Pain Management Drugs

Global Veterinary Pain Management Drugs Market Likely To Spearhead Growth By Rising Prevalence Of Animal Diseases

Mar 26, 2019 (American News Hour via COMTEX) —  “Global Veterinary Pain Management Drugs Market: Global Demand Analysis & Opportunity Outlook 2024”

pain management drugsGlobal veterinary pain management drugs market is expected to flourish at a CAGR 0f 7.8% over the forecast period. Rising prevalence of animal diseases coupled with increasing number of veterinary hospitals and clinics are likely to spearhead the growth of the veterinary pain management drugs market. Moreover, the global veterinary pain management drugs market is expected to garner noteworthy revenue by the end of 2024.

The global veterinary pain management drugs market is segmented into opioids, agonists, Local Anesthetics, NSAIDs (Non-steroidal Anti Inflammatory Drugs), Disease-modifying Osteoarthritis Drugs (DMOAD) and others. Growing number of veterinary clinics and hospitals across the globe is aiding to the growth of veterinary pain management drugs market. Moreover, growing spending on pet healthcare is expected to accelerate the growth of the veterinary pain management drugs market in the upcoming years.

North America accounted for largest market share in overall veterinary pain management drugs market in 2016. Moreover, North America is expected to continue its dominance over the forecast period. Increasing number of veterinary practitioners in the region is believed to significantly increase the demand for veterinary pain management drugs during the forecast period. U.S. is witnessing the augmented demand for veterinary pain management drugs. Asia Pacific is also expected to showcase significant growth in the veterinary pain management drugs market. Increasing adoption of companion animals coupled with growth in number of veterinary clinics signals promising growth of veterinary pain management drugs market in the upcoming years.

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Growing Pet Ownership

Significant increase in the number of pet parents or pet owners who consider pet as a part of their family is anticipated to positively impact the growth of the market. For instance, As per PetSecure, more than 90% of the Americans consider pets as a part of their family. In addition, pet owners are spending more on the healthcare of pets due to their strengthening bond. This factor is anticipated to positively impact the growth of the Veterinary Pain Management Drugs Market.

Rising Number of Veterinarians Across the Globe

Rise in the number of veterinarians across the world is believed spearhead current and future market growth of Veterinary Pain Management Drugs during the forecast period. For instance, according to American Veterinary Medical Association, in U.S., the number of veterinarians increases from 92,547 in 2011 to 107,995 in 2016. Moreover, the number of veterinarians is expected to increase across the globe which is expected to drive the growth of the veterinary pain management drugs market.

However, increasing cost of veterinary pet care is expected to negatively impact the growth of the global veterinary pain management drugs market.

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The report titled “Global Veterinary Pain Management Drugs Market: Global Demand Analysis & Opportunity Outlook 2024″ delivers detailed overview of the global veterinary pain management drugs market in terms of market segmentation by product, by animal type, by application, by distribution channel and by region.

Further, for the in-depth analysis, the report encompasses the industry growth drivers, restraints, supply and demand risk, market attractiveness, BPS analysis and Porter’s five force model.

This report also provides the existing competitive scenario of some of the key players of the global veterinary pain management drugs market which includes company profiling of Boehringer Ingelheim, Zoetis, Inc. , Merck Animal Health , Elanco , Bayer AG, Vetoquinol S.A., Ceva Sante Animale, Virbac Group, Norbrook Laboratories Ltd, Dechra Pharmaceuticals and other key players . The profiling enfolds key information of the companies which encompasses business overview, products and services, key financials and recent news and developments. On the whole, the report depicts detailed overview of the Global veterinary Pain Management Drugs market that will help industry consultants, equipment manufacturers, existing players searching for expansion opportunities, new players searching possibilities and other stakeholders to align their market centric strategies according to the ongoing and expected trends in the future.

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Recro Pharma Falls As FDA Denies Approval To Pain Candidate

Shares of Recro Pharma, Inc. REPH plunged 34% on Mar 25, following a complete response letter (“CRL”) to the new drug application (“NDA”) seeking approval of its pain candidate, meloxicam. The company was looking to get this approval to the intravenous (“IV”) administration of meloxicam for the treatment of moderate to severe pain.

The FDA has cited that delayed onset of the candidate has failed to meet the prescriber expectations for IV drugs. Moreover, the regulatory authority raised concerns about the role of meloxicam monotherapy for acute pain, based on its interpretation of clinical data.

So far this year, shares of Recro Pharma have lost 9.7% against the industry’s 15.3% rally.

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We remind investors that this is second CRL for meloxicam. In May, the FDA had issued a CRL related to the NDA for meloxicam. The regulatory authority had stated that although the candidate met primary endpoints in clinical studies, analgesic effect failed to meet the FDA’s expectations based on data from ad hoc analyses and selective secondary endpoints. In October, the company re-filed the NDA following discussion with the FDA.

Recro Pharma stated that it strongly disagrees with the FDA and firmly believes that the non-opioid candidate (meloxicam) holds significant potential. The company remains committed to get regulatory approval for IV meloxicam and plans to meet the FDA to resolve the issues and discuss the path forward for the same.

In December 2018, the company amended its license agreement with Alkermes ALKS related to milestone payment on the approval of meloxicam. Previously, Recro Pharma was liable to pay $45 million to Alkermes on receiving the approval. The amended agreement allows Recro Pharma to spread the payment over seven years, which reduces cash requirement for 2019 by $30 million. The availability of more funds will help Recro Pharma to consistently support development and getting approval for meloxicam.

Recro Pharma is also evaluating the candidate in a phase III study for the treatment of pain following abdominoplasty surgery. The company is also developing intramuscular administration of meloxicam for acute pain.  The company has another clinical-stage pain candidate and an anesthetic candidate in its pipeline.

A potential approval to meloxicam will boost the company’s top-line performance as it may get better acceptance in the pain market due to prevalence of abuse of opioid-based drugs approved for treating pain.

However, the market for the pain drugs is crowded with availability of multiple drugs and several candidates under development based on different technologies which include Ocular Therapeutix’s OCUL Dextenza and Heron Therapeutics’ HTX-011.

Recro Pharma, Inc. Price

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Women’s Pain Is Different From Men’s—the Drugs Could Be Too

Men and women can’t feel each other’s pain. Literally. We have different biological pathways for chronic pain, which means pain-relieving drugs that work for one sex might fail in the other half of the population.

So why don’t we have pain medicines designed just for men or women? The reason is simple: Because no one has looked for them. Drug development begins with studies on rats and mice, and until three years ago, almost all that research used only male animals. As a result, women in particular may be left with unnecessary pain—but men might be too.

Now a study in the journal Brain reveals differences in the sensory nerves that enter the spinal cords of men and women with neuropathic pain, which is persistent shooting or burning pain. The first such study in humans, it provides the most compelling evidence yet that we need different drugs for men and women.

“There’s a huge amount of suffering that’s happening that we could solve,” says Ted Price, professor of neuroscience at the University of Texas, Dallas, and an author of the Brain article. “As a field, it would be awesome to start having some success stories.”

Modern-day pain control is notoriously dismal. Our go-to medicines—opioids and anti-inflammatories—are just new versions of opium and willow bark, substances we’ve used for thousands of years. Although they are remarkably effective in relieving the sudden pain of a broken bone or pulled tooth, they don’t work as well for people with persistent pain that lasts three months or longer.

Some 50 million people struggle with pain most days or every day, and chronic pain is the leading cause of long-term disability in the United States. Women are more likely than men to have a chronic pain condition, such as arthritis, fibromyalgia, or migraines.

Meanwhile, pain medications are killing us. About 17,000 people die each year from prescribed opioids as clinicians write almost 200 million opioid prescriptions, or more than one for every two American adults.

The failure to include sex differences in the search for better pain relief stems in part from flawed but deep-seated beliefs. “[Medical researchers] made the assumption that men and women were absolutely identical in every respect, except their reproductive biology,” says Marianne Legato, a cardiologist who began sounding an alarm in the 1980s about differences in heart attack symptoms among women. She went on to pioneer a new field of gender-specific medicine.

The physiology of pain is just one of many ways that men and women differ, she says. But she isn’t surprised that no sex-specific medicines have emerged. The medical community—including pharmaceutical companies—didn’t appreciate the variation between men and women, including in their metabolisms, immune systems, and gene expression. “If there were differences in how their drugs worked between men and women, they didn’t want to hear about it,” she says.

The Brain study came about from a unique opportunity at M.D. Anderson Cancer Center in Houston. You can’t take a biopsy of spinal tissue, but researchers were able to study clusters of sensory neurons in eight women and 18 men who had spinal tumors removed. The analysis included sequencing RNA to determine which genes are active in the neural cells. They compared men and women who had a history of chronic neuropathic pain to those who didn’t. Their pain wasn’t caused by the tumors themselves. Some patients had nerve compression causing neuropathic pain, while others didn’t have neuropathic pain or chronic pain at all.

In men who did have neuropathic pain, macrophages—cells of the immune system—were most active. In women, neuropeptides, which are protein-like substances released by neurons, were prominent. “This represents the first direct human evidence that pain seems to be as sex-dependent in its underlying biology in humans as we have been suggesting for a while now, based on experiments in mice,” says Jeffrey Mogil, professor of pain studies at McGill University in Montreal and a leading researcher on sex differences in pain, who was not involved in the Brain study.

