Conference Information


Managed Markets Educational Forum 2013

Feb 4, 2013 - Feb 6, 2013
The Westin Beach Resort & Spa
Fort Lauderdale, FL

Conference Overview
Who Should Attend
Featured Speakers
Registration Information
Hotel Information
Conference Agenda
Additional Information

Conference Overview

PCMA’s Managed Markets Educational Forum (MMEF) is an educational and trainingconference geared specifically towards professionals ofall levels within pharma managed markets or marketaccess divisions. However, many others looking to improve their knowledge of the PBM industry attend this event. Session speakers are the most highlyregarded senior executives from PBM, specialtypharmacy, and payer organizations.

The MMEF includestwo session tracks. The “Professional Track” focuseson industry fundamentals. This track is designed formid-level managed markets staff, and/or those whose corejob function may not involve direct interaction with thePBM and specialty pharmacy sector. Those who attendthese sessions will greatly improve their understandingand grasp of the industry fundamentals. The “Executive Track”covers more complex and advanced strategic PBMindustry topics that are relevant and actionable to seniormanaged market executives.

 

Who Should Attend

Pharma and Biotech Industry

  • Managed Markets - Market Access - Managed Care
    • Account and marketing VPs
    • National account managers and directors
    • Regional account managers and directors
    • Employer, payer, and corporate account managers and directors
  • Sales and marketing teams
  • Pricing, contracting, and reimbursement professionals
  • Health economic outcomes and data professionals
  • Pharmacy and medical officers and directors
  • Healthcare quality or innovation professionals
  • All others doing business in the PBM and specialty pharmacy space

Featured Speakers

Registration Information

REGISTER NOW!

  • There are no restrictions on the number of types of individuals who may attend this event.
  • Companies may register as many individuals for this event as they wish.
  • Anyone entering PCMA or sponsor-designated meeting space during the event dates/times MUST be registered and wearing a badge.
  • Registration cancellations will be accepted up to 14-days prior to the start of the conference and a full refund will be issued. If a registration is canceled within 14-days of the start of the conference, PCMA cannot refund the registration.

REGISTRATION FEES:

Category

Fee

PCMA Members (PBMs)

$1,695

PCMA Affiliates

$1,695

Non-members/Non-affiliates

$2,495

If you have questions regarding registration, please contact Erin Bamrick at ebamrick@pcmanet.org, or by phone 202-207-3610.

Hotel Information

The Westin Beach Resort & Spa
321 North Fort Lauderdale Beach Boulevard
Fort Lauderdale, FL 33304
Hotel Website

Room reservations can be made online or by calling the resort directly at (888) 627-7108. The cut-off date for making reservations is January 11, 2013. Room rate and availability cannot be guaranteed after this date. Attendees should reference Pharmaceutical Care Management Association (PCMA) to receive the negotiated group rate of $259. Attendees are highly encouraged to make lodging arrangements as soon as possible.

In order to reserve a room at the host hotel, you must be registered for the MMEF. Any hotel reservation made in the PCMA room block without pre-registering for the conference will be cancelled.

*Please note that registration fees do NOT include hotel. 

Group Room Rate
Run of House    $259

PLEASE NOTE: Your conference registration does not guarantee hotel availability. 

IMPORTANT: A two-night minimum will be required for each reservation of two nights or more. A deposit equal to two night's stay is required to hold each guest's reservation. Such deposit confirms the reservation for the dates indicated and upon check-in will be applied to the first and second night of the reserved stay. These deposits are refundable only if notice is received at least (14) days prior to arrival and a cancellation number is received. All deposits will be charged (14) days prior to arrival date.

 

Conference Agenda

PCMA is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. The MMEF agenda includes a total of sixteen (16) sessions that are eligible for CE credits. Because sessions are concurrent, pharmacist attendees will have the opportunity to participate in twelve (12) of the 16 CE sessions, and earn up to 9 contact hours, or 0.9 Continuing Education Units (CEUs).

Sessions that are eligible for CPE credits at the MMEF are designated with ** before the session title. Per ACPE standards, All PCMA continuing pharmacy education (CPE) sessions are designed to be knowledge-based activities (K) for pharmacists (P). Please note that participants must provide PCMA Staff with their NABP e-profile PID. If you do not already have one, click HERE to obtain an e-profile PID from ACPE.

