Access Insights 2024: Notable Breakout Sessions

PC: What other sessions at the conference have you found to be the most interesting?

Sarraille: Well, I've been very impressed, and it certainly has fed my inherent pessimism, with the discussion about retail pharmacy, particularly as a sort of uniquely challenged aspect of the supply chain. Bill Roth had an absolutely fantastic presentation to lead off that really scoped out the many challenges and just how significant those challenges are. His takeaway was that we are really reverting to an almost pre-World War II world in which services are based on cash increasingly, and where compounding is a bigger and bigger part of the delivery of drugs to patients. But those were some really important observations there. A little later, there was a panel that talked about the state of retail pharmacy from a number of different perspectives, including large chain pharmacies, and even those big players are under huge pressure to innovate great drugs and get them through the FDA process. You can theoretically even create coverage and reimbursement for them at the payer level. But if there's not actually a means to deliver those drugs to patients, you've got a huge problem and the degree of pressure that retail pharmacies are under, certainly the independence, but even really the chains are a disturbing component of what we're facing as an industry right now.

Full Interview Summary: The implementation of the Inflation Reduction Act is expected to be challenging, with both short-term losses and operational difficulties. While the Act aims to help patients through measures like a $2,000 out-of-pocket cap and a smoothing mechanism, it may also lead to higher premiums and deductibles. Additionally, the negotiated prices might not yield the expected savings, and there could be negative consequences for biosimilars, generic drugs, and pharmaceutical innovation.

Retail pharmacy is facing significant challenges, including a potential return to a cash-based system and increased compounding. Even large chains are under pressure, impacting patient access to treatments. Other factors affecting patient access include the potential for plans and PBMs to move away from negotiated price drugs, maximizers and accumulators, and alternative funding programs involving unapproved drugs. These issues collectively pose a significant threat to patient access to treatments.