Price and his colleagues emphasize that the finding needs further study. But it suggests that a new type of migraine drug that targets a neuropeptide known as CGRP might be broadly effective for chronic pain in women, he says. Women greatly outnumber men among migraine sufferers, and women made up about 85 percent of the participants in the Phase 3 clinical trials of the three anti-CGRP drugs approved by the Food and Drug Administration in 2018. Price wonders if the anti-CGRP drugs aren’t specific to migraines—but to women. His work with mice suggests that the drugs don’t work in males, but block pain in females. “CGRP is a key player in lots of forms of chronic pain in women, not just migraine,” he says.

Tailoring new medicines to men or women would be revolutionary, particularly considering that it took many years for women (and female animals) to get included in pain research at all. Fearful of potential birth defects, in 1977 the FDA cautioned against including women of childbearing age in clinical trials, which meant women used drugs solely designed for men. By 1993, the thinking had changed, and Congress passed a law requiring the inclusion of women in clinical trials funded by the National Institutes of Health. Although clinical trials now include both men and women, they often don’t report results by sex.

Meanwhile, animal researchers continued to use mostly male animals. As a graduate student in the 1990s, Mogil was killing time one day and decided to run some data separately for male and female mice—and discovered the drug the lab was testing worked only in males. When he excitedly told his supervisor, the post-doctoral neuroscientist responded, “Jeff, sex differences are to enjoy, not to study.” (He spent his career studying them, anyway.)

In a 2005 review of research in the journal Pain, Mogil found that 79 percent of pain studies involved only male animals. Only 4 percent looked for sex differences. In a huge leap forward, in 2016 the NIH began requiring most animal research it funds to involve both male and female animals—and to evaluate sex differences.

What is the legacy of the gender-blind research? Mogil once emailed a researcher, asking whether a pain drug worked better in men than women. The researcher didn’t know, and couldn’t pursue the question because the data was controlled by the pharmaceutical company. Mogil was left wondering if drugs that looked promising in male-only animal studies might have failed in clinical trials when the results were blended with those in women, depriving men of a viable treatment.

Medicines that could work best for women wouldn’t make it into the pipeline at all when basic science excluded female animals. Price wonders if unresolved pain among women might have led to their higher levels of chronic pain.

The acknowledgement of sex differences in pain could stir up the field and lead to new advances. Amid the promise of “personalized” medicine, with drugs tailored to patients based on genetic sequencing, developing pain medicines for half the population seems like a no-brainer. “Now there’s a whole new frontier opening up in front of our eyes,” Price says.

Prescription Drug Discount Program

a close up of a sign: UnitedHealth Group saw profits up 28 percent over last year after their third quarter. © Kris Tripplaar/Sipa USA/TNS UnitedHealth Group saw profits up 28 percent over last year after their third quarter.

UnitedHealth Group said Tuesday it is expanding a program to provide consumer discounts at the pharmacy counter via rebates from drug manufacturers – the very rebates that have been labeled by the Trump administration as a driver of high medication costs.

Drug companies have long provided rebates to pharmaceutical benefit managers (PBMs) that administer the drug benefit portion of employer health plans. UnitedHealth Group, based in Minnetonka, Minn., runs the nation’s largest health insurer. It says these rebates in the past have been passed to employers so they could decide whether to direct the savings to individuals or use them against overall health plan costs.

Tuesday’s announcement means UnitedHealth Group starting in 2020 would extend the value of these rebates to more individual consumers, building on a program announced last year for a subset of employers that buy the company’s health insurance.

“We’ve seen some really compelling results,” said Daniel Schumacher, the chief operating officer at UnitedHealthcare, in comments Tuesday at the Barclays Global Healthcare Conference in Miami, Fla.

Consumers so far are seeing average savings of $130 per eligible prescription, Schumacher said, adding that the savings range from a couple of dollars to “one person who saved on a single prescription $4,400.”

UnitedHealth Group, which is Minnesota’s largest company, runs both the UnitedHealthcare health insurance carrier and a growing health services business called Optum. OptumRx is one of the nation’s largest PBMs. Pharmaceutical benefit managers negotiate prices with manufacturers, create formularies that specify coverage levels for different medicines and establish networks of pharmacies where health plan subscribers can fill prescriptions.

The company’s announcement comes about six weeks after the Trump administration proposed eliminating legal protections for rebates between drug companies and PBMs, saying manufacturers attribute rising drug prices to the growing demand from PBMs for rebates. Drug companies say insurers and PBMs have been pocketing too much of the rebate money, but the companies insist they pass along savings to consumers.

Asked during Tuesday’s investor conference about the Trump administration’s proposal, John Penshorn, a UnitedHealth Group senior vice president, said: “We’re concerned that this is potentially a windfall for pharma. We don’t think that was an intention of the proposed regulation, and we’ll provide comments to that extent.”

With Tuesday’s announcement, new business proposals beginning January 2020 at OptumRx and UnitedHealthcare would incorporate what are known as “point-of-sale” discounts to consumers who use medications as part of their plan design. While employers have had the option of adopting this approach for several years, UnitedHealth Group said it expects the change will accelerate adoption of point-of-sale discounts including in self-insured health plans run by large multistate employers.

Last year, UnitedHealth Group first announced the program, which took effect January 2019, for about 9 million people covered by fully-insured employer health plans. The expansion announced Tuesday includes an exception for current customers.

When consumers do not have a deductible or large out-of-pocket costs, medication adherence improves by between 4 and 16 percent, the insurer says. Pharmacy accounts for about 15 percent of the total premium for an employer, Schumacher said, adding that point-of-sale discounts have a “low single digit impact on 15 percent of the spend.”

The per-person savings “in combination with better medical adherence rates we think drives to a better overall health outcome,” Schumacher said.

Seema Verma, administrator of the Centers for Medicare and Medicaid Services, wrote Tuesday on the social media website Twitter that her agency applauded the move and UnitedHealth Group’s push “to increasing transparency in the convoluted market for prescription drugs.”

In January, the Trump administration proposed a rule that would encourage manufacturers to pass discounts directly to consumers, and create fixed fee service arrangements between drug companies and PBMs. The proposal was applauded by the trade group for drug companies, which argued patient co-payments and cost-sharing is often based on the list price of medications rather than the lower net price that factors savings from rebates.

“We need to ensure that the $150 billion in negotiated rebates and discounts are used to lower costs for patients at the pharmacy counter,” said Stephen J. Ubl, president of the Pharmaceutical Research and Manufacturers of America, in a statement. “This proposal would also help to fix the misaligned incentives in the system that currently result in insurers and pharmacy benefit managers (PBMs) favoring medicines with high list prices.”

Insurers countered that drug companies were trying to deflect attention from their high prices “by convincing Americans that health insurance providers and their PBM partners are the problem, acting as so-called ‘middlemen,'” said Matt Eyles, president of America’s Health Insurance Plans, in a statement.

“We are not middlemen – we are your bargaining power, working hard to negotiate lower prices with drugmakers,” Eyles said. “We cannot achieve those savings if our leverage and negotiating power is weakened through well-intentioned but misguided actions like this proposed rule.”

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Pharmacy In Edmond Features Special Department For New Moms

By Hospital Discount Pharmacy

Published: Sun, February 17, 2019 1:06 AM

Nothing is much more exciting than the arrival of a new baby, and one area pharmacy is extremely proud of a special new arrival, Edmond Baby.

Edmond Baby is a new department inside Hospital Discount Pharmacy, offering support to expectant moms and families with young children.

Located at Second and Bryant in Edmond across from the OU Medical Center, Hospital Discount Pharmacy has been a constant in the Edmond community for 45 years.

With six pharmacists on staff and technicians employed for more than 20 years, it is no surprise that Hospital Discount Pharmacy has many loyal customers that consider themselves to be part of a pharmacy family.

Edmond Baby provides pregnancy support resources, breastfeeding supplies like breast pump replacement parts, and specialty bottle feeding accessories.

Edmond Baby also has nursing bras, modesty covers, milk trays, teething toys, meal time products, as well as adorable gift items. One of the most popular products is the Legendairy Milk lactation supplement line.

These products are recommended by many local lactation consultants.

Pharmacist Courtney Lundeen is a new mother herself and has a passion for helping others transition into parenthood.

Pharmacy Discount Card Company Fined For Violations

Monday Feb 25, 2019 at 10:56 AM

TOPEKA – A pharmacy discount drug card company has been ordered to pay $10,000 for marketing prescription discount cards in Kansas without registering with the Secretary of State.

Acquire Health, a Delaware limited liability company, doing business as USA Medical Card, agreed to a consent judgment ordering it to pay $10,000 in fees for failing to register as required by law.

The judgment was approved this month by Judge Teresa L. Watson in Shawnee County District Court. In addition, Acquire Health, which is now registered with the state, was enjoined from further violations of the Kansas Consumer Protection Act.

The Attorney General’s Consumer Protection Division began investigating Acquire Health last year after receiving complaints from Kansas consumers about the company marketing prescription discount cards in Kansas.


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BLOG: CVS Stands Down In Walmart Pharmacy Battle

Remember part 1 of my series on why our medicines are so expensive for our patients? If you take the “way back machine” to the days before pharmacy benefit managers began to dominate the pharma landscape, buying a prescription was pretty much like buying anything else. Your pharmacy purchased a medicine from a wholesaler, marked it up, applied your insurance payment to whatever the price turned out to be and collected the remainder from you. Standard commerce in a market-based economy.

