sPMCA

Conference Information


2016 sPCMA Business Forum

Feb 8, 2016 - Feb 9, 2016
JW Marriott Orlando Grande Lakes
Orlando, FL

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

Conference Overview

The sPCMA Business Forum is a networking and educational conference designed for professionals of all levels engaged in the business of specialty pharmacy and pharmaceutical care. Companies in attendance manage all patient care and drug delivery aspects of the specialty pharmacy industry. The Business Forum is designed to be an essential component of your annual conference schedule and business strategy.

From an educational standpoint, our speakers are among the industry's top thought leaders. When it comes to networking and conducting meetings with industry partners and customers, the Business Forum attracts the highest number of executives and decision makers from PBMs and the nation's largest specialty pharmacies of any industry conference.

Conference features include:

  • Presentations by C-suite and other senior PBM, specialty pharmacy and pharma executives
  • Timely and thought-provoking CPE sessions
  • Dedicated time and facilities for private meetings
  • Pre-conference networking through PCMA-Connect, a LinkedIn Group and online networking community
  • Networking receptions with members and conference sponsors

 

Who Should Attend

The sPCMA Business Forum's 1,300 attendees range from C-suite executives to mid-level professionals involved in all aspects of the business of specialty pharmacy and pharmaceutical care, including:

PBMs, Payers, and Specialty Pharmacies
- C-suite executives
- Pharma and Trade Relations divisions
- Specialty Pharmacy Strategy and Operations
- Contracting
- Pharmacy and Medical Directors
Pharma and Biotech Industry
- C-suite executives
- Managed Markets/Market Access divisions
- Medical Affairs
- Trade, Sales, and Marketing
- Pricing, Contracting, and Reimbursement
- Health Economics Research and Outcomes
- Pharmacy and Medical Directors
- Health Care Quality and Innovation
Wholesalers and Distributors
Consultants, Vendors, and Suppliers
Wall Street Analysts and Investors

 

Featured Speakers


Mark Merritt, President & Chief Executive Officer, PCMA


George Paz, Chairman & Chief Executive Officer, Express Scripts, and PCMA Chairman of the Board


Lee Newcomer, MD, Senior Vice President, Oncology, Genetics and Women’s Health, UnitedHealthcare


Josh Ofman, Senior Vice President, Global Value, Access and Policy, Amgen


Everett Neville, Senior Vice President, Supply Chain, Express Scripts


Michael Anderson, Chief Pharmacy Officer, UnitedHealthcare Medicare & Retirement


Steve Pearson, President, Institute for Clinical and Economic Review


Chris Bradbury, Senior Vice President, Integrated Clinical Solutions and Specialty Pharmacy, Cigna Pharmacy Management


Mike Kolodziej, National Medical Director, Oncology Solutions Office, Aetna

   

Registration Information

Register now! 

Registration for this event is open to anyone interested in attending. Please contact Jenny Dawson with questions.

Registration Fees
PCMA Affiliates - $2,396
Non-member/Non-affiliate - $2,995

Please note that anyone entering PCMA or sponsor-designated meeting space during the conference must be registered and wearing a conference badge.

Registration Cancellation Policy: Registration cancellations received in writing will be accepted up to 25 days (January 14, 2016) prior to the start of the conference for a full refund. Cancellations after January 14 and "no shows" will not be refunded. Registration slots are non-transferable from one company to another; however, substitutions within companies are welcome at any time.

 

Hotel Information

JW Marriott Orlando, Grande Lakes
4040 Central Florida Parkway
Orlando, FL 32837

Negotiated group rate: $279 plus applicable taxes/night. The rate is only guaranteed until 11:59pm on Friday, January 8.

Attendees should make their own hotel reservations on a PCMA-JW Marriott reservations site or by calling 1.407.206.2300 and referencing "PCMA". Conference registration does not guarantee hotel availability.

Please contact Jenny Dawson with questions.

Hotel Cancellation Policy: All reservations of two nights or more require a two-night room deposit. This deposit will be applied to the first two nights of the stay and will be charged on January 15, 2016 to the card provided when making the reservation. Cancellation requests must be received in writing before 11:59 pm on January 14, 2016 to avoid forfeiting the hotel deposit. Failure to arrive on your scheduled arrival date will result in the cancellation of remaining reserved room nights.

 

Conference Agenda

February 7, 2016

  4:00 PM - 6:00 PM Registration Desk Open
  6:00 PM - 10:00 PM Super Bowl Party

If you're in town, please join PCMA for the big game.

