foundational Analytics on Emerging Risks to Sustainability”

The process that constructing and piecing together a report of this magnitude entails, along with where the idea itself came from

The ongoing challenges surrounding ASP-based reimbursement

A closed-door, multi-stakeholder virtual roundtable (based on his original report) that was previously held

Vibhu Tewary offers insight on this market segment, including a behind-the-scenes of what goes into designing a report. 

The Path Forward for Infused Biosimilars in the US

Trade & Channel Strategies conference explores the frontline issues related to strategy, distribution, and reimbursement—while digging into creative solutions to solve them. 

Conference Connect: Navigating the Future  of Pharma Trade

CVS Caremark, Express Scripts, OptumRx made more than $7.3 billion in revenue, with markups as high as thousands of percent. 

FTC Report Finds Big Three PBM Mark Ups for Specialty Generics Generated Billions

A forum intended for HCPs, policy experts, and industry leaders addresses pressing obstacles facing this sector of the industry today. 

Navigating Access and Reimbursement Through Uncertainty 

Jon Hamrick, partner, Curatio Scientia Advisors, discusses upcoming industry challenges at this year's Trade & Channel Strategies Conference in Philadelphia. 

Trade & Channel Strategies 2024: Navigating Industry Challenges

A panel examines the gross-to-net bubble across various product mixes, how pricing impacts market access, and more.  

Trade & Channel Strategies 2024: A GTN Bubble Balancing Act

How Trade Strategy Impacts Business Success

, Amanda Salindong, associate director of channel & distribution at Alnylam Pharmaceuticals

explains how she participated in two key sessions: “Trade 101” and “Women in Trade.” The former, which she presented at both this year and last, is designed for those new to the trade function in biotech and pharma. It offers a high-level overview of the trade function, explaining its role in connecting various business areas such as revenue, contracting, pricing, supply chain, and finance. The session is beneficial for individuals from different backgrounds, including those transitioning into trade from other roles. Salindong enjoys the opportunity to meet attendees, engage in discussions, and help newcomers better understand the trade function. Audience feedback indicated that attendees found the session helpful in building foundational knowledge and sparking further questions.

The “Women in Trade” session, which Salindong co-hosted with colleagues from both the manufacturing and vendor sides, focused on career development, networking, and leadership. The session was intimate and inclusive, featuring both women and men from diverse experience levels. It allowed for open discussions on topics like allyship, career growth, and leadership development. Participants appreciated the chance to engage in meaningful conversations in a more personal setting, unlike larger networking events where deeper discussions can be difficult. Feedback from attendees was positive, as they valued the opportunity to share experiences, exchange best practices, and foster connections with others in the trade industry.

Overall, both sessions were well-received, offering valuable insights, networking opportunities, and practical takeaways for individuals at various stages of their careers in trade. She emphasized the importance of fostering relationships and creating spaces for open dialogue within the trade community.

Salindong also speaks on her day-to-day workflow of that involves supporting her organization’s channel strategy, the factors she believes that manufacturers should consider when selecting a third-party logistics provider, and much more. 

A portion of your day-to-day workflow involves supporting your organization’s channel strategy. What does that entail?

 It is a bit of a smaller company, but I do focus on the channel strategy and operations of the company. As I mentioned before, trade is a nexus of various business functions—you get involved with anywhere from pricing to contracting and revenue, so it's key that the person in trade has a seat at the table to be able to contribute toward broader discussions of an organization's initiatives.

There's a lot of heavy collaboration with the internal stakeholders, and other members—whether it be a market access team or another team—to be able to make sound business decisions to accomplish the company's goals. One of my roles is introducing trade terms and the trade business, and to be able to consider certain factors within the trade and channel to help support a business decision. Thinking bigger picture, whether it be being involved with strategic account initiatives or a revenue business school, it's really important for the trade person to come and bring in how the channel will impact that decision, considering all different factors. How is that going to positively and or negatively impact the business?

That area is where I heavily support within channel. Also, a lot of times in trade, the ultimate goal is to ensure that there's seamless distribution of products to the channel to provide optimal product access. You want to make sure patients get treated, so in order to do that, that involves a lot of contracting, fostering relationships, as well as making sure that the business with other collaborators is running smoothly, whether it be within supply chain or finance.

In the second part of her video interview with Pharma Commerce Editor Nicholas Saraceno, Amanda Salindong, associate director of channel & distribution at Alnylam Pharmaceuticals, describes how she supports her organization’s channel strategy.