How quaint.

Once again, a quasi-public battle between two leviathans sheds light on how things really work. Late in 2018, Walmart informed CVS that it would no longer fill prescriptions covered by CVS Caremark, the huge PBM. It turns out that pharmacists have been turned into high-volume piece workers. Now, a PBM pays the pharmacy a fixed fee per prescription dispensed regardless of what it is or how much it costs. CVS and its PR hacks pushed the narrative that Walmart was demanding an increase in this per prescription fulfillment fee. Walmart countered with the reality that CVS was proposing a decrease in the fee.

We can all relate to Walmart’s wanting not to be asked to do the same work for less money. In the end, CVS blinked. CVS and Walmart kissed and made up. I now have a better understanding about how the business of selling prescription medications works. At the dispensary, it’s a high-volume/low-margin game, like a classic PBM v1.0. A PBM that owns or controls a pharmacy can play games by paying its own stores more per script than it pays competitors (note that nowhere in any story was the per prescription fee ever stated). I predict that this will be a factor when and if Congress or HHS takes aim at the PBM industry. You can shift PBM profits to the pharmacy side if you own one of each. (Note: Anthem has announced it will launch an in-house PBM. Will it buy a pharmacy chain, too?)

I also have a new appreciation for the life of a pharmacist on the front lines. If your boss only gets paid when a script is filled, you are probably evaluated by how many prescriptions you process to completion. Imagine the pressure. It makes me think of that classic I Love Lucy clip where Lucy and Ethel are working on the assembly line in a chocolate factory and the conveyor belt just keeps going faster and faster. In order to keep up, the ladies had to resort to eating the chocolates that they couldn’t process.

There’s a joke in there someplace, but I just feel too bad for the poor pharmacists to make it.

Disclosure: White reports he is a consultant to Allergan, Shire, Sun, Kala, Ocular Science, Rendia, TearLab, Eyevance and Omeros; is a speaker for Shire, Allergan, Omeros and Sun; and has an ownership interest in Ocular Science and Eyevance.


The Whole Paycheck Tracker: Walmart Vs. Amazon







There is a possibly apocryphal story of Amazon’s early days (around 2001) where Founder Jeff Bezos was invited to Bentonville, Arkansas to discuss the possibility of Walmart purchasing his still young – and, at this point, struggling – online bookstore. But Bezos really didn’t want to sell Amazon to Walmart; he wanted Walmart to outsource its still mostly nonexistent eCommerce business for Amazon to run on its platform.

Walmart executives politely declined, and the two firms went their separate ways.

Flash forward almost two decades, and Walmart and Amazon spend a lot of time thinking about each other – though the idea of Walmart purchasing Amazon has long since become somewhat comical. Amazon’s market cap is over $800 billion while Walmart’s is at $290 million, making one Amazon worth approximately 2.5 Walmarts.

Of course, that’s not an entirely fair comparison, since Amazon’s empire includes its massive AWS cash machine. But with its roughly 50 percent share of all online retail, its $13 billion acquisition of Whole Foods and the expansion of its cashless convenience stores, Amazon is a serious retail challenger.

And that includes the consumer’s share of wallet. As the latest updates to the PYMNTS Whole Paycheck Tracker indicate, Walmart continues to have the same difficulties in facing off against Amazon that have been the trend for the last five years: Walmart controls more of the consumers’ retail and total spend, but Amazon is rapidly eroding that lead with big gains.

By the numbers, Walmart commands 9.1 percent of the consumer’s total retail spend as of February 2019, compared to Amazon’s 6.4 percent – but flash back to 2014: Walmart controls the exact same share of retail spend as it did then, while Amazon’s share has grown by nearly 300 percent.

Share of total consumer spend, however, is perhaps a more sobering figure. Walmart holds the lead – by a slice – and Amazon’s rapid growth over the last five years suggests those lines will soon intersect.

But Walmart is certainly not settling into second place gracefully, nor is it about to give up much more of its market share than absolutely necessary.

Coming off its last earnings report, Walmart reported its strongest holiday earnings in a decade, with a total revenue increase of 1.9 percent. Walmart has recorded 18 quarters, or over four straight years, of comparable U.S. sales growth, unmatched by any other retailer. It also saw online revenue growth of 43 percent during the quarter, and 40 percent growth in its eCommerce sales on the whole for 2018.

The company credited that pickup to a broader assortment on its website, improved delivery services and increased use of store pickup for online grocery orders (grocery is Walmart’s biggest sales driver). The retailer also noted that digital grocery basket orders have been increasing: Curbside pickup will be at 3,100 stores by next January, and delivery will double to 1,600 stores.

Looking at the Whole Paycheck Tracker, food is one of the few categories where Walmart continues to hold a commanding lead on Amazon: 19.1 percent of the consumer spend as opposed to Amazon’s 1.9 percent. But it has only been 18 months since Amazon bought Whole Foods, and that number is on the uptick. Walmart’s share has remained relatively flat over the last four years.

Health and personal care comprise another area where Walmart leads, with over 5 percent of the market. But again, Amazon is growing fast and strong, from less than 1 percent four years ago to 2.2 percent today.

In short, the race is on – and it’s running on a variety of tracks, as each super-retailer battles to create an ecosystem that commands a larger share of the consumer’s whole paycheck. And because the news comes quickly – and often in large blocks – PYMNTS will keep you posted each week on how Amazon and Walmart are moving, and counter moving, to grow their share of retail and consumer spend. The numbers only change every quarter, but the updates on what they’re doing – well, that’s a daily thing.

And, as luck would have it, there is no shortage of things to cover for our inaugural edition.

Walmart pharmacy

The Big Move of the Week: Walmart Embraces POS Financing

Walmart has announced a new partnership with digital lender Affirm that will make Affirm’s POS underwriting services available as an alternative to cash and traditional credit at nearly 4,000 Walmart Supercenters nationwide. Customers will also be able to use the service online at The rollout will happen over the next several weeks.

“Walmart serves millions and has become a leader in the retail landscape with its commitment to help shoppers ‘save money and live better,’ which closely mirrors our own mission to improve lives with our products,” noted Affirm CEO Max Levchin. “I’m looking forward to introducing Walmart customers to a modern and innovative way to buy the things they need.”

Loans will range from $150 to $2,000, with terms of three, six or 12 months. To complete a purchase, consumers are offered a barcode that is scanned in-store by an associate.

As Levchin noted in an interview with PYMNTS, retailers report that consumers who use Affirm leave with a 75 percent greater basket size and enjoy site-wide conversion rates as much as 20 percent higher, with revenue-per-visitor lifts of more than 10 percent.

Product Play: Bring Up Premium Baby

Walmart will now be the exclusive retail partner of Hello Bello. Founded by actress Kristen Bell and her spouse, actor Dax Shepard, it is a line of premium baby care products developed for “value-oriented” parents.

“Parents shouldn’t have to choose between what’s good for their baby and good for their budget. That’s why we couldn’t ask for a better exclusive retail partner than Walmart, who is making it possible for us to offer premium products at a non-premium price,” Shepard noted.

The move comes as Walmart has been expanding its push into the baby product market, having revamped its baby department in over 2,000 of its stores and expanded its baby assortment by 30,000 items. It’s a move that follows the market: has seen searches for baby-related items jump by a whopping 40 percent, per reports at the time.

Logistics Look: Lowering Costs and Embracing Teamwork

Walmart has begun expanding the scope and capabilities of its private fleet, according to reports. Walmart officials say they are reassessing terms of contracts with third-party service providers, with an eye toward handling more deliveries in-house and converting part of its inbound highway freight to lower-cost rail shipping.

Currently, Walmart employs more than 8,000 drivers and uses its fleet of more than 6,400 tractors and 60,000 trailers to deliver goods to the vast majority of its 4,700 stores in the United States. As part of an attempt to lower transportation costs, over the past year, Walmart has replaced dedicated contract carriers at distribution centers in Lewiston, Maine; Gas City, Indiana; and, most recently, in Washington Court House, Ohio, displacing fleets operated by Prime Inc., US Xpress Inc. and Schneider National Inc., respectively.

Walmart is also one of a handful of retailers working with FedEx on an experimental robotic delivery effort. Testing of the project, which will deploy a robot for “last-mile” delivery efforts, will begin this summer, and will be supported by Walmart, Target and Pizza Hut, among others.

“The FedEx SameDay Bot represents the next chapter in our long legacy of delivering innovation and outstanding service, supported by an already existing FedEx logistics ecosystem,” said Brian Philips, president and CEO of FedEx Office. “The companies [that] have provided feedback on its potential use have been instrumental in ensuring we are looking toward the future of eCommerce.”

Unexpected Directions: Digital Ads and Natural Voice Processing

Walmart announced that it will consolidate advertising sales for its stores and websites as part of an effort to push profits from an untapped business. The push for digital advertising revenue puts the retailer into direct competition with most of the FANG, as Facebook, Amazon and Google are all major players.

According to the firm, Walmart suppliers looking to advertise will deal with one consolidated  inside team instead of a mix of different groups in the company and third-party digital ad space sellers. The move comes as rival Amazon is boosting profits by letting merchants pay for high placement in its search results. Its ad sales and other revenue jumped 95 percent to $3.4 billion in the fourth quarter.