[View Details]

February 8, 2016

  6:30 AM - 6:00 PM Registration Desk Open
  7:00 AM - 6:00 PM Private Meeting Rooms & Networking Break in the Lobby

While conference sessions are scheduled all day, we recognize the unique opportunity PCMA conferences offer attendees to maximize private meetings and networking with peers and customers.  If you're not in a private meeting, be sure to spend some time in the JW Marriott lobby and Porte-Cochere to catch up with old colleagues and make new business connections. We'll have designated space for just this purpose, as well as refreshments throughout the day.

[View Details]
  8:00 AM - 9:00 AM Networking Breakfast
  9:00 AM - 9:30 AM **Breakout Session 1 of 2: Indication-Based Pricing in Oncology

Mary Dorholt - Senior Director and Clinical Practice Lead, Specialty, Express Scripts

  **Breakout Session 2 of 2: PBMs Prepare for Biosimilars - How PBMs are preparing for an expansion of the biosimilar market

Steve Avey - Vice President, Specialty Pharmacy, MedImpact

Patient advocates and payers anticipate that biosimilars will foster competition—thus negotiating discounts—and that interchangeable biosimilars will compete in the same way generic drugs compete with brand-name small-molecule drugs. Without active PBM management of this expanding biosimilars market however, none of these projections will be realized. PBMs are focused on preparing clients and their members to adapt to this changing environment. They are relying on the use of P&T committee recommendations and other forms of education to increase plan sponsors' utilization of biosimilars.

PBMs are designing and updating their formularies to reflect the ongoing changes and FDA approvals. By establishing partnerships with network pharmacies, PBMs are beginning to conduct post-launch surveillance for adverse events and the effectiveness of biosimilar products. Switch study results, immunogenicity data reviews, and clinical outcomes data will help allay fears in clinical settings.

Since the introduction of the first biosimilar to the market, PBMs have been adding programs and services to better support plan sponsors and their beneficiaries. This session will address many of these programs and services, including the evolution of contracting processes, formulary management, and the continued encouragement of competition in the biosimilar space.

By attending this session, you should be able to:
• Describe the key elements of a biosimilar product adoption policy;
• List the steps a PBM should take to improve biosimilar utilization; and
• Outline the pitfalls that can still hamper the utilization of biosimilars as they become available.

[View Details]
  9:45 AM - 10:15 AM **Breakout Session 1 of 2: Strategic Changes in Medicare Part D

Michael Anderson - Chief Pharmacy Officer, UnitedHealthcare Medicare & Retirement

The Medicare Part D program is ten years old, and it is constantly evolving. Mike Anderson, Chief Pharmacy Officer with UnitedHealthcare Medicare & Retirement, will review ten significant changes that are now impacting the program, including changes to the benefit design, program funding, regulatory environment, and competitive landscape.

By attending this session, you should be able to:
• Explain key benefit design changes that are impacting the Part D program, including those driven by the government and by plan sponsors;
• Describe the funding challenges that Part D sponsors are now facing;
• Summarize changes to the Star Rating and MTM programs that impact pharmacy benefits; and
• Describe emerging trends in the Part D competitive landscape.

[View Details]
  **Breakout Session 2 of 2: An Analyst’s Perspective on Market Dynamics - Future of the formulary, biosimilars, and specialty pharmacies

Ronny Gal - Senior Analyst, Global Specialty Pharmaceuticals, Sanford Bernstein

Wall Street analysts always offer a highly informed and sometimes different perspective of our industry than you might otherwise hear from your peers. During this session Ronny Gal will discuss biosimilars, a topic for which he is a frequent speaker, and how these products will start to penetrate the U.S. market. He will also address a handful of other hot topics including the future of the formulary and why commercial markets are expanding their exclusion lists, and various implications around specialty pharmacy.

By attending this session, you should be able to:
• Outline two issues Ronny sees to be impactful for the specialty pharmacy industry in the next year;
• Describe profitability and margins expectations for biosimilars; and
• List at least two reasons why drug exclusion lists are growing, and at least two implications this growth will have on the market.