Fostering Relationships and Leadership Within the Trade Sector

Amanda Salindong, associate director of channel & distribution at Alnylam Pharmaceuticals

You participated in various capacities at last month’s Trade & Channel Strategies conference, including a session regarding “Trade 101,” and as member of the “Women in Trade” roundtable. What was the premise of those sessions, along with some of the audience feedback that you received?

 I look forward to the Trade & Channel strategies conference every year. I mean, I've only been a couple times. I attended last year and this year, and I think it's just a really great conference to go to. It's a bit of a smaller conference, so it's a little more personal, where you get to interact and meet and network with other folks within trade and outside of trade. People attend for learning, development. Others attend to network. Others attend to link up with, or further forge relationships they already have. I look forward to it every year.

Another thing that I look forward to is when I get the opportunity to speak at this conference. This year, I was able to speak at the “Trade 101” session, and the “Women in Trade” session, along with a few other esteemed female colleagues. The “Trade 101” session I presented at last year and this year as well. That's tailored, but it's not limited to typically, folks who are new into their career, new into the industry, new into an organization, or even within trade. There's a vast array of attendees that sit in on that session. I've had folks who used to be in a more payer type role that are new to trade, that want to attend the session, some folks that are new to their career. It's a very helpful session, and I'm glad that Trade & Channel Strategies has offered this session—last year, this year, and hopefully in consecutive years—because what it does is give a high-level overview of the trade function within the biotech and pharma industry, and it gives people an understanding of what the trade function is, how it’s the nexus of many different business functions within an organization. Trade is involved with revenue, involved with contracting and pricing, so people who are new to the function start to understand what trade is, and how you collaborate with stakeholders. You're constantly working with not only internal folks—like people in supply chain and finance—but also with channel partners, external partners.

How you foster those relationships is one of the things that we talked about in that session. We also talked about—at a high level—some of the hot topics that are going on currently within the industry, but then, at the same time, also learning, and maybe providing a refresher of what the trade function is. I really enjoy presenting at that session and meeting other people. I think it's been positive feedback, because a lot of people are new. The best way to learn is sometimes talking with other people and attending these types of sessions, and then leaving and even having more questions about it. That's the first session that I've actually presented at Trade & Channel Strategies for that session, and I think it was a really good one.

The second session is “Women in Trade,” which I collaborated with, as I mentioned, a few esteemed colleagues within the industry. Some of them were from the manufacturing side. Some of them were from the vendor side. This was actually the first session within the Trade & Channel Strategies conference this year, and it was a collective group of not only females, but also males who attended. It was a more personal session with a little bit of a smaller group, but the attendance was well received, actually. What we did was, there were a few areas that we focus on: career development, networking, and best practices. This consisted of a lot of free discussion that was guided by the facilitators, talking anywhere from allyship to how you develop in your career, to how you can become more of a leader.

I think because there were so many different types of people with many different experiences, we did take a poll of what type of people were in the room. There are people from anywhere from under a year or two of experience, to 15 plus-years of experience, so it was a great time for us to discuss best practices and what our experiences have been. Some of the feedback we got from that was that they really appreciated the time they got to talk to other females or males within the trade function and network. Sometimes, certain networking sessions are very large and not as personal. You can't really have a good discussion on these things, so I think they really found this opportunity as a good one to be able to talk to others and relate.

In the first part of her video interview with Pharma Commerce Editor Nicholas Saraceno, Amanda Salindong, associate director of channel & distribution at Alnylam Pharmaceuticals, explains the premise of the Trade & Channel sessions that she participated in, along with some of the audience feedback that she received.


Latest Conference Coverage

Women in Trade

PC: You participated in a roundtable surrounding women in trade. What were the key takeaways from that discussion?

It was interesting to me that the people in the room had similar experiences. What they liked the most about their trade roles was that they were challenging, they learn something new every day, and the importance of the trade role in the organization as a whole. They commented on that, and those were some of the key takeaways.

The other one was mentorship. We had four pillars as part of this exercise. One was networking, one was mentorship, one was allyship, and one was executive education. Every table ended up talking a little bit about mentorship and how important it is to find a strong mentor, whether it's female or male, to help you grow in your career.

PC: How can women in the pharma trade industry continue to empower future leaders in this space?

I think it comes down to three C's, communication, collaboration and commitment. Helping the younger generation or new individuals in this field by communicating with them, collaborating with them on some things that they might need to do or want to do to help their career, but also be committed to helping them.

I’ll get back to the mentorship. Depending on who you find as a mentor, that could make your career. You need to find someone that’s willing to go that extra mile for you, and I saw a lot of that yesterday. It was really interesting to see how quickly, how many people started sharing contact information and really wanted to help one another in any capacity that they could. At the end of the day, I think that's what it's about, just helping somebody else.