During Walmart’s investor day last fall, Chief Executive Doug McMillon said its ad business was “tiny” and that “it could be bigger.”

“We have a unique opportunity to leverage our first-party shopping data from online and offline purchases to reach our customers and influence their purchase decisions,” Walmart Chief Merchandising Officer Steve Bratspies said in an interview.

In other slightly unexpected moves, Walmart announced it has acquired Aspectiva, the Israel-based startup focused on natural language processing capabilities. The financial terms of the deal have not been disclosed, but early details indicate that Aspectiva will join Walmart’s Store No. 8, which is the incubation unit it rolled out in 2017.

Walmart said the company’s technology will help it enhance the shopping experience across its channel. Aspectiva’s team joined the incubation as of this week and will continue operating in Tel Aviv.

According to Walmart’s Principal of Store No. 8 Lori Flees, Aspectiva’s technology in machine learning and natural language processing will have a “profound” impact on how customers shop in the future.


The Big Move: Prime Deliveries on Amazon Day

If you already have one day named for you – Prime Day, in Amazon’s case – why not go for two?

It’s logic pervasive to Amazon, which announced the launch of Amazon Day, a new delivery service that lets Prime members in the U.S. pick the day of delivery each week. With the new service, Amazon will group orders together and deliver them on the same day of the week – though if customers have a pressing need, they can also choose the two-day Prime shipping rate for specific items.

The move comes as part of the brand’s sustainability efforts to achieve Shipment Zero, its vision to make all Amazon shipments net zero carbon. By 2020, the retailer aims to make 50 percent of all shipments net zero.

“Prime members can now choose to get their orders delivered together in fewer boxes whenever possible on the day that works best for them,” said Maria Renz, vice president of delivery experience at Amazon. “We’ve been testing this program with a group of Prime members, and Amazon Day has already reduced packaging by tens of thousands of boxes – a number that will only continue to grow now that the program is available to Prime members nationwide.”

Once Prime members choose the day to have packages delivered, they can add orders to Amazon Day. All items arrive together on the chosen day.

Vertical Hopping: The Pharmacy Expansion Pushes Forward

Amazon has chosen Nader Kabbani to serve as the head of their emerging pharmacy business. Kabbani is a 14-year company veteran who was formerly the head of Amazon Flex. He will now go by the title “vice president of consumables, special projects.” Employees reporting to Kabbani include the team at PillPack, which Amazon acquired for more than $800 million in June 2018.

The move comes as Amazon is looking to make a move on the $600 billion per year market that pharmacy spending represents. The PillPack acquisition was considered a strong signal of Amazon’s intent, though the team has been relatively quiet since the deal. PillPack has, however, filed for several new pharmacy licenses, most of which are to secure clearance to ship drugs from its warehouse in Phoenix to customers.

Analysts have also identified additional licenses for operations in Washington, New Mexico and Indiana.

Stay tuned – they might not be keeping quiet much longer.

Logistics Look: The Coming Electric MegaFleet

Reports have emerged that “megafleets” of Amazon delivery vans and trucks are coming.

What is a “megafleet?” It’s a term to describe the tens of thousands of vehicles owned by certain companies like Amazon, which will be going electric.

According to a Morgan Stanley report, the eCommerce company’s goal of having half its delivery trips “carbon neutral” by 2030 will spark a buying spree of electric vans and trucks. While Amazon won’t be the only major company making such a move, Morgan Stanley said, it will be one of the bigger ones: “We think investors should prepare for more moves by megafleets to solve for sustainability.”

And, according to GreenBiz, early indications of Amazon’s moves in this direction are shown in a (relatively small) order that has already been placed for electric vehicles.

“Amazon does have at least one small public EV purchase order – 100 EV Mercedes-Benz Sprinter vans – that it plans to use in Germany,” GreenBiz said. “It might sound like a stretch for Amazon to make its own electric delivery fleet, but the company actually has made major leaps in cleaner logistics before. Amazon is one of the largest purchasers of fuel cell-powered forklifts for its warehouses, and it made a big investment in fuel cell maker Plug Power.”

Security Shore-Up: Keeping Counterfeiters in Check With AI

Amazon, which has long struggled with counterfeit products appearing on its site, is using artificial intelligence to fight the problem. On Thursday (Feb. 28), the company unveiled Project Zero, which it says will allow brands to take down counterfeit items on their own without Amazon’s help.

In addition, Amazon’s new product serialization service offers a unique code for every item, which brands place on products during the manufacturing process. When products with these special serial numbers are ordered, the company scans and verifies the authenticity of the purchase and can stop transactions for fake products.

Amazon has been testing the new offering with brands such as Vera Bradley, ThunderWorks and ChomChom Roller. So far, the system reportedly finds 100 times more suspected fakes than its previous process of relying on what brands report to the company.

The project is powered by AI, which constantly monitors the site and pulls down suspected fakes on the basis of data that companies provide to Amazon. That can include logos, trademarks and other important information about the brand, which the machine learning can then incorporate into its rules to better spot fakes.


Latest Insights:

Our data and analytics team has developed a number of creative methodologies and frameworks that measure and benchmark the innovation that’s reshaping the payments and commerce ecosystem. Check out our February 2019 Payments And The Platform Economy Report

Amazon, Consumer Spending, delivery, ecommerce, grocery, logistics, News, Pharmacy, POS financing, Retail, walmart, whole paycheck








Walmart Pharmacist With Palsy Wins $744K In ADA Trial

Law360 (March 7, 2019, 9:43 PM EST) — A Washington federal jury on Wednesday found that Walmart violated the Americans with Disabilities Act when it forced out a pharmacist with cerebral palsy and multiple sclerosis, awarding the pharmacist over…

Program Offering Professional Medical Assistant Training To High School Seniors Expanding To 12 O’ahu Schools

A program offering professional medical assistant training to high school seniors is now expanding to twelve public schools on Oahu.

Developed by Hawaii Pacific Health last year, students go through fifteen months of training, where they can then pass a national certification exam and score a job in the medical workforce straight out of high school.

The innovative program is the only of it’s kind in the U.S., and helps fill the huge demand for medical assistants in doctor’s offices and clinics in Hawaii.


Medical Assistant Program Offers Classroom Lessons With Hands-on Skills

Medical assistant students at the North Hawaii Education and Research Center in Honokaa were getting hands-on experience Saturday.

While some worked with medical dummies on the tables before lunch, another woman in scrubs took the blood pressure of a partner.

Saturday was a skills lab for a medical assistant course now being led by Island CPR at NHERC, a satellite location of the University of Hawaii at Hilo.

“There were discussions since 2017 about how to have some kind of medical assistant program happening here in North Hawaii because our health care partners had said there’s a need for it and a shortage of certain health care positions,” said NHERC Director Kei-Lin Cerf.

According to a news release from UH-Hilo, the course was developed in partnership with NHERC, Alu Like, Island CPR, Hamakua-Kohala Health and Bay Clinic’s Keaau Family Health and Dental Center.

Island CPR provides the training and NHERC contributes marketing, public relations and technology support.

“We wanted to be industry and employer informed,” Cerf said. “When putting the course together, in the past we were looking to hire a lecturer for the program, but when we also did a scan for who else was offering the program and where students might go instead of coming to our program, we found … Island CPR.”

After reaching out to Island CPR’s owner, Cerf said it made more sense to partner with the agency to provide the course work, than it was to find another lecturer and to compete.

Island CPR manager Crystal Hale said the company has been teaching the medical assistant course for two years “and the reason that we teach this course is because there’s a need. There is a large island wide and statewide need for medical assistants.”

Now offered for the first time at NHERC, the program offers a hybrid format and distance learning opportunities for students who live elsewhere on the island.

“We are a small company that has an office in Kona and Hilo and that isn’t necessarily the most ideal for people who live in Ka‘u or Honokaa,” Hale said.

When NHERC approached Island CPR about hosting the company to teach the curriculum, Hale said it was “such a wonderful experience” because they have interest from people from all over the island.

Alan Ku, NHERC’s testing and technology support specialist said that during the course the instructor is on site, and more than a dozen of the current cohort’s participants are in class and four participate by video conference on lecture days.

The four students who participate via video make the trek to Honokaa for the skills labs.

“It’s very intensive so the students can change their earning potential as fast as possible,” Cerf said. “… Island CPR’s really good in that they built these skill days so students are getting hands-on experiences. That’s the hybrid that we really wanted to understand how to do — how do you teach something that is a combination of hands-on and lecture-based and could you design it in a way where the students weren’t missing out on an experience because they were seeing it all through the computer. And I think Island CPR did a good job (with) that.”

To better facilitate the distance learning, NHERC purchased a 360-degree video conferencing camera that can see the entire room at once and also focuses on whoever is speaking.

Ku said it’s like someone from afar and a person in the room are “able to have this collaborative process, versus just hearing a voice in the back of the room while still looking at the teacher.”

“We don’t want the technology and the distance to put them at a disadvantage or for them to have a fraction of the experience that an in-person student would have,” Cerf said.

Allison Loy lives in Hawaiian Paradise Park and is one of program’s long-distance learners.

“It makes it a lot easier, obviously, because I’m so far away,” she said. “I wouldn’t have done it if they didn’t have the online option because coming here for four classes isn’t so bad, but coming for 10 would have just been miserable.”