[View Details]
  10:30 AM - 11:15 AM General Session: Drug Pricing and Affordability Challenges for Payers and Policymakers

Everett Neville - Senior Vice President, Supply Chain, Express Scripts

Steve Pearson - President, Institute for Clinical and Economic Review

  11:15 AM - 12:00 PM General Session: Defining and Differentiating the Many Types of Specialty Pharmacies

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

Mike Zeglinski - Senior Vice President, Specialty Pharmacy, OptumRx

Moderator: Adam Fein - President, Pembroke Consulting

  12:00 PM - 1:30 PM Member Company Lunch Receptions & Networking Lunch

Select PCMA members host receptions exclusively for conference attendees from the drug manufacturer industry. These Member Company Receptions bring together all attendees from each PBM host company and offer excellent opportunities for networking and one-on-one interactions between PBM and specialty pharmacy and pharma executives.

Monday: Aetna, Humana, OptumRx

Tuesday: Prime Therapeutics, CVS Health, Express Scripts

Lunch will be served in reception rooms and public foyers. Manufacturers will be able to flow in and out of the individual receptions. Please note that in addition to manufacturers, only employees of the host company are allowed in their respective reception rooms. Individuals with companies that are not PCMA members or affiliates are welcome to eat and network in the Palzzo Foyer and under the Mediterranean Porte-cochere.  

[View Details]
  1:30 PM - 2:00 PM **Breakout Session 2 of 2: Oncology Pathways and Other Management Strategies – How payers and pharma should engage in a changing marketplace

Debbie Stern - Senior Vice President, Strategy and Business Development, eviCore Healthcare

  **Breakout Session 1 of 2: The Role of Copay Coupons in Specialty

Pat Gleason - Director, Health Outcomes, Prime Therapeutics

Growth in the development and spending for specialty drugs has important implications to a number of stakeholders including patients, employers, insurers, and manufacturers. With the pharmaceutical industry spending an estimated $7 billion on coupons and discount cards annually, it is important to understand how much is going toward specialty drug and the potential value. This session will examine trends in the specialty drug market, including member cost sharing, prevalence of coupons, employers' specialty management intentions, and the role of coupons. At the end of this session, participants should have a better understanding of employers' and pharmacy benefit managers' specialty pharmacy benefit management tools and the role of coupons/drug discount cards.

By attending this session, you should be able to:
• Describe the trends and evolution of the specialty drug market and coupon use;
• Outline the implications of increases in specialty drug spending and utilization on health insurance benefits and coverage decisions;
• List employers' and pharmacy benefit managers' specialty tools and intentions to implement the tools in the near future;
• Describe the value of specialty coupons.

[View Details]
  2:15 PM - 2:45 PM **Breakout Session 1 of 2: The 340B Program’s Impact on the Specialty Pharmacy Industry

Stephanie Hales - Partner, Sidley Austin

HRSA published its proposed mega omnibus guidance for covered entities and manufacturers for the 340B Drug Discount Program in August. As expected, many components of the 340B Program were clarified and modified but many questions still remain while we wait for the final rule to be released in May or June. During this session, Bill Sarraille will provide a recap of the most significant implications of the guidance and final rule to the specialty pharmacy industry. In particular he will address regulatory impacts – contract pharmacy guidance, civil monetary provisions, and the recent Novartis settlement and what it might suggest is the federal government's view on specialty pharmacy models. Outside of regulatory implications, he will also introduce some by-products of the program such as the growth of ACO and IDN specialty pharmacies, and the potential for increased government and commercial interest in shared savings arrangements.

By attending this session, you should be able to:
• Outline at least three of the main impacts the proposed rule will have on the specialty pharmacy industry;
• Compare and contrast payer and manufacturer perspectives about 340B prices being offered in specialty pharmacy distribution networks; and
• List at least two potential by-products of the proposed rule.

[View Details]
  **Breakout Session 2 of 2: 2015 Specialty Pharmacy Patient Satisfaction Survey Results

Jason Rucker - Director, Trade Research, Zitter Health Insights

  3:00 PM - 3:30 PM **Breakout Sessions 1 of 1: Separating Facts and Myths with Specialty Drug Management under the Medical Benefit – An integrated PBM/specialty pharmacy perspective

Thom Stambaugh - Vice President, Cigna Specialty Pharmacy Services

Payment and operating models for specialty drugs covered through the medical and pharmacy benefits differ. The pharmacy benefit is carefully managed by payers and PBMs, and the medical benefit is carefully and primarily managed by health plans. Confusion often exists as to which benefit coverage approach – medical or pharmacy – and under what conditions provides the best affordability, outcomes and customer experience. Simply put, even after many years, separating "fact from myth" remains difficult for plan sponsors. During this session, Thom will discuss why a whole view cost approach can bring important insights to plan sponsor so they pursue specialty management strategies that drive to the best affordability, outcomes and customer experience.