Lisa Arthurs, VP, trade, Two Labs, discusses a roundtable discussing women in trade as well as empowering future leaders. 

Trade & Channel Strategies 2024: Empowering Women in Pharma Trade

editor Nicholas Saraceno, Douglas Bock, Partner, Archbow Consulting, discusses his breakout session and other key factors of the Trade & Channel Strategies conference. 

Discussion on the Inflation Reduction Act

Interview with Douglas Bock 

Which trends at Trade & Channel Strategies have caught your eye and why?

This is a great trade and distribution conference, and I've been to this conference several times in the past. First of all, what's fantastic is that there are about 200 people here. You get a lot of people with a trade distribution background and they're thinking about how we physically move products from the factory to the patient. It's fantastic. 

: Could you provide an overview of your Inflation Reduction Act (IRA) presentation?

One of the things that we're seeing with the Inflation Reduction Act is products that say, cost $100, are going to cost insurance plans much more money. They have a higher responsibility for covering the costs. Manufacturers also have a higher responsibility for products for about $100,000. While those programs are good for beneficiaries and they're good for taxpayers, they might not be good for plan sponsors and or pharma manufacturers. The challenge for a pharmacy benefit manager is that they sell their services and compete on price. If their costs are going to have to increase, they're now going to have to pass on those costs to their consumers or they'll need to find other sources of revenue. One of the things that we're closely watching at Archbow is whether or not those other sources of revenue are things like increase utilization of co-pay accumulator and adjustment programs. Whether it's an accumulator, whether it's a maximizer, or if it's something like an alternate funding program, these are other sources of revenue that we're seeing being tapped for the benefit non necessarily of patients, but for those other players in the ecosystem.

What are the specifics of the PAP Business Rules, and how are they being utilized?

Patient assistance programs have been around for a long time and they're really one of the nice things that we as a pharmaceutical industry can show the altruistic side of what we do. We can help patients that truly are in need of getting drugs because they can't afford them. But, that generosity has been taken advantage of by some third party actors. Traditional PAP programs typically include eligibility criteria like a patient has to be or an indication that's on label, they need to be a US resident, make less than a certain percentage of the poverty limit, and that's all good and we've tried to make it as easy as possible for patients who really need a drug to be able to access it. That willingness to try and make it easy like I said is being exploited by third parties. What these third parties are doing is getting themselves in-between the physician, the payer, the pharmacy, and the manufacturer. They're actually carving out high cost specialty drugs that have generous patient assistance program benefits and instead of going to a patient who truly needs the drug, they're classifying the patient as uninsured because they've decided they're not going to cover the product. They're taking advantage of the eligibility criteria by saying a patient who doesn't have coverage for a specific product now is eligible for the patient assistance program. What's happening is that manufacturers are giving away many more free drugs than they anticipated. What's really dangerous about this type of program is that plan sponsors are being trained that they don't need to pay for innovative new treatments. That there's a way to get things for free. It's not really free, nothing is free. Those companies that are sort of intervening are charging 25 to 30 percent for the service of a willing patient. It is something that we need to take a look at closely as an industry because not only does it have short term implications on the financial health of a brand, but has long term implications for the viability of the industry itself. 

Partner for Archbow Consulting discusses the conference, the IRA, and specifics of PAP business rules

Trade & Channel Strategies 2023: An Interview with Douglas Bock of Archbow Consulting

editor Nicholas Saraceno, Bill Trombetta, PhD, Professor Emeritus, Healthcare Strategy & Marketing, St. Joseph’s University, discusses keys to successfully navigating the coming perfect storm” in healthcare. 

Interview with Bill Trombetta, PhD

What are the keys to successfully navigating what you describe as “the coming perfect storm” in healthcare?

The coming perfect storm is broken into three parts. First, there's the transition of healthcare delivery from volume based care to value based care. Volume based care is based on the healthcare provider, whether it's the doctor of the hospital. The more money I make, the more patients I see, etc. The more expensive stuff I can do for you, the more money I make. Value based care means my goal is to keep you out of the hospital, out of the emergency room, and keep you healthy up front. This way, if I only get paid when you're sick, that's fine. But now, I can get paid to keep you healthy. So, I get access to the full healthcare dollar. That's easier said than done, we want to shift to value based care. With that in mind, remember that ever since the time of Hippocrates, for 5000 years, it's been a volume based world. The regulations took effect and said "wait, we want to curve the attempt by drug firms to make money on expensive drugs and devices by doing things for you," The regulations have focused on issues that have been called fraud and abuse, and anti-kickback. Let's take a homeless person who has diabetes too, and you're saying "Gee, I'm going to give this guy some insulin, and the patient says he's homeless and lives under a bridge." What good is the insulin going to do? This guy is going to be in the ER about 15 to 20 times a year at about $1000 a pop. Then, he's going to be in a hospital bed maybe five times a year. You're talking about a $30,000 cost a year to keep this guy relatively healthy. If you did some things up front like give him a home, provide healthy food, that'll cost $10,000. You just saved $30,000. 