Being such a rural island, Loy said she’s happy these kind of courses are even offered “because there is limited opportunity on the island for advancing your career, outside of the university.”

Loy attends UH-Hilo, where she was just accepted into the nursing program.

“This is going to help me (because) I’m trying to find a weekend job, then I can network and I can have that experience so that when I graduate, it won’t all be shocking,” she said.

Loy said the remote learning opportunity is also beneficial because she has a young son.

“I can semi-watch him or at least snuggle with him on breaks. … I’ve been kind of just a student and a stay-at-home mom so I haven’t been away from him for more than a few hours at a time.”

Student Cheryl Cabrera drives from Kohala to attend the class every Saturday.

“I wanted to take this course because of family history; I have a lot of family members with medical issues, and to further my education — maybe I can go out there and help someone else with the same medical conditions my family had and still is going through.”

A health assistant at Kohala High School, Cabrera said having the class available in Honokaa is easy and simple.

The instructors are “just awesome,” and having the classes in Honokaa “instead of us traveling (a) further distance” is good, she said.

According to Hale, the course covers patient check-ins, basic office skills, how to take vitals and how to perform electrocardiography tests, uninalysis, basic phlebotomy and injections, and assisting the provider in general.

Once students complete the 70-hour course, they are eligible to take the National Healthcareer Association’s certified clinical medical assistant exam.

The next 10-week course in Honokaa starts April 6.

Email Stephanie Salmons at


UEI College Brings Career Training & Education To Sacramento

SACRAMENTO, Calif., March 6, 2019 /PRNewswire/ — UEI College, a national provider of career education is now making hands-on training available to students in Sacramento and surrounding communities.

Hundreds of students started school in February to experience the welcoming and caring learning environment typical of UEI Colleges across many other cities.  Located at 4424 Florin Road in the Southgate Plaza, the new campus is well-equipped with industry standard equipment, hands-on training labs, bright classrooms, and many computer labs.

UEI College Brings Career Training & Education to Sacramento UEI College Brings Career Training & Education to Sacramento

The Sacramento campus will feature training for entry-level careers in healthcare, trades and business, with programs like Medical Assistant, Dental Assistant, Medical Billing & Insurance Coding, Automotive Technician, and Heating, Ventilation & Air Conditioning (HVAC). Students can earn a diploma, utilize the skills learned in class, and be ready to build their future in as few as 10 months for most programs.

Jim York, Campus President is grateful to be leading the UEI College campus in Sacramento. “It is such an honor to be an integral part of this beautiful Sacramento community.  When we located the campus here, I personally promised Sacramento County leaders that we would take good care of our students, and in turn, our students would enhance the community through providing stable, skilled, well-trained, certified contributors to the base.  Our mission is to drive personal and community transformation by empowering students to make a positive and enduring life change.  In short, we are paying it forward.”

We value our students and work hard to help them become proficient and experienced in their specific area of study. Our smaller classes do just that. To accommodate the busy lives of our students, we provide multiple class options during days and evenings for all program offerings.

At UEI College, our faculty and staff are committed to provide students the encouragement and support they need to succeed.  They want to make their campus community feel like home for students, employers of our graduates and the community at large.

Daniela, a Medical Assistant student, shares her first day experience at UEI College in Sacramento:

“It’s been a very long time since I was in school and I finally did it.  I am so excited to be here.  I want my family to be proud of me and what I’m doing.  When I arrived for the first day I was very emotional and nervous and didn’t know what to expect.  When my department was called our teacher led us to class for the first day.  I was very nervous and when we came around the corner the staff had formed a welcome line and were cheering, clapping and high fiving us.  It was so emotional and I cried happy tears.  I have found my way and it’s at UEI College Sacramento.  As our Director of Education pointed out, we are ‘First Class.'”

Find out more about the programs offered at UEI College’s new Sacramento campus. Contact us at 866.566.9295 or click here to visit us online.

UEI College Sacramento is accredited by the Accrediting Commission of Career Schools and Colleges (ACCSC). We provide timely short-term career education programs in high-demand marketplace verticals such as healthcare, business, technology, trades, transportation, and criminal justice. UEI College has campuses in many other cities in California including one in Stockton.

CONTACT:Cori Blas International Education Corporation


skyrocketing drug prices year one of the trump administration

More Drug Price Hearings This Week (and What’s Worth Tracking From Last Week)

By SARAH OWERMOHLE (; @owermohle), SARAH KARLIN-SMITH (; @SarahKarlin)

03/04/2019 12:00 PM EST

With help from Allie Bice, Dan Goldberg and Brianna Ehley


— Yes, there are more drug price hearings. Two more committees will delve in this week. We’ll tell you what you should know.

Story Continued Below

— And there are still questions from the last one. We highlight some of the top issues to track after seven executives went before Senate Finance.

— FDA warns a Canadian drug broker. CanaRx is happy to talk about how it organizes safe and legal shipments following FDA’s unique warning letter — raising questions about the limits of personal drug imports.

** A message from the Pharmaceutical Care Management Association: The proposed New York budget imposes so-called “transparency” mandates on pharmacy benefit managers (PBMs) that increases drug costs for New Yorkers. PBMs work for New York consumers to reduce drug costs. Make no mistake: the Governor’s proposal increases drug costs by undermining cost-saving tools. Learn more at **

Happy Monday and welcome back to Prescription PULSE, where we took some time this morning to read our eHealth colleague Darius Tahir’s story on Apple’s big PR push to make a case for its smart watches as life-saving heart monitors. Cardiologists are skeptical — what do you think? Send your morning pharma reads, news and tips to Sarah Owermohle ( or @owermohle) and Sarah Karlin-Smith ( or @SarahKarlin).

Drug Pricing

HEARINGS GALORE — The pharma CEOs have come and gone from the Hill, but the drug pricing conversation isn’t dying down anytime soon.

This week, two other committees will delve into the topic. The Senate Aging Committee will hold a two-day hearing on reducing drug prices, starting Wednesday with a panel of five patients who are struggling with the costs of medicines. On Thursday, the senators will hear from an array of health policy experts.

The House Ways and Means Health Subcommittee will hold a simultaneous hearing Thursday morning on promoting competition to lower Medicare drug prices. Three academics will be on the witness stand, along with Doug Holtz-Eakin, executive director of the American Action Forum, and Frederick Isasi, executive director of Families USA.

Don’t expect the same level of attention or fireworks as at the Senate Finance Committee last week, but the sheer number of hearings on the topic is significant. The key thing to watch for: if and when lawmakers move from exploratory hearings to actually debating legislation. Until then, it’s just more hot air in D.C.

OUTTAKES FROM THE SENATE FINANCE HEARING — A lot was packed into Tuesday’s nearly four-hour hearing with seven drug industry executives. Here are a few items we didn’t get to highlight earlier that are worth tracking going forward:

1. Is there a CREATES Act compromise? CEOs from Sanofi, Pfizer, and Merck all indicated at the hearing that they would support some version of the legislation, which aims to make it harder for brand-name companies to deny samples in order to block generic competition. Then, PhRMA CEO Stephen Ubl tweeted that the brand drug lobby had worked with the generic drug lobby, the Association for Accessible Medicines, on a modified version of the bill, S. 340 (116). The endorsements were surprising since the brand industry has spent years fighting CREATES and similar proposals.

PhRMA told POLITICO that the modified version of the bill that it could support would add additional patient safety protections and include safeguards against frivolous litigation — but declined to provide a copy of the full text. It is not the version that the Senate has already placed on its legislative calendar, teeing it up for a floor vote.

A potentially problematic twist: The generics‘ AAM group took issue with Ubl’s tweet, telling POLITICO the generic industry “does not support a diluted version of the CREATES Act.” The group said it supports the current Senate bill.

2. Is industry spending more on R&D than marketing? All seven executives told the Senate committee their companies spend more on research and development than they do on marketing. We were a bit surprised, having seen numerous reports through the years that indicate the opposite. Some of the reports are dated, like this 2008 study in PLOS Medicine that estimated companies spend almost twice as much on promotion as they do on R&D, or 2013 statistics from GlobalData showing that nine out of 10 large drug companies spent more on sales and marketing than on research and development.

It’s possible that company practices have changed over the years. But there are indications that might not always be the case. For example, AbbVie CEO Richard Gonzalez said his company has invested about $50 billion in developing new innovative medicines since 2013, but a Bloomberg Law review of the company’s SEC filings published Thursday found that it spent only about half that — $24.8 billion on R&D from 2013 to 2018.

There’s also a lot of disagreement about what expenses fairly belong in which category. About half of AbbVie’s R&D spend in 2018 ($5.1 billion), for example, was due to a fee it paid a company after AbbVie decided the drug it had acquired was no longer worth ongoing study or submission for FDA approval.

Other reports on the industry’s R&D investment have found that companies sometimes include spending for another company’s drug as an R&D expense, such as when as Pfizer paid $250 million in 2012 to obtain exclusive rights to over-the-counter Nexium from AstraZeneca, according to the Institute for Health and Socio-Economic Policy, the research arm of the California Nurses Association/National Nurses United.