By attending this session, you should be able to:
• Outline how select specialty drugs are managed by health plans under the medical benefit;
• Summarize which benefit, pharmacy or medical, optimizes affordability for key drug classes – and under what situations; and
• Describe the customer service experience differences in carve-out versus carve-in models.

[View Details]
  3:45 PM - 4:15 PM **Breakout Session 1 of 1: The Role of Drug Pipeline Data and Analytics in Payer Decision Making

Farrah Wong - Director, Pipeline and Drug Surveillance, OptumRx

This presentation goes beyond your typical pipeline session by offering a glimpse into how PBMs analyze health plan data and model for future expenses. The first part of the presentation will include an overview of the "high impact" products coming to market in the next few years. Farrah will also outline why her organization is calling some of these products "buzz drugs," how they have enhanced their data, modeling, and clinical program over the past year, and what this might mean for monitoring the drug pipeline and drug prices moving forward.

By attending this session, you should be able to:
• Identify at least two high impact pipeline drug trends;
• Define industry "buzz drug" according to the presenter; and
• Outline how health plan data and clinical modeling influence formulary decisions.

[View Details]
  6:30 PM - 10:00 PM Cocktail and Dinner Reception with Live Music

Live music, food stations, and views of the lake and golf course provide a relaxed and fun atmosphere perfect for business networking during this special reception and dinner. Conference attendees are encouraged to plan their private dinners on Sunday or Tuesday night so that everyone may attend this unique event outside.

[View Details]

February 9, 2016

  6:30 AM - 4:00 PM Registration Desk Open
  7:00 AM - 4:00 PM Private Meeting Rooms & Networking Break in the Lobby

While conference sessions are scheduled all day, we recognize the unique opportunity PCMA conferences offer attendees to maximize private meetings and networking with peers and customers. If you're not in a private meeting, be sure to spend some time in the JW Marriott lobby and Porte-Cochere to catch up with old colleagues and make new business connections. We'll have designated space for just this purpose, as well as refreshments throughout the day.

[View Details]
  7:30 AM - 9:00 AM Networking Breakfast
  9:00 AM - 9:10 AM General Session: Welcome

Mark Merritt - President & Chief Executive Officer, PCMA

  9:10 AM - 9:30 AM General Session: PBM Industry Keynote Address

George Paz - Chairman & Chief Executive Officer, Express Scripts, and PCMA Chairman of the Board

  9:30 AM - 10:15 AM General Session: Evolving Oncology Drug Management Programs - Prior Authorization, Comparative Effectiveness Displays, Performance Contracting, and a New Episode Payment Program

Lee Newcomer, MD - Senior Vice President, Oncology, Genetics and Women’s Health, UnitedHealthcare

  10:15 AM - 11:00 AM General Session: Latest Trends in Drug Product Utilization

Doug Long - Vice President, Industry Relations, IMS Health

This session will address the current and future state of the U.S. Pharmaceutical market. Topics addressed will include current growth, top class performance, top product performance, top company performance, biosimilar impact, and cost containment efforts.

By attending this session, you should be able to:
• Outline where the U.S. Pharmaceutical market growth has been and near-term forecast for growth;
• Describe the performance of the various sectors of the dispensing side;
• Describe the performance of brand, generic and specialty products; and
• Identify which factors will affect future growth.

[View Details]
  11:15 AM - 12:00 PM **Breakout Session 1 of 2: The Value of Specialty Drugs across the Health Care Continuum

Martin Zagari - Vice President, Global Health Economics, Amgen

  **Breakout Session 2 of 2: The Growth of IDN and ACO Specialty Pharmacies

Bill Roth - Founding Partner, Blue Fin Group

  12:00 PM - 1:30 PM Member Company Lunch Receptions & Networking Lunch

Select PCMA members host receptions exclusively for conference attendees from the drug manufacturer industry. 

Select PCMA members host receptions exclusively for conference attendees from the drug manufacturer industry. These Member Company Receptions bring together all attendees from each PBM host company and offer excellent opportunities for networking and one-on-one interactions between PBM and specialty pharmacy and pharma executives.