After the conference, attendees will be contacted by PCMA staff within 1-2 weeks to complete learning assessment(s) for session(s) attended. Learning assessments will be reviewed by PCMA staff and attendees will be provided feedback based off of the individual responses.

All CPE sessions are planned independently of commercial interests and PCMA does not accept grants to support any specific CPE programming.

Please contact Erin Bamrick, ebamrick@pcmanet.org or 202-207-3610, or refer to our printed program for final CPE activity information.

** Indicates CE Credit Sessions

February 4, 2013

  12:00 PM - 7:30 PM Registration Open
  3:15 PM - 4:00 PM Breakout Sessions - A1

** The Changing Landscape of the PBM Industry: A Lesson in Diversification
Rob Earnest - Vice President, Industry Relations, Catamaran

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 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.

By attending this program, you should be able to:

  • Name three of the key mergers that have taken place in the past ten years that have significantly altered the makeup of the PBM industry
  • Compare and contrast three PBM core competencies two decades ago versus today
  • Describe two current PBM business models and two, possibly conflicting, business drivers of each

UAN Number: 0841-0000-13-001-L04-P

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

Track: PROFESSIONAL

[View Details]
  **Specialty Pharmacy Tools: What is working and what are clients signing up for

Rae McMahan - Vice President, Specialty Pharmacy Programs, Prime Therapeutics

This session will highlight what multiple types of clients are looking for from their specialty pharmacy. 

By attending this program, you should be able to:

  • Discuss the differences in clients (payers, regional and national / employer groups / PBM's / Pharma) and reasons why they may want certain programs or not
  • Outline case studies showing the differences of what is needed by a client
  • Explain the challenges in delivering programs that are needed and proving the value of a program

UAN Number: 0841-0000-13-006-L04-P

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

Track: PROFESSIONAL and EXECUTIVE

[View Details]
  ** Rebate Contracting with Public and Commercial Payers

Fred Brownfield - Director, Trade Relations, Humana Pharmacy Solutions

Bethanie Stein - Medicare Contracting Manager, Humana Pharmacy Solutions

This session will detail the wide range of complexities that are considered when negotiating rebate contracts.

 By attending the program you should be able to:

  • Recognize the differences  in contracting with various types of PBMs
  • Understand how rebates play a role in formulary decision making
  • Identify the key components of a valuable contract
  • Compare and contrast commercial contracting strategies with Medicare contracting strategies

UAN Number: 0841-0000-13-014-L04-P

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

Track: PROFESSIONAL

[View Details]
  4:15 PM - 5:00 PM Breakout Sessions - A2 (same sessions as A1)
  5:30 PM - 7:30 PM Opening Reception

February 5, 2013

  7:00 AM - 8:00 AM Networking Breakfast
  8:00 AM - 8:15 AM General Session

Welcome Remarks
Mark Merritt - President & CEO, PCMA

Jerry Miller - Retired PBM & Pharma Industry Consultant,

  8:15 AM - 9:00 AM General Session

The Manufacturer-PBM Relationship: Dynamics, Alignment, and Differences
Allen Dunehew - Chief Procurement Officer, Express Scripts

Albert Thigpen - Senior Vice President, Industry Relations & Pharmacy Operations, Catamaran

Peter Wickersham - Senior Vice President, Cost of Care, Prime Therapeutics

This panel of PBM industry thought leaders will discuss the ever-evolving nature of the relationships and perspectives of payer driven PBMs, and innovation focused drug manufacturers.  The business of our two industries will continue to present opportunities for alignment, as well as ongoing and new differences.  This subject matter is more critical today than ever before, as the evolving marketplace is driving PBMs and manufacturers to work more closely, and on more critical healthcare challenges than ever before.       

[View Details]
  9:00 AM - 9:45 AM General Session -

The Evolution of the Healthcare System: PBM Opportunities and Challenges, A Wall Street Perspective
Tom Gallucci - Managing Director and Senior Healthcare Service Analyst, Lazard Capital Markets

  10:00 AM - 10:45 AM Breakout Sessions - B1

PBM and Pharma Paradigm Shifts Resulting from Rapid Healthcare Industry Evolution
Albert Thigpen - Senior Vice President, Industry Relations & Pharmacy Operations, Catamaran

Our healthcare marketplace has undergone dramatic change in recent years driven by Mergers and Acquisitions, state and federal government action, the rapidly rising costs of new therapies, and many other factors.  This activity will drive numerous paradigm shifts in how we do business as PBMs and drug manufacturers.  During this session Albert will offer strategic considerations for conducting business in this new world.   