3. Wyden gave the pharma execs some homework. Ranking member Ron Wyden (D-Ore.) asked all seven companies to put in writing within 10 days whether they would support legislation mandating that drugs’ list prices drop to amounts equal to current rebates if discounts are eliminated from both the public and private system. While all the executives committed during the hearing to lowering list prices, the big question is how low they are willing to go — and if any would back bills that actually required it. If prices don’t drop to current net levels post-rebates, payers and taxpayers could be on the hook for billions.

Wyden also told AbbVie’s Gonzalez to explain how executives’ bonus pay is linked to Humira sales. A Wyden spokesperson said formal letters will be sent to the companies this week.

4. Bipartisan agreement on patent problems — but not by the Trump administration. There was a lot of unity from Finance Committee Rs and Ds on tackling potential drug industry abuses of the patent system that may keep cheaper versions of medicines off the market. But testifying at a simultaneous Senate Judiciary Committee hearing on intellectual property was Vishal Amin, the White House’s IP enforcement coordinator. When Sen. Richard Blumenthal (D-Conn.) asked if he would commit to making it a priority “to prevent pharmaceutical companies from abusing patent laws,” Amin was noncommittal, saying he would “take it back” to the White House. Blumenthal tweeted a clip from the exchange.

But one administration official’s hesitancy to go after the issue may not be a huge setback — both HHS Secretary Alex Azar and FDA Commissioner Scott Gottlieb have expressed interest.

SENIORS OVERSPENT BILLIONS ON GENERIC DRUGS WITH PLAN CHANGES — Medicare Part D participants could have saved $15.7 billion if CMS’ proposed 2020 changes were in effect the last three years, according to an Avalere report sponsored by the Association for Accessible Medicines. While generics typically are placed on the lowest tier of insurers’ formularies, with the smallest co-pays, a 2017 change from CMS led plans to steadily push cheaper versions to higher tiers, the report stated.

CMS is looking to correct that trend in 2020, according to its advanced notice and call letter. Meanwhile, Avalere estimated that plans placed Part D-covered generics on the lowest tier only 14 percent of the time from 2016 to 2019. Read the full report here.

The 2020 Election. The new Congress. The Mueller investigation. … Keep up with POLITICO Playbook. Be in the know. Sign up today here.


FDA WARNS CANADIAN GROUP STRIKING DRUG IMPORT DEALS — The agency’s letter to CanaRx on Tuesday was not your typical warning to a company importing drugs. An FDA spokesperson said that by 2017, the Windsor, Ont.-based broker had contracts with more than 150 public and private employers in 35 states. That made its business — brokering deals with foreign physicians to write prescriptions and ship drugs to the U.S. — “particularly concerning” because patients trust their health plans to provide safe medicines, according to the letter. The agency wrote that CanaRx used the name to suggest it imported medicines from the tightly regulated Canadian market (along with the U.K. and Australia) but that they likely originated in other countries with less oversight. That may mean differing dosages and even counterfeit versions of FDA-approved drugs.

But CanaRx argued it’s within bounds on personal importation: Company attorney Joseph Morris told Prescription PULSE that it contracts with patients, not their employers, to ship medicines. Still, Morris said those various employer plans — now more than 500, he said — are fully aware of the contracts because they decide whether to cover the imports. So many employers end up promoting CanaRx to their staff themselves because of the expected savings.

At least two dozen Maine businesses use the broker, said Scott Wellman, CFO of Puritan Medical Products, a small business in the state that has contracted with CanaRx for14 years.

“We take this seriously,” Wellman said. “But in rereading it, I haven’t been able to find anything from the FDA letter that has actually occurred. It’s more that it could happen and they are trying to tell them to make sure that it doesn’t.” Puritan is alerting its employees but otherwise won’t stop covering CanaRx shipments: “All it would do is instantly cause a significant number of our employees to pay a lot more money for the same medication,” Wellman said.


ALEXANDER ASKS IF CDC OPIOID PRESCRIBING GUIDELINES SHOULD BE REVISED — Sen. Lamar Alexander (R-Tenn.) asked experts and officials from several states if CDC’s 2016 prescribing guidelines should be revised, noting reports of chronic-pain patients having difficulties accessing their pain medications. “We were careful in the bill that we worked on not to prescribe federal prescription limits or a number of other federal rules of how states dealt with the opioid epidemic,” he said during a Senate Appropriations panel on the opioid crisis. “We knew that could be a problem.”

This Week in Pharma

Wednesday-Thursday: FDA’s Vaccines and Related Biological Products Advisory Committee meets to recommend vaccines for the 2019-20 flu season (Wednesday) and consider the safety and effectiveness of Sanofi’s dengue tetravalent vaccine (Thursday).

Thursday-Friday: MACPAC holds public meetings on various issues.

Friday: FDA’s advisory Microbiology Devices Panel discusses new ways of evaluating medical devices that detect HPV.

The Advisory Commission on Childhood Vaccines hears updates on various agencies’ vaccine-related activities.

Pharma in the States

Pennsylvania auditor general takes on rebates — A new drug pricing report from state Auditor General Eugene DePasquale calls on the Legislature to require a flat fee for pharmacy benefit managers to administer drug claims instead of a rebate based on a percentage of list price. Rebates encourage manufacturers to artificially inflate prices in order to make up for federally mandated discounts they must give to state Medicaid programs, DePasquale said at press conference Wednesday. “I’m not calling for rebates to be discontinued,” he said, noting that they do save Medicaid money. “But for people with private insurance, rebates do not save money.”

Colorado to work on value-based drug deals — CMS granted Colorado’s request to negotiate drug prices paid by Medicaid based on a medication’s value and effectiveness. Oklahoma and Michigan have similar programs.

Pharma Worldwide

Generic lobby pushes back on patent database — A global patent database backed by the U.N. could “unnecessarily delay patient access to more affordable medicines,” an international lobby for generic and biosimilar manufacturers claimed last week. The database, a collaboration between the World Intellectual Property Organization and the branded drug industry, launched in September with a goal of helping procurement agencies “better understand the global patent status of medicines.” But the generics lobby is asserting the tool could “mislead” governments, preventing the sale of cheaper generic drugs, in part because pharma companies are responsible for uploading the information. More from POLITICO Europe’s Katie Jennings here.


Pelosi aide: Hill is ‘not trying to grind drug industry into the ground’ — Wendell Primus, senior health policy adviser to House Speaker Nancy Pelosi, said Washington’s efforts to lower drug prices are focused on some companies’ “excessive profits” and also seek to reduce the amount of time and money drugmakers spend on advertising and marketing, S&P Global’s Donna Young reports. Primus was speaking last week at a meeting of rare disease patient advocates. His tendency to avoid sharp rhetoric aimed at the industry may add to concerns already percolating among liberals that House Democratic leaders may move away from broad campaign promises to let the government negotiate prices in Medicare Part D and instead focus on narrower ideas like using an independent arbiter to set prices and targeting only a select group of high-cost medicines. Read the broader story from Sarah Karlin-Smith and Adam Cancryn earlier last month here.

Klobuchar defends her record on medical devices — Sen. Amy Klobuchar (D-Minn.) stands by her record regulating medical devices despite some experts’ claims that her proposals to accelerate FDA approval of medical devices and limit the number of questions the agency asks could harm consumers, according to an article by AP and the International Consortium of Investigative Journalists. The presidential hopeful has a reputation as a champion for consumer safety, but her support of the device industry — a huge employer and campaign contributor in Minnesota — complicates the issue.

Novartis wanted access to Trump administration, Cohen says — Michael Cohen, President Donald Trump’s former personal attorney, confirmed that Novartis wanted him to lobby the administration. “Novartis sent me their contract which stated specifically that they wanted me to lobby, that they wanted me to provide access to government including the president,” Cohen said during Wednesday’s House Oversight Committee hearing. Cohen’s claim contradicts Novartis’ narrative that the company wanted only insight on the administration’s health care policies in exchange for the $1.2 million contract, POLITICO reported last July.

Pharma Moves

Doug Andres starts today as a senior adviser for FDA Commissioner Scott Gottlieb, handling communications. Andres previously worked for former House Speaker Paul Ryan.

Roshan Navagamuwa will be CVS Health’s new chief information officer, according to The Wall Street Journal. He served as interim CIO for the past year.

Forbes Tate Partners added Merck, MilanaPharm, Sanofi and Verde Technologies as health care lobbying clients, according to POLITICO Influence.

Amy McKee, former deputy director of FDA’s Oncology Center for Excellence, joins Parexel as vice president, regulatory consulting services.

Teva hired lobbyists from Holland & Knight to lobby on drug pricing.


FDA’s Office of Pharmaceutical Quality published its 2018 annual report.

FDA’s Office of Generic Drugs published its 2018 annual report.

FDA issued draft guidance for industry on quality considerations for continuous manufacturing.

FDA issued draft guidance for industry on evaluating bulk drug substances for use in compounding.

FDA released draft guidance for industry on assessing the effects that foods have on drugs for investigational and new drug applications.

FDA, CDC and CMS announced the creation of a joint emergency diagnostics task force.

AdvaMed President and CEO Scott Whitaker commended the introduction of the Medical Innovation Never Stops Act, H.R. 1362 (116), intended to enable continuing medical device reviews by FDA during a government shutdown.

The Reagan-Udall Foundation for the FDA released a report on leveraging real-world data from expanded access protocols.