The other issue is that I want to do value based care, and that's premised on something called the triple aim. I want to lower costs, improve patient outcomes, and increase access to healthcare. I want to try and frame whatever I do in terms of that triple aim. For example, Geisinger Pharmacy in Danville, PA has something called Food Farmacy, and what they do is give healthy meals to diabetics. Well, that costs money. The healthy food gets you to eat better and be healthier and you save money in the long run. 

There are things called advisory opinions. There are about 450 of them, which is a lot to read. But, there are about two dozen of them that focus on the kind of things that we're talking about. You'll go through those, and you'll see the officer of inspector general and the justice department come back and say "We will not challenge you based on what you said you're going to do, and here are the reasons why." Then they'll lay it out. 

There has been this transformation of healthcare delivery from volume-based care to value-based care. As a result, healthcare providers (HCPs) will encounter regulatory constraints that many say are critical to volume-based healthcare but stand in the way of value- based care. How will HCPs handle this?

First of all, doctors didn't go to business school. At St. Joe's, I had the privilege to teach at Philadelphia College of Osteopathic Medicine for about 25 years. I see doctors in my sleep. I've gotten to know them very well. You can see now that they're thinking "Oh my god, this isn't what I went to med school for." The doctors are now undergoing this transition. At the end of the day, the crunch issue is going to be risk. The more risk you can take on, the more you're going to minimize the fact that you're going to get challenged by the regulators. Here you're saying I'm not as interested in making money as much as I am keeping you healthy, keeping you out of the hospital. One thing would be to say "when I treat you, I get a fixed, capitation fee." That's scary because doctors are used to getting paid on an ICD10 code, which means no matter what I do, I get paid based on that code. For example, I have a situation now where I have a contract from doctors that are possibly going to enter into a healthcare provider group for diabetic patients. The plan is going to give the doctors $14,000 per patient. There are 1,000 patients in target population. Even with that $14,000 per patient, are you going to make money? One of the crunch things up front is an analysis of profitability. Putting all those things together, this is what's going to make it tough for the doctors. It's going to come, because the feds have said that by 2030, they want the vast majority of all the things healthcare providers do to be in a value based healthcare setting. 

You recently worked with our sister publication, 

, to publish the 22nd Annual Industry Audit, which offers a look at the performance of the top 15 companies across seven business-key metrics, including the latest standouts in market capitalization and creating shareholder value. Could you describe the process involved with gathering and presenting these metrics?

: I got the idea back in 2002. I proposed it to the editor and he said yes. That just blew the roof off the joint. So, he said "hey, do you want to do this every year?" I said yes. I take a look at publicly traded drug companies, specifically the top ones and the ones that are on the stock exchange. The first process is take a look and narrow the drug companies by that. So, I look at 15, and the 15 is because of mergers. At one time, I think we did 25 but now there's only 15. I use a lot of sources. The biggest and best is called Fact Set. They give you so many financial aspects that you could drown. I use seven metrics. The three crunch metrics are enterprise value, enterprise value sales, and return on investment capital. 

Bill Trombetta, PhD, discusses successfully navigating what he calls “the coming perfect storm” in healthcare. 

Trade & Channel Strategies 2023: An Interview with Bill Trombetta, PhD, Professor Emeritus, St. Joseph's University

editor Nicholas Saraceno, Spencer Miller, Director, Market Access, Trade and Payer, Bayer, previews the Enable Holistic Hub and Provider Services session.

Spencer Miller

: Based on your panel discussion, what is the importance of patient and provider access and support solutions?

I think it's super important to not only think about the patient journey throughout the prescription that's being written by the physician, but to be mindful of multiple journeys on that path from being prescribed medication to fulfillment. 

: What are key decision points when considering patient and provider access and support solutions?

There's precision points all through the journey we just spoke about. The initial decision point around what's my strategy if I'm in distribution. That begins probably 18 to 36 months before the drug launches. Once a drug launches, how do I get it into the ecosystem? Are there analog products that I want to mirror or do I want to go on a different sort of "choose your own" journey with the physicians and the patients. Once you get that prescription pen to paper, then we talk about the patient journey. We need to make sure that we are continuously discussing the ethics of what we're doing, measuring that, and making sure that we're doing our due diligence to ensure the best experience. 

