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

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

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

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.       

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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