Sixteen advocacy groups sent a letter to Pelosi, Ways and Means Chairman Richard Neal (D-Mass.) and Energy and Commerce Chairman Frank Pallone (D-N.J.) urging Congress to pursue easier-to-pass incremental legislation on lowering drug prices while also developing a bold and comprehensive plan for the future.

Catching Our Attention

Tech startup finds central role with FDA — The heath data company Flatiron is deepening its relationship with the FDA just as the agency alludes to opening the door to allowing more real-world evidence in new drug submissions. Stat’s Matthew Herper reports that FDA and Flatiron, which focuses on harnessing real-world data to guide clinical research, have renewed and expanded an agreement to explore how that evidence can be used. The company is expected to announce the agreement today, just days after Gottlieb told the House Appropriations Committee that the FDA would update its clinical evidence guidelines for the first time in 20 years to include more real-world data. It’s also just weeks after Flatiron Chief Medical Officer Amy Abernethy left to become Gottlieb’s principal deputy commissioner.

** A message from the Pharmaceutical Care Management Association: The core mission of PBMs is to be the primary advocate for consumers and health plans in the fight to keep prescription drugs accessible and affordable. PBMs negotiate on behalf of consumers, and are able to keep a lid on prescription drug costs with market-based tools that encourage competition among drugmakers and drugstores, and incentivize consumers to take the most cost-effective and clinically appropriate medication. Learn more at **   skyrocketing drug prices year one of the trump administration


Anti-Obesity Prescription Drugs Market Improvised Report Of The Forecast 2019 To 2028

Mar 04, 2019 (WiredRelease via COMTEX) — The impactful research study of the Anti-Obesity Prescription Drugs Market which represents magnitude, position, and prediction of 2019-2028 market. This report provides detailed and useful information about Anti-Obesity Prescription Drugs Market type, key players, techniques, applications, and regions.

Obesity is a medical condition in which excess body fat get saturated into human body to the level that it may have adverse impact on health. Obesity results from a combination of causes and individual factors such as behaviour and genetics. Behaviours can include dietary patterns, limited physical activity, medication use, and other exposures. Body Mass Index (BMI) is a method used for measuring obesity among people. The body mass index (BMI) is a statistical measurement derived by using basic variables such as height and weight of a person. World Health Organization (WHO) defines obesity for adult who have a BMI greater than or equal to 30 and children, ages 5-19 years, at or above the 85th percentile on the CDC growth charts. Anti-obesity drugs contain certain pharmacological ingredient intended to reduce or control weight.

The report reflects on various elements to inspect the international Anti-Obesity Prescription Drugs Market to 2028, inclusive of evolution in concern with Anti-Obesity Prescription Drugs Market products; technology growth in this sector; accounts of pioneering market competitors and providers; current evolving activities in the Anti-Obesity Prescription Drugs Market. Additionally, it also provides information related to international Anti-Obesity Prescription Drugs Market actual drivers, prudence, provocations, arising markets, pricing framework, current trends and industrial strategies around the world that will influence this particular market business in upcoming days.

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Leading Players Of Anti-Obesity Prescription Drugs Market Are:

Bristol-Myers Squibb Co., Takeda Pharmaceutical., Eisai Company., GlaxoSmithKline plc., Pfizer Inc, Shionogi USA Inc, Vivus Inc, Zafgen Inc, Norgine bv, Boehringer Ingelheim GmbH.

Global Anti-Obesity Prescription Drugs Market Segmentation:

Global anti-obesity prescription drugs market segmentation by mechanism of action:Incretin mimetics/GLP-1 agonistsSNDRIsLipase inhibitorsSerotonin receptor agonistsSympathomimetic-GABA receptor agonistsSympathomimeticsOthers (human Glucagon-like peptide-1 analog, inhibitors of dopamine & noradrenalin etc.)

Global anti-obesity prescription drugs market segmentation by target site:Peripherally acting anti-obesity drugsCentrally acting anti-obesity drugs

Global anti-obesity prescription drugs market segmentation, by therapy:MonotherapiesPolytherapies

Global anti-obesity prescription drugs market segmentation, by end user:HospitalClinicsPharmacies

Anti-Obesity Prescription Drugs Market phase by Regions/Countries:

Southeast Asia, Central, and South America, India, Europe, US, China, Japan

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Prescription Drug Pricing Hearing: Is The Senate Probing In The Wrong Place?

prescription drugsKen Frazier, chairman and chief executive officer of Merck & Co., second right, testifies during a Senate Finance Committee hearing on drug pricing on Capitol Hill in Washington, D.C., U.S., on Tuesday, Feb. 26, 2019. Top executives from seven of the world’s biggest drug companies were testifying before Congress to talk about drug costs. Photographer: Zach Gibson/Bloomberg© 2019 Bloomberg Finance LP

The media has constructed a straw man of sorts when repeating the mantra of the “relentless rise of prescription drug prices.” That growth has not been so relentless in recent years. This is due in large part to the increased pressure on net prices as a result of rebates. So while list prices exhibit an inexorable rise, net prices have stagnated during the last few years.

Last week, during a Senate hearing on prescription drug prices, chief executives from seven large pharmaceutical firms each offered arguments in defense of the ways in which they set prices, citing the fact that high rebates nullified for the most part the increases in list prices. The executives hammered home the point that net price increases have become stagnant due to the growing gross to net bubble.

However, the recent proliferation of high deductible health plans has led to patients paying a larger share of prescription drug costs. And while rebates are lowering the cost of drugs paid for by health plans, pharmacy benefit managers, and employer sponsors of health insurance, rebates aren’t helping patients; at least not as far as their out-of-pocket spending is concerned, as co-insurance is usually calculated on the basis of list and not net prices.

Naturally, for politicians their constituents’ out-of-pocket spending is what matters most. If constituents cannot afford prescription drugs – whether because they’re uninsured, under-insured, or insured with substantial co-payments – the public outcry will be aimed at the drug companies for “high prices.”

In addition, what grabs media attention and therefore the eye balls of constituents are the high prices of a number of recently approved drugs and therapies when introduced to the market. It is perhaps unfortunate that during the Senate hearing little mention was made by the chief executives of the high prices of certain newly approved treatments; for example, new cancer drugs, rare disease products, and gene therapies, for which rebates play less of a role, and whose launch prices are not considered price increases yet contribute, albeit modestly, to driving up drug expenditures.

This said, not one of the executives favored the status quo. There was consensus that something must be done about improving the functioning of the prescription drug marketplace by way of more robust generic and biosimilar competition, better patient affordability, and revamping the notoriously opaque rebate system. On rebates, Pfizer chief executive Albert Bourla claimed that “none of the close to $12 billion in rebates that Pfizer paid in 2018 found their way to American patients.” Bourla appeared to be the most committed to sweeping changes, not only related to the rebate system (making it more transparent and ensuring pass-through to patients), but also promotion of biosimilars, and alignment of price and value. Bourla asserted that drug makers should be paid in proportion to the value of their medicines. He used several concrete examples of value-based pricing, such as being “paid based on the number of strokes prevented or the number of cancer patients who go into full remission, rather than the number of pills sold.”

It’s refreshing to not only hear the common refrain that prices reflect the amount being spent on research and development in a highly risky venture, but that there also needs to be a nexus between price and value in order for the system to be sustainable going forward.

prescription drugs
Various medicine pills and capsules in plastic container

As mentioned in a previous article value-based pricing is more promise than reality at this point. In order for value-based pricing to happen on a large scale policy must change on many levels, from making it easier to apply for exemptions from Medicaid’s best price requirement, to the sharing of risk and the cost of maintaining patient registries and collecting data. Regarding the latter, placing all the onus on the payer or the drug maker to fund post-marketing studies is not reasonable when the risks and benefits from such studies accrue to both stakeholders.

To be constructive the Senate should not only probe the pricing of prescription drugs by pharmaceutical manufacturers, it should also investigate the billing and pricing practices of hospitals, physicians, and insurers. Ultimately the problems related to the relentless rise of overall healthcare costs are not going to be solved by putting blinders on and solely targeting the pharmaceutical industry.

Drug Middlemen Got Big Markup In New York, Pharmacists Say

New York PharmacistsPharmacy-benefit managers are taking increasingly large markups on generic drugs in New York, according to an analysis of Medicaid prescriptions at independent pharmacies in the state.

In Medicaid, private insurers are paid by the state to cover low-income citizens. The insurers in turn usually contract with pharmacy-benefit managers, or PBMs, paying them to provide drug coverage. PBMs run by CVS Health Corp., Cigna Corp. and UnitedHealth Group Inc. then bill insurers for coverage, and reimburse pharmacies for drugs.

For years, small pharmacy owners have been complaining that PBMs have been shortchanging them, cutting to unsustainable amounts the reimbursement they get for dispensing prescriptions to millions of Americans. Drugstores have also claimed that PBMs are charging larger per-prescription amounts to their insurer and employer clients — and sometimes pocketing the difference.

A Bloomberg analysis this year of 90 frequently prescribed generic drugs in Medicaid managed-care plans in 31 states found wide variations in reimbursement and drug cost from state to state. In some states, Medicaid plans appear to be getting a good deal, Bloomberg reported earlier this year. In others, plans pay markups of threefold or more on some treatments, the Bloomberg analysis found. But Bloomberg’s analysis couldn’t tell how much of the markup was going to PBMs and other middlemen, versus how much was going to pharmacies.