Monday: Aetna, Humana, OptumRx

Tuesday: Prime Therapeutics, CVS Health, Express Scripts

Lunch will be served in reception rooms and public foyers. Manufacturers will be able to flow in and out of the individual receptions. Please note that in addition to manufacturers, only employees of the host company are allowed in their respective reception rooms. Individuals with companies that are not PCMA members or affiliates are welcome to eat and network in the Palzzo Foyer and under the Mediterranean Porte-cochere

[View Details]
  1:30 PM - 2:00 PM **Breakout Session 1 of 2: Personalized Medicine in Oncology Care

Mike Kolodziej - National Medical Director, Oncology Solutions Office, Aetna

The understanding of the molecular basis of cancer has transformed cancer treatment. From the humble beginnings of targeting the estrogen receptor through her 2 directed therapies for breast cancer to the present day molecular sub-typing of lung cancer, the treatment of adult solid tumors has evolved from a discussion of dose-intensive cytotoxic chemotherapy to one of very precise molecularly-driven therapy. In fact, there is now discussion around reclassifying malignancies based on molecular profile rather that anatomic origin. Yet, despite the intellectual attractiveness and preliminary promise of this approach, it remains far from being routinely implemented at the bedside. During this session Dr. Kolodziej will discuss the payer's views regarding personalized medicine in oncology care and how we can overcome these hurdles.

By attending this session, you should be able to:
• Outline challenges associated with complex molecular testing from the perspectives of analytic and clinical validity;
• Describe incomplete data available around clinical utility; and
• List at least two reasons why value is not yet established for this approach.

[View Details]
  **Breakout Session 2 of 2: The Growing Importance and Impact of Fair Market Value in Specialty Pharmacy

David Galardi - Vice President, Worldwide Managing Director, Apogenics

  2:15 PM - 2:45 PM **Breakout Session 1 of 2: Value-based Contracting - The future for specialty survival in the US

Brian Kelly - President, Optum Life Sciences

Brian Solow, MD - Chief Medical Officer, Optum Life Sciences

  **Breakout Session 2 of 2: Opposing Influences of Evidence and Market Forces in Pharmaceutical Pricing and Payer Net Cost

Larry Blandford - Senior Vice President & Managing Partner, Precision for Value

Steve Carter - Vice President, Pricing and Market Access, Precision for Value

This session will outline the process often used by manufacturers to establish a price for a product and compare that to how payers assess how that price impacts perception of value.  The presenters will outline how clinical and economic evidence, research, and market forces can shift price points through launch preparation.  New research on how payers perceive a product based on price will be unveiled along with implications across different benefits plans, such as Medicare Part D and employer-funded. Lastly, evolving and future methods for alignment between these stakeholders will be shared.

By attending this session, you should be able to:

  • Outline a process and influences by which the price of pharmaceutical products may be established;
  • Explain how payers perceive the value of pharmaceutical products, based on price, evidence, and value added services on their overall net cost; and
  • Identify evolving and future methods for aligning pharmaceutical product price with payer value.  
[View Details]
  8:00 PM - 10:00 PM Cocktail and Dessert Reception

Unwind after a busy two days at our always-popular Cocktail and Dessert Reception.  Enjoy casual conversation as you bid your colleagues farewell.

[View Details]

Additional Information

acpe 489 469PCMA is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education (CPE).

Stay tuned for more information about CPE-eligible sessions at the sPCMA Business Forum. Sessions eligible for CPE credit will be designated with two asterisks in the agenda above.

Obtaining Continuing Pharmacist Education Credit
As of January 1, 2013 a system called the CPE Monitor, a joint collaboration between ACPE and NABP, became mandatory for all CPE providers and pharmacists to submit and receive CPE credit. The CPE Monitor allows providers to submit attendee lists online. The system communicates CPE participation to NABP, which then communicates it to state boards of pharmacy electronically, removing the need for pharmacists to submit individual statements of credit.

In order to receive credit for attending accredited CPE offerings, you must have an e-profile ID number (e-PID) provided by NABP. If you have not yet obtained your NAPB e-PID, please do so by clicking here. Questions about this system or your number should be directed to NABP customer service at 847.391.4406.

During the Conference: To receive CPE credit at the conference, be sure to write your name, birthdate and NAPB e-PID on the sign-in sheet so PCMA may verify your attendance. Sign-in sheets will be placed on a designated table inside each CPE-eligible session room.

After the Conference: Be on the lookout for post-conference communications from PCMA. Depending on the session(s) you attend, it might be necessary for you to complete a learning assessment or evaluation before receiving credit.

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