By attending the program, you should be able to:

• Discuss the fundamentals of drug reimbursement across different types of payers including Medicare, Medicaid, and private insurance
• Explain how coverage, coding, and payment work for products managed under the pharmacy benefit versus products managed under the medical benefit
• Recognize key stakeholders along the drug delivery pathway, from manufacturer to patient, and see how products and dollars flow within the system

Activity type: Knowledge-based (K); Audience: Pharmacists (P); CEUs: 0.075

By attending this program, you should be able to 

• Understand how companies are navigating healthcare issues in an deficit reduction environment
• Discuss Congressional and political dynamics of health policy
• Explain the latest on healthcare reform implementation
• Describe the leading issues for PBMS – transparency, FDA and PDUFA legislation, regulatory changes, and pressures for access to generics

Activity type: Knowledge-based (K); Audience: Pharmacists (P); CEUs: 0.075

This session will provide a broad overview of the operational challenges facing full-line specialty pharmacies. 

By attending the program, you should be able to:

• Describe how SP works to meet the requirements of bio/pharma manufacturers – HUBS, REMS programs and limited distribution networks,
• Outline the benefit verification process,
• Discuss how an appropriate return on investment for compliance and persistence programs is determined,
• Explain the increasing role of co-pay assistance programs in specialty pharmacy.

Activity type: Knowledge-based (K); Audience: Pharmacists (P); CEUs: 0.075

By attending the program, you should be able to:

• Indicate why manufacturers contract with PBMs
• Discuss the benefits of being “on-Formulary”
• Explain how formularies are developed
• State other factors and legal considerations in Pharma contracting

Activity type: Knowledge-based (K); Audience: Pharmacists (P); CEUs: 0.075

• Industry consolidation and diversification – How they will change the business landscape  
• Pharma innovation is cycling upward, and will result in a multitude of exciting new products
• Specialty and biotech drugs – How the new class of drugs will create opportunity, force change, and challenge all aspects of the drug supply chain
• Industry hot topics – copay coupon programs, diagnostics, and much more

• What is the current versus future state of REMS in the market?
• What are the challenges of ensuring patient safety without delaying or compromising access?
• impact on generics/ biosimilars

By attending the program, you should be able to:

• Describe how various payers and providers are moving away from average wholesale price (AWP)- based reimbursement to new payment metrics
• Explain the potential reimbursement scenarios across key payers for biosimilars when they come to market
• Identify trends in Medicaid reimbursement, as program enrollment is set to expand, and States face increased financial strain

Activity type: Knowledge-based (K); Audience: Pharmacists (P); CEUs: 0.075

By attending the program, you should be able to:

• Describe the history of P&T's
• Define the roles and responsibilities of P&T's
• Explain the composition of P&T's
• Describe the drug evaluation process
• Explain the decision making of P&T’s

Activity type: Knowledge-based (K); Audience: Pharmacists (P); CEUs: 0.075

• Comparative Effectiveness Research: it will happen with you or to you; which do you prefer?
• Collaborations/Partnerships:  is this an opportunity for your company? 
• CER:  it isn’t limited to pharmaceutical products.
• Why does CER matter to the end user – the patient?

As the pharmaceutical industry continues to evolve through health care reform and other market forces, PBMs are at the cusp of a new role in this new world. What hasn’t changed, at least for some, is the importance of health plan and PBM initiatives to improve all aspects of patient care. Prime CEO Eric Elliott will address the critical role health plan-PBM integration will play in the emerging market, especially with respect to the growing importance of specialty pharmaceuticals. He will discuss:  

• What are the roles of the PBM and health plan in Prime’s integration model?
• How should a health plan and PBM share the responsibility for physician and consumer education?
• What are their respective roles, responsibilities, and how is success/failure monitored and responded to?

By attending the program, you should be able to:

• Describe the trend, extent, and future of medical pharmacy
• List current and future quality and cost of care medical pharmacy management opportunities
• Develop a quality and cost of care management strategy to address medical pharmacy
• Measure meaningful changes in medical pharmacy quality of care and cost over time.

Activity type: Knowledge-based (K); Audience: Pharmacists (P); CEUs: 0.075

• Governments potential influence on reimbursement and contracting across the board
• Outcomes based contracting or simply an alternative reimbursement methodology
• What about comparative effectiveness?

What payers want to purchase from their PBM is not always consistent with what the PBM has to offer.  Differences abound – mostly in philosophical approach to treating patients.  What will be covered is:

• The US pharmaceutical market from a payer perspective
• Innovative  contracting practices
• The employers’ current perspective on providing employer based health care benefits

By attending the program, you should be able to:

• Explain the drivers of specialty drug trend
• Understand current specialty drug pricing practices
• Consider alternative strategies for pricing of specialty drugs

Biosimilars will soon be moving into a period where we can stop talking about them purely in the abstract, and we will begin seeing them as a reality in the marketplace.  This session will explore current issues facing biosimilars, and will touch on the strategies and factors that are likely to determine their success or failure.

The PBM Industry has seen and developed multiple business models over the last two decades.  This session will take an in depth look at where the industry has been, and where it has evolved to through unique mergers and acquisition strategies.   What PBM core competencies were two decades ago, are not the same competencies for the business models today.  This session will explain the complexities of the business drivers of the multiple PBM business models of today and the future.

• Patent Cliff Dynamics
• Globalization
• Government Regulation
• Biosimilars
• Product Shortages

• Current Market Trends
• Patent Cliff
• Innovation Outlook
• Specialty and Biosimilars
• Future Outlook

• Discuss the primary pillars of PBM value from a net ingredient cost/rx perspective
• Discuss how pharmacy utilization is a significant driver of both total health costs and clinical outcomes
• Learn new ways of thinking about how pharmacy utilization can be managed from a total cost of care perspective

By attending the program, you should be able to:

• Determine who and what is driving outcome cost models
• Understand current and future market dynamics
• Recognize the key therapeutic conditions where outcomes programs are effective
• Review examples of program results
• Understand how system integration and aligned processes leverage and contribute to meaningful outcome results
• Project how payers may apply specialty total health outcome information to drug and medical benefit design strategies

Activity type: Knowledge-based (K); Audience: Pharmacists (P); CEUs: 0.075

• Overview of the Pharma Pipeline highlighting 2011 introductions
• key events and introductions expected in 2012
• the rationale for needing this information
• Additional Focus on the following
  • New brand and generic drugs on the horizon
  • Specialty drugs
  • Opportunities in 2012 and beyond 
  • Why PBMs/MCOs need this information

By attending the program, you should be able to:

• Recognize the various types of HUBs in the markteplace
• Explain current trends in HUB management
• Describe HUB integration rational

Activity type: Knowledge-based (K); Audience: Pharmacists (P); CEUs: 0.075

By attending the program, you should be able to:

• Provide an overview of current market dynamics
• Discuss opinions and views from different market segments
• Address leading perceptions in the market
• Evaluate the potential and current responses

Activity type: Knowledge-based (K); Audience: Pharmacists (P); CEUs: 0.075

By attending this session you should be able to:

• Discuss how payers are moving UM strategies to the medical benefit
• Explain how formulary development in an integrated model works
• Understand technology's effect on clinical programs
• Detail the investigational/experimental uses of FDA approved drugs and programs to support / monitor use

Activity type: Knowledge-based (K); Audience: Pharmacists (P); CEUs: 0.075