The new analysis sponsored by the Pharmacists Society of the State of New York is one of the first efforts to quantify that spread in private Medicaid plans that cover about 4.3 million New York state residents. The state society has been a critic of the PBM industry and represents pharmacy owners upset over declining reimbursements.

In 2017, PBMs paid independent New York pharmacies in the analysis an average of $10.85 per generic-drug prescription. Private health plans that provide state-financed Medicaid coverage reported a cost of $14.34 per prescription. That represents a markup of 32 percent over what pharmacies were paid. The markups by PBMs more than doubled from 2016, according to the analysis.

Drug costs have become a major national issue for patients and politicians. Along with scrutiny of pharmaceutical companies that manufacture drugs, distributors, insurance companies and middlemen like PBMs have attracted attention for their role in health costs. State officials, in particular, have looked at how PBMs function in Medicaid, which relies on getting low prices to cover as many low-income people as possible.

Middlemen “are taking an increasing share of the margin on generic drugs” in New York, said Eric Pachman, a consultant at 3 Axis Advisors and former pharmacy executive who conducted the study. While PBMs often keep the spread on generic drugs, the analysis can’t rule out that some of the spread was shared by PBMs with their health plans clients, Pachman said.

The Pharmaceutical Care Management Association, a trade group representing PBMs, said that drugstores are overpaid in the New York Medicaid program.New York Pharmacists

New York’s Medicaid program wastes millions every year by overpaying drugstores,” said Charles Cote, a spokesman for the group. “By defending wasteful spending in a program that’s clearly in trouble, New York’s special interest drugstore lobby wants to rearrange deck chairs on the Titanic without offering ways to keep Medicaid afloat.”

PBMs, including CVS’s Caremark unit and Cigna’s Express Scripts unit, have said that spread pricing adds stability and predictability to drug costs for their clients. Health plans freely choose the spread arrangements over other fee-based options, they have said.

PBMs’ health-plan clients “are highly sophisticated purchasers” that negotiate exactly the type of contract they want, Cote said. Rates paid to pharmacies are designed to incentivize drugstores to manage their generic-drug inventory so PBM clients don’t overpay, he said.

The society’s analysis looked at payment data from 11 independent pharmacies around New York State, which included claims paid by 17 different private Medicaid plans. Those data were compared to a federal database of Medicaid spending. While the results are likely to be similar at other independent pharmacies, they don’t include data from large chains that may have more bargaining power, said Pachman.

The New York analysis follows a report by Ohio that also dug into the practice in great detail. The full Ohio report hasn’t been released publicly.

On Jan. 20, the Columbus Dispatch reported that an unredacted version of the Ohio report showed that CVS had been paying some large competitors, including Walmart Inc., far less than it was paying its own pharmacies in Ohio’s Medicaid managed care program.

CVS oversees drug benefits for about 94 million people in the U.S., while also operating about 9,800 pharmacies. CVS declined to comment on the New York report.

OptumRx, the third big drug benefit manager, is a unit of insurer UnitedHealth Group Inc.

CVS Pharmacy Unveils New Beauty Aisles Reflecting Significant Progress In Commitment To Transparency And New Standards For Beauty Imagery

Nearly 70 percent of Beauty imagery in CVS Pharmacy locations nationwide will be CVS Beauty Mark compliant1

Key national brand partners including Neutrogena, COVERGIRL, Olay and Revlon embrace unaltered beauty for new 2019 Campaigns

WOONSOCKET, R.I., Jan. 24, 2019 /PRNewswire/ — CVS Pharmacy, the retail division of CVS Health (CVS), today announced significant progress toward the goal of full transparency for all of its beauty imagery by the end of 2020 and its efforts to create new industry standards for post-production alterations of beauty imagery.  Just one year after the Company made the commitment to create new standards for post-production alterations of beauty imagery, nearly 70 percent of beauty imagery in CVS Pharmacy locations nationwide will be CVS Beauty Mark compliant.

Original Image with CVS Beauty Mark

CVS Pharmacy

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Original Image with CVS Beauty Mark


First announced in January 2018, the CVS Beauty Mark initiative was introduced to lead positive change around transparency in beauty in order to educate customers on the difference between authentic and digitally altered imagery.

At an event at the CVS Pharmacy in Times Square today, the Company revealed the first look at its updated beauty aisles and celebrated the leadership of the brand partners that joined in the effort over the past year to strive for transparency for beauty imagery. CVS Executives were joined by key brand partner executives at the event and by COVERGIRL Ayesha Curry, who appears digitally unaltered in a campaign image for COVERGIRL Outlast Lipstick.  Additionally, Neutrogena Brand Ambassador, Kerry Washington, and Revlon Brand Ambassador, Ashley Graham, as well as other influential brand ambassadors also appear digitally unaltered in their images as part of their respective new campaigns.

“As a purpose-led health care company as well as the second largest beauty retailer in the country, we want the millions of customers that visit CVS Pharmacy locations each day to see a more authentic and diverse representation of beauty,” said Kevin Hourican, president of CVS Pharmacy.  “We applaud the brand partners that truly embraced this initiative and helped us in taking significant steps forward in our effort to change an industry standard that has an impact on the health and self-esteem of our mutual customers.”

Brand partners throughout the beauty industry that have made the commitment to work together to reach the goal of full beauty imagery transparency by the end of 2020 include Neutrogena, COVERGIRL, Revlon, Olay, Almay, Aveeno, Rimmel, JOAH, L’Oreal, Maybelline, Unilever, Burt’s Bees and  Physician’s Formula.

In addition to the beauty imagery in CVS Pharmacy locations, all beauty imagery, including brand partner imagery, used on, and in all marketing to customers, including on social media and for external advertising and promotions, reflects the CVS Beauty Mark commitment.  These channels reach more than 100 million consumers each year. In addition, CVS Pharmacy has instituted a contractual requirement for all of its beauty influencer partners to create and share only imagery that has not been digitally altered and does not use social filters.

“From TV to social media to walking retail aisles searching for a beauty product, Americans, particularly young women, are influenced by media portraying an unrealistic representation of beauty, leading to negative feelings about their own appearance,” said Dr. Tochi Iroku-Malize, a practicing family physician in Bay Shore, New York, and member of the American Academy of Family Physicians Board of Directors. “Research shows that exposure to altered media is linked to poor self-image, and that dissatisfaction can lead to critical health concerns. Working to reduce altered imagery from beauty campaigns and addressing this issue at the point of purchase is a great first step to improve how young people feel about their appearance.”

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CVS Pharmacy is proud to support Girls Inc. in their mission to help all girls become strong, smart and bold in celebration of the CVS Beauty Mark initiative.  During select weeks in February, with the purchase of select Johnson & Johnson, Procter & Gamble and L’Oreal beauty products, a $1 donation will be made to Girls Inc., up to $300,000 collectively for the entire promotion period.  Learn complete promotion details, including offer periods and participating products at

 “The mission of Girls Inc. is to inspire all girls to be strong, smart and bold. Foundational to this work is ensuring girls have the skills and knowledge to critically analyze the messages and images they receive daily and reinforcing the importance of valuing their whole selves. The commitment CVS Pharmacy has made through the Beauty Mark initiative aligns perfectly to our mission and sends a powerfully positive message to girls that beauty comes in all forms and is a reflection of every part of who they are and what makes them unique,” said Judy Vredenburgh, Girls Inc., president and CEO.

CVS Pharmacy also partnered with lifestyle experts Sara and Erin Foster to create a limited-edition t-shirt that celebrates unaltered imagery and the CVS Beauty Mark. The Sara & Erin x CVS “Sans Retouching” t-shirt will be available for purchase on beginning January 24, 2019 with 100% of the proceeds also supporting Girls Inc.

To raise awareness about the CVS Beauty Mark and the importance of a more authentic and transparent beauty imagery standard, CVS Pharmacy is encouraging consumers to post an unfiltered and unaltered picture of themselves on their social media channels with the hashtag #beautyunaltered.

CVS Health has previously made significant changes in its retail stores with the health of its customers in mind, such as ending the sale of tobacco products, delivering healthier food options throughout CVS Pharmacy stores and committing to remove parabens, phthalates and the most prevalent formaldehyde donors from our store brand beauty and personal care items by the end of this year.

To learn more about CVS Pharmacy’s beauty imagery initiative, visit

About CVS Pharmacy: CVS Pharmacy, the retail division of CVS Health (CVS), is America’s leading retail pharmacy with over 9,800 locations. It is the first national pharmacy to end the sale of tobacco and the first pharmacy in the nation to receive the Community Pharmacy accreditation from URAC, the leading health care accreditation organization that establishes quality standards for the health care industry. CVS Pharmacy is reinventing pharmacy to help people on their path to better health by providing the most accessible and personalized expertise, both in its stores and online at General information about CVS Pharmacy is available at

1 Beauty Mark compliant means that all beauty imagery either features the CVS Beauty Mark watermark, highlighting that it has not been materially altered, or the image is clearly labeled “digitally altered.”

Media Contact: Erin Pensa/CVS Pharmacy/401.770.4786/

Kerry Washington in a Neutrogena Ad Featuring the CVS Beauty Mark

CVS Pharmacy

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Kerry Washington in a Neutrogena Ad Featuring the CVS Beauty Mark

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Digitally Altered Image

More CVS Pharmacy Logo

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