Track: EXECUTIVE

[View Details]
  Pharmacy Benefit Challenges for Payers: Specialty Still Leading Concern

Julayna Meyer - Vice President, Strategic Relations and Clinical Program Management, Express Scripts

This session addresses some of the areas that most concern plan sponsors today regarding their pharmacy benefit. We'll review specific strategies they are considering and adopting to address those concerns.

Track: EXECUTIVE

[View Details]
  ** Pricing Benchmarks, ASP, and Reimbursement 2012 vs. 2013

Amanda Bartelme - Director, Reimbursement and Product Commercialization, Avalere Health

An expert look at emerging reimbursement benchmarks as private payers, Medicare, and Medicaid seek to define replacement metrics for Average Wholesale Price (AWP) and increase drug pricing and payment transparency

By attending this program, you should be able to:

  • Identify the various pricing and payment benchmarks currently used to reimburse for patient-administered and self-administered therapies.
  • Evaluate the appropriateness of new and emerging benchmarks for use as reimbursement metrics.
  • Recognize the inputs and exclusions from calculations of key drug pricing metrics, including NADAC, NARP, and AMP.
  • Explain the impact of drug pricing changes across key stakeholders including pharmacies, manufacturers, wholesalers/distributors, payers, and PBMs.

UAN Number: 0841-0000-13-007-L04-P

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

Track: PROFESSIONAL and EXECUTIVE

[View Details]
  ** Site of Care Strategies

Lynn Karst - Director, Medical Benefit Management Programs, CVS Caremark

By attending this program, you should be able to:

  • Detail the market forces that impact site of care selection in today’s market
  • Compare and contrast the benefits and disadvantages of various sites of care for infusion of specialty drugs
  • Provide an overview of infused specialty products in the pipeline, and discuss how they might impact payers’ management strategies for site of care selection

UAN Number: 0841-0000-13-013-L04-P

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

Track: EXECUTIVE

[View Details]
  11:00 AM - 11:45 AM Breakout Sessions - B2 (same sessions as B1)
  11:45 AM - 1:15 PM Networking Luncheon
  1:15 PM - 2:00 PM Breakout Sessions - C1

The Impact of Healthcare Exchanges on Rebate Contracting
Everett Neville - Chief Trade Relations Officer, Express Scripts

This session addresses how state exchanges that will come online in 2014 may impact the pharmacy benefit, including pharmacy networks, formularies, and patient benefits.  Everett will discuss how employers’ and payers’ offerings and decision making will be effected, as well as how manufacturers and PBMs should think about 2014 and beyond.


Track: EXECUTIVE

[View Details]
 

** Payer Considerations for Determining Coverage and Cost of Oncology Drug Therapies
Ed Pezalla - National Medical Director for Pharmacy Policy and Strategy, Aetna, Inc.

This session will address how drugs arrive at either the medical or pharmacy benefit and why this matters to the pharmaceutical company.

By attending this program, you should be able to:

  • Understand differences between medical and pharmacy benefits
    • Implications for patients
    • Implications for manufacturers
    • Implications for providers
  • Be able to describe the role of P&T and other managed care decision making bodies
  • Be able to explain how managed care firms use safety, efficacy and other clinical data in coverage and utilization decision making

UAN Number: 0841-0000-13-002-L04-P

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

Track: EXECUTIVE

[View Details]
  ** The Affordable Care Act and Federal Fiscal Battles: Essential Insights for the Pharma Supply Chain

Kristin Bass - Senior Vice President, Federal Government Affairs, PCMA

This session is Part I of two sessions relating to the Affordable Care Act and how it is changing the landscape of healthcare.  Kristin will discuss the macro realities and threats of the law impacting the pharma supply chain.  

By attending this program, you should be able to:

  • Discuss the impact of the ACA’s insurance expansion on drug coverage in both public programs and private insurance, and potential ramifications for PBMs and pharmaceutical companies.
  • Discuss the similarities and differences between Medicare and ACA regulatory requirements, and their impact on the supply chain.
  • Understand potential threats and opportunities arising from sequestration and congressional efforts to find savings in federally funded health care programs.

