The PCMA Annual Meeting is the industry’s premier executive conference. The event provides an un-matched and ideal venue for senior executives from PBMs, specialty pharmacy, payer organizations, and pharmaceutical manufacturers to network, conduct business and learn about the most current issues impacting the industry.

The decision makers in attendance, educational insights and business connections made while on-site, are ultimately what make the Annual Meeting so successful. The high level interactions that take place at this event help to promote continued industry collaboration and dialogue.

Conference Program Book

Annual Meeting 2017 Agenda

Monday, September 25
9:30 am - 9:45 am

Welcome

Conference Moderator: Betty Nguyen, Anchor and Journalist, NBC News & MSNBC

The Political and Policy Environment of Health Care

Mark Merritt, President & Chief Executive Officer, PCMA

9:45 am - 10:15 am

Embracing Industry Disruption and Innovation to Improve Patient Care and Outcomes

Mostafa Kamal, Chief Executive Officer, Magellan Rx Management

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We are living in a world where the consumer is key and where industries are rapidly evolving to respond to increased consumer awareness and engagement. Amazon and Uber offer excellent examples of businesses that are booming because of their ability to successfully engage their constituencies and respond to evolving needs and demands.

The PBM industry needs to also embrace innovation and disruption and in doing so, can improve patient care and outcomes. During this session, Mostafa will discuss the need for both traditional and new PBM tools to respond to industry challenges and client needs. He will provide examples of industry innovation that embraces disruption, and he will discuss the importance of PBMs and manufacturers working as partners, rather than as adversaries, to effect change around patient care and outcomes.

10:15 am – 10:45 am

The Long View from Wall Street: Four Inflection Points

Ronny Gal, Senior Analyst, Global Specialty Pharmaceuticals and Biotechnology, Sanford Bernstein

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Wall Street analysts always offer a distinctive perspective of our industries. This session will address what Ronny believes to be the current key drivers impacting the U.S. pharmaceutical market.

Topics will include:

  • The emergence of the U.S. biosimilar market model;
  • The expansion of the orphan drug model, gene therapy to material size of drug costs;
  • New drug classes to watch: Alzheimer’s, NASH, pain and migraine; and
  • Drug market niches growing to become market distortions – 340B and patient assistance cycle.

10:45 am – 11:15 am

How Drug Channel Disruption Will Alter Pharmacy Benefit Management

Adam Fein, President, Pembroke Consulting, Inc. & Chief Executive Officer, Drug Channels Institute

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In this thought-provoking session, you’ll hear from industry expert Dr. Fein as he provides you with his perspective on crucial channel trends affecting pharmacy benefit management.

During his presentation, Adam will:

  • Explain the economic megatrends trends reshaping drug channel;
  • Describe key strategic responses by PBMs, wholesalers, pharmacies, and hospitals;
  • Examine the emergence of novel vertical and horizontal partnerships; and
  • Highlight business and strategy implications.

11:15 am – 11:45 am

A Recent Insider’s Assessment of Drug Trend and Marketplace Challenges

David Pyott, Professional Director, Private Investor, Philanthropist & Former Chairman of the Board and Chief Executive Officer of Allergan

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As somewhat of an industry observer since he left Allergan in 2015, David Pyott has the unique opportunity to offer a candid and unbiased assessment of the trends he has seen as shaping the pharma industry over the last three years and how those dynamics are shaping pharma’s interaction with PBMs in the context of a high price drug debate.

During this session, David will touch on themes such as:

  • Why drug price is getting attention from the Administration, Congress and the media like never before;
  • Tensions around transparency of price and incentivizing innovation;
  • Pharma channel strategy and the implications and financial incentives of the medical versus pharmacy benefit;
  • In a global health care world, the growing disconnect between evidence required by the FDA (or other regulatory agencies) versus evidence required by payers for formulary access;
  • Considerations around R&D compared to acquisition and managing for performance; and
  • How the growth of population health plays into all of this.

Tuesday, September 26
9:00 am – 9:30 am

State of the PBM-Manufacturer Partnership

Tim Wentworth, Chief Executive Officer & President, Express Scripts

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As the other sessions at the conference highlight, a number of challenges and opportunities exist for the future of the prescription drug market.  During his session, PCMA’s incoming Chairman of the Board, Tim Wentworth, will offer a strategic perspective with regard to those challenges and opportunities.  Tim will offer comments on the state of PBM-manufacturer relations and business objectives. Additionally, he will review changes in the pharmacy marketplace, options for changes to public policy, and a path forward to solve legislative and regulatory issues of interest to both the PBM and pharma industries.

  

9:30 am – 10:15 am

Shared Responsibility for Managing the Overall Cost of Care and Ensuring Patient Access at a Reasonable Cost Burden

Troy Brennan, Executive Vice President & Chief Medical Officer, CVS Health

Jim Meyers, Executive Vice President, Worldwide Commercial Operations, Gilead Sciences

Moderator: Ren Elder, President, Affect Rx, LLC

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Prescription drug cost continues to be an important subject for the PBM and pharma industries. Breakthrough therapies are entering the market and delivering tremendous value to our health care system. But we have to figure out how to pay for them. Every health care industry stakeholder including manufacturers, payers, PBMs, specialty pharmacies, hospitals, 340B entities, etc. has a role to play in managing the overall cost of care in the U.S. healthcare system and in ensuring patient access at a reasonable cost burden. Policymakers are telling all of us that if we can’t figure it out, they will figure it out for us and everyone in the audience can probably all agree that substantive government intervention would not be in the best interest of patient care.

During the course of this discussion, the panel will address the following proposed ideas that highlight the need for collaboration in addressing the challenges of drug access and affordability:

  • The benefits and barriers to value-based pricing and the alignment of price to clinical value;
  • The potential benefits and limitations of the proposed state-level transparency initiatives for both manufacturers and payers;
  • The potential impact  of increased government intervention on patient access and the overall cost of healthcare; and
  • How do we pay for transformative and curative therapies in a U.S. healthcare system built upon quarterly/annual budget cycles?

10:15 am – 11:00 am

Challenges in Payment and Delivery Systems for a New World of Complex Therapies

Jim Clement, Executive Director, Cost of Care and Supply Chain Strategy, Aetna Pharmacy Management

John Furey, Chief Operating Officer, Spark Therapeutics

Moderator: Tom Knox, President, Fathom Healthcare Solutions, Inc.

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A once just imagined world where complex treatments like gene and CAR T-cell therapies brought new hope to people suffering from life-threatening and life-altering diseases is suddenly here today. These products have the potential to fundamentally change the way we treat disease, but upfront costs and long-term durability of response present pricing and market access challenges. Gene therapy specifically, is an emerging field filled with great discoveries and the potential of creating major medical breakthroughs, including new approaches that may provide long-term, life-altering benefits to patients through the one-time administration of therapy. The health care system will need to evolve to be able to support the availability of these medical breakthroughs. Manufacturers and PBMs are exploring new and unique payment and delivery models to accommodate these new therapies.

During this session, the panel will explore the thought processes and steps it takes to navigate these unique arrangements and they will reflect on early lessons learned.  The panel will talk about the steps taken and issues considered to get where they are today, why it’s important to start the process early, and the importance for both sides to be willing to consider alternative, innovative solutions to help ensure access to innovative therapies.

The discussion will start with a foundation of novel, one-time therapies with key considerations and opportunities, followed by short-term solutions and finally discussing what some of the longer-term solutions may look like.

11:00 am – 11:30 am

Delