All GLG News Analyses Filed Under: Healthcare Services

Adam FeinFounder & PresidentPEMBROKE CONSULTING INC

Wholesaler Impact of a Longs Drug Deal

September 16, 2008

Analysis of:Walgreen Jumps In With Rival Bid for Longs Drug | online.wsj.com

Walgreens (NYSE:WAG) and CVS Caremark (NYSE:CVS) are now in a bidding war for Longs Drug Stores (NYSE:LDG). No matter which company wins, the long-term outcome will probably be negative for AmerisourceBergen (NYSE:ABC), which is Longs’ primary wholesale supplier.  The sale of Longs Drug Stores will be one more step in the ongoing consolidation of the pharmacy supply chain.

Updating Pricing on Brand to Generic Drugs are Timing and Inventory Issues for Payers and Providers

September 16, 2008

Analysis by: GLG Expert Contributor

Analysis of:Medicare overpaid on drugs with new generics, report says | www.latimes.com

Payers in the private sector have historically tried to get providers to pay the generic price for branded multisource products using maximum allowable cost (MAC) terminology in their contracts as soon as the branded drugs have a generic source. This has caused problems for providers that still have branded products in thier inventory. The government is now trying to follow the private sectors example and force providers to pay for the generic drugs bypassing the 2-month delay used to help providers deplete their inventory of the branded products.

Another reason why government intervention doesn't work

September 15, 2008

Analysis by: GLG Expert Contributor

Analysis of:Medicare overpaid on drugs with new generics, report says | www.latimes.com

The Medicare drug system was a political ploy. This just confrims it. The private insurers were unwilling to offer Rx coverage before then because they understood the economics of it.

Trust and "intelligence"

September 15, 2008

Analysis by: GLG Expert Contributor

Analysis of:Applying Emotional-Social Intelligence to Healthcare Administration and Bedside Care | www.raoleadership.com

Simply put, there's no incentive to be "emotionally supportive". In primary care, establishing a long term relationship between provider and patient evolves into a trusting relationship. Without the trust part, patient encounters are hollow, theatrical, and not supportive. There is no incentive to either doctor or patient to stay in one doctor's care, and the doctors move around from "job" to "job", rather than being incented to stay put. I would add incentive kickers every 3-5 years to encourage doctors to keep patients in care, and in some fashion, encourage patients to keep one "primary" provider. Trust, unmeasured, and unrewarded, reduces unnecessary utilization of resources, and malpractice claims as well.

Adam FeinFounder & PresidentPEMBROKE CONSULTING INC

Drug Importation and Global Wholesalers

September 12, 2008

Analysis of:Biotech industry not seeing much difference between McCain, Obama | thehill.com

Both Barack Obama and John McCain have made negative statements about the pharmaceutical industry. Both also favor drug importation into the U.S. from countries with price controls. The emergence of global wholesalers makes it more likely for an importation law to pass, despite the dangers to supply chain security.

Adam FeinFounder & PresidentPEMBROKE CONSULTING INC

Generic Drug Profits: Too High or Appropriate Incentive?

September 11, 2008

Analysis of:Medicare overpaid on drugs with new generics, report says | www.latimes.com

A new OIG report highlights supposed “excess” payments by Medicare’s cost-plus drug reimbursement model, giving us a peek at the time path of generic margins in the Part B program. However, OIG overstates their case by ignoring the powerful incentives for rapid generic substitution that are created by higher profits early in the generic life cycle. Pay attention to this report because it illustrates the generic drug profit dynamics that exist elsewhere in healthcare – retail pharmacies, providers, wholesalers, and PBM mail order. And as generic utilization rates will move toward 75 percent over the next few years, I expect that pharmacy channel margins on generic drugs will be increasingly seen as a mechanism by which payors can manage their drug trend.

Adam FeinFounder & PresidentPEMBROKE CONSULTING INC

Progress on Federal Pedigree Will be Slow

September 5, 2008

Analysis of:Drug Stores Don’t See Progress for Electronic Drug-Pedigree Bill | fdanews.com

Representatives Steve Buyer (R-IN), Gene Green (D-TX), Jim Matheson (D-UT), and Mike Rogers (R-MI) co-sponsored H.R. 5839 Safeguarding America’s Pharmaceuticals Act of 2008. H.R. 5839 was going to be incorporated into other related FDA legislation, but intense behind-the scenes lobbying by the pharmacy industry against the bill has now stopped that option. However, I believe that it would be best for the FDA to implement national serialized e-pedigree in sync with a new California timeline. Although the FDA has not decided on its next step, I presume that nothing will happen until after the Presidential election and a possible new FDA commissioner.

Adam FeinFounder & PresidentPEMBROKE CONSULTING INC

CA E-Pedigree Delayed to 2015

September 4, 2008

Analysis of:Bill to track medicines is praised | www.signonsandiego.com

Implementation of California’s e-pedigree law has (probably) been pushed back to 2015. The widespread industry support for the bill makes me believe that the 2015 date might actually stick. The more realistic timeline should encourage pharmaceutical manufacturers to get serious about mass serialization for their products – a necessary first step for California’s vision of serialized e-pedigree. I expect that “mass serialization” will become increasingly important for supply chain security efforts at multinational drug makers, especially given the new serialization requirements in countries such as Belgium, Italy, and Turkey. The new California legislation also clears the way for a Federal approach to serialized e-pedigree by setting strong federal pre-emption language.

False economy by companies

August 27, 2008

Analysis by: GLG Expert Contributor

Analysis of:Healthways' Guidance Not So Healthy | www.forbes.com

Healthways is currently struggling, but hopfully this will only be a temporary local difficulty. In the long run Healthways provides a good service

Frederic GoldsteinPresident and Chief Operating OfficerU.S. Preventive Medicine, Inc.

Healthways A Market Downturn and Results

August 26, 2008

Analysis of:Healthways' Guidance Not So Healthy | www.forbes.com

Healthways reported lower than expected earnings in its current quarter and analysts are pointing to a tightening in the healthcare markets and the fact that Healthways products are expensive. Does this really make sense?

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