UAN Number: 0841-0000-13-010-L04-P

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

Track: PROFESSIONAL and EXECUTIVE

[View Details]
  2:15 PM - 3:00 PM Breakout Sessions - C2 (same sessions as C1)
  3:15 PM - 4:00 PM Breakout Sessions - D1

**Pharmacogenomics & PBMs: When Does “Great Potential” Become Everyday Reality? (This session will take place from 3:15pm-4:00pm and will not repeat.)
Peter Wickersham - Senior Vice President, Cost of Care, Prime Therapeutics

Pharmacogenomics, or “personalized medicine,” carries with it the burdens and blessings of enormous potential benefit.  It’s one of the most exciting – and still largely developing – areas of medicine today. Pharmacy benefit managers will ultimately play a key role in sorting out the evidence to identify tests and treatments that are sound both clinically and economically.  

By attending this program, you should be able to:

  • Describe the current state of the field - what's changed from five years ago?
  • Outline Prime's pilot framework
  • Discuss opportunities that lie ahead in the next 2-3 years

UAN Number: 0841-0000-13-008-L04-P

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

Track: PROFESSIONAL and EXECUTIVE

[View Details]
  ** Distribution, Access, and Success in Today’s Specialty Market (1999 was fun, but a lot has changed….)

Bill Martin - Vice President, Pharma Strategies and Account Management, Express Scripts

This session will cover going to market considerations and the evolved and evolving specialty distribution and channel environment.

By attending this program, you should be able to:

  • Understand current service and distribution options
  • Describe the operational baseline of specialty pharmacies
  • Identify the stakeholders and the decisions that will contribute to success 
  • Review current market dynamics that impact access and utilization

UAN Number: 0841-0000-13-003-L04-P

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


Track: PROFESSIONAL and EXECUTIVE

[View Details]
  ** State Medicaid Activity: Essential Insights for the Pharma Supply Chain (This session is designed to complement Kristin Bass' preceding session.)

Brady Augustine - President & CEO, Aggressive Analytics, Inc.

This session is Part II of two sessions relating to the Affordable Care Act and how it is changing the landscape of healthcare.  Brady will dive deeper into implantation of the law at the ground level. 

By attending this program, you should be able to:

  • Outline the primary factors driving change and impacting trend in the medical benefit drug sector for fee-for-service Medicaid
  • Identify drug coverage and payment policy changes that may expand to additional states
  • Discuss the types and emerging role of managed care models in this sector
  • Explain the challenges of potential Medicaid expansion and its relation to Health Insurance Exchanges (HIX)

UAN Number: 0841-0000-13-009-L04-P

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

Track: PROFESSIONAL and EXECUTIVE

[View Details]
  4:15 PM - 5:00 PM Breakout Sessions - D2 (same sessions as D1)
  5:30 PM - 7:30 PM Cocktail Reception

February 6, 2013

  7:00 AM - 8:00 AM Networking Breakfast
  8:00 AM - 9:00 AM General Session -

The US Pharmaceutical Market: 2012 Insights, and a Look Ahead
Doug Long - Vice President, Industry Relations, IMS Health

This session addresses the current and future trends in the U.S. pharmaceutical market, along with market factors we will see more of, less of, and what’s ahead in the future. 

  • Current market trends
  • Most notable things about 2012
  • Impact of the Patent Cliff
  • Innovation outlook
  • Specialty and biosimilars
[View Details]
  9:15 AM - 10:00 AM Breakout Sessions - E1

** New Perspectives on Evolving Trends and Impact on the Distributor and Pharma Industry
Allen Dunehew - Chief Procurement Officer, Express Scripts

This session will review current and future trends and their impact on the industry and stakeholders.

By attending this program, you should be able to:

  • Describe the impact of the patent cliff on brand and generic manufacturers
  • Identify trends in the pharma industry resulting from the entry of blockbuster generics
  • Compare and contrast strategies for introducing biosimilars vs. a typical brand product to the US market
  • Describe the impact of the patent cliff and future entry of biosimilars on the wholesaler/distributor sector

UAN Number: 0841-0000-13-004-L04-P

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

Track: EXECUTIVE

[View Details]
  ** Pharmaceutical Pipeline Insights

Brian Kolling - Senior Director, Pipeline and Trend Forecasting, Part D, OptumRx

This session provides an overview of the current pharma pipeline, highlighting 2012 approvals as well as key events and introductions expected in 2013.   