Given that you will be a part of a session surrounding “Trade 101 for Existing Products,” what do you believe are the fundamentals for success in this sector, especially for newcomers?

This is a topic near and dear to my heart. I have a heart for training people and bringing folks who are newer to trade distribution up. We're really excited to present this new colleague that I just met named Amanda. This is her first attending, she's also on a panel with Paul, ironically. She's getting baptized by fire. The goal of this is to truly bring trade distribution and what it looks like to the masses. Then, we'll get into specifics on how we interface with the stakeholders inside these organizations. Hopefully, this becomes an annual session. 

Bayer executive talks Enable Holistic Hub and Provider Services panel.

Trade & Channel Strategies 2023: An Interview with Bayer's Spencer Miller

editor Nicholas Saraceno, Cheryl Allen, Founding Partner, Curatio Scientia, talks about her breakout session, 

Enable Holistic Hub and Provider Services

 at the 2023 Trade & Channel Strategies conference. 

Discussion about Trade & Channel Strategies 2023

An Interview with Cheryl Allen of Curatio Scientia

From an importance perspective, those two stakeholders, you have the patients here, and the prescribers and support community. Providing access and support solutions based on the attributes of the product is incredibly important. Patients can be confused, especially when newly diagnosed. In the prescriber community, there's so much noise out there. Finding solutions that can be easily accessible by these two groups is going to be extremely important in the success of branded products. 

: Can you share trends that you are seeing in the space?

Excited to say that because of some of the challenges with the pandemic we came through, decentralized clinical trials. We also have new ways of engaging patients from a technology perspective. Those are being brought into the patient services space. So, I'm really excited to talk about access and support solutions. 

: My distinct colleagues will be speaking about different models. We'll have Spencer talking about telemedicine and those types of support models. Paul will be talking about specialty products, where you have some direct to consumer type of engagement. I'll be focusing in on the exclusive model. There are instances where a patient population is small enough and usually this is in rare disease, where the manufacturer has the opportunity to select an exclusive provider. This exclusive provider supports all of distribution, access, and ongoing patient services. Some key decision points there. Number one, will the prescriber community accept that exclusive model? Is this something new to them? Do you have to educate and if so, what does that look like? The second area would be the payers. What are the payers thinking about this? This is a known model for them. Third and probably as important is internal stakeholder perspective. After the decision is made to go exclusive, how do those internal stakeholders feel about that? Are we all feeling good? Once that product launches, what's the messaging? Message to market around that. What are the success factors for that?

Founding Partner of Curatio Scientia speaks on her upcoming panel at Trade & Channel Strategies 2023. 

Trade & Channel Strategies 2023: An Interview with Cheryl Allen of Curatio Scientia

editor Nicholas Saraceno, Paul Chen, Senior Director, Trade and Channel, Lexicon Pharmaceuticals, discusses the upcoming group panel. 

Paul Chen Trade and Channel 2023

 Based on your panel discussion, what is the importance of patient and provider access and support solutions?

I think it really depends on what lens you look at. One of the things we're going to in our session is address it from three different angles. The first one will be from a general pharma perspective, because those people probably look at things one way. Spencer is going to touch on new technology and digital pharmacy capabilities. Cheryl will then go into orphan drugs. Hopefully, it provides for each person in that room. 

Can you share trends that you are seeing in the space?

I think Bill Roth talked about it very well during his opening session. There's a lot of different partners coming out. We're looking at things that are nontraditional and breaking away from the big three for instance when you think of the big 3PL and the big three wholesalers. Where I work, we're a small company. It's interesting that we get levied with the highest fees. I always make an analogy to credit cards. You have the poorest and least likely to be able to pay, but they get hit with the highest interest rates. That's kind of the world we live in now. So, are there other avenues we can explore that will help mitigate some of those expenses to ourselves and still allow us to reach our ultimate goal of providing for the patients?

You also have a session on branded products coming up. Could you dive into any specific that this presentation will entail?

That session is really more of a facilitation session. It's not where I'm going in to say "This what you should know about this segment of the business," but really, to solicit the knowledge and expertise of everybody that's in the room and then point out examples that I think might be of interest in trade and channel perspective that they can leverage and use in their own business when they go back to their companies. It's about facilitating the right questions and getting a panel of experts within that room to engage. 

Lexicon Pharmaceuticals exec discusses upcoming Enable Holistic Hub and Provider Services panel. 

Trade & Channel

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