 By attending this program, you should be able to:

  • List three new brand, specialty and generic drugs approves for the marketplace in 2012.
  • List three new brand, specialty and generic drugs on the horizon in 2013.
  • Compare and contract approval trends since 2008.
  • Discuss the macro view of the current pharmaceutical drug pipeline and potential impacts it could have for industry stakeholders.

UAN Number: 0841-0000-13-012-L04-P

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

Track: PROFESSIONAL and EXECUTIVE

[View Details]
  ** Specialty Call Center Warfare: Access to Appropriate Specialty Drug Therapy

David Galardi - Co-founder, Apogenics

Patients faced with chronic debilitating disease are increasingly prescribed specialty drugs that improve health outcomes and drive-up the cost of drug therapy.  Payers and manufacturers are engaged in a silent battle to provide access to such therapy while maximizing the healthcare benefit coverage available to them.  

This discussion focuses on defining the landscape of market access programs and seeks to highlight areas where payers and manufacturer scan find synergies in their effort to make appropriate specialty drug therapy available to patients at affordable costs.

By attending this program, you should be able to:

  • Describe the techniques used to promote market access to specialty drugs
  • Outline the primary factors driving change and impacting trend in the medical benefit drug sector
  • Explain the challenges of developing workable solutions for managing the coordination of drugs in the pharmacy and medical benefit
  • Identify challenges payers face while maintaining appropriate access to specialty medications
  • Discuss the options available to manufacturers and payers to collaborate and reduce costs associated with market access

UAN Number: 0841-0000-13-011-L04-P

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

Track: EXECUTIVE

[View Details]
  10:15 AM - 11:00 AM Breakout Sessions - E2 (same sessions as E1)
  11:15 AM - 12:00 PM Breakout Sessions - F (sessions do not repeat)

Pharma Services: Leveraging Data and New Efficiencies in Reimbursement and HUBS (This session is designed to complement David Galardi's preceding session.)
Kevin Cast - Vice President, Strategy and Contracting, Pharma and Biotech, Express Scripts

Topics covered during this session include:

  • Define BIG DATA
  • Appropriate utilization of medical claims data to generate reimbursement efficiencies
  • Future crossroads of medical and pharmacy claims in one database
  • Wrap- around HUB services

Track: EXECUTIVE

[View Details]
  ** Working with Payors: Making the Puzzle Pieces Fit

Kim Gwiazdzinski - Senior Director, Pharmaceutical Trend Relations, Prime Therapeutics

There are many pieces that make up a strong and productive relationship between payers and pharmaceutical manufacturers.  The key is to know what the pieces are and how the pieces fit together to complete the puzzle (i.e: build the relationship).

By attending this program, you should be able to:

  • Describe various methods that manufacturers can utilize in developing relationships with payers
  • Define the expectations around these methods with the ultimate goal of building strong and productive relationships
  • Compare and contrast two of the relationship methods listed above, both from the payer and the manufacturers’ perspective

UAN Number: 0841-0000-13-005-L04-P

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

Track: PROFESSIONAL and EXECUTIVE

[View Details]
  12:00 PM - 12:45 PM Light Lunch
  12:45 PM - 12:45 PM Conference Adjourns

Additional Information

Attendance at a Pharmaceutical Care Management Association (PCMA) meeting or event includes the limited, non-exclusive, revocable, and non-transferable right and license to use any PCMA materials, whether written, oral or electronic, made available by PCMA to the attendees for informational or personal use purposes only.  PCMA reserves all other rights. The use of such materials for reporting or media purposes, including blogging, is strictly prohibited. PCMA or its licensors own all rights in and to all of its presentations, content, designs, methodologies, processes, programs, products, information, and documentation.  PHARMACEUTICAL CARE MANAGEMENT ASSOCIATION, PCMA and all other names, logos and icons identifying PCMA and its products and services are proprietary trademarks of PCMA, and any use of such marks without the express written permission of PCMA is strictly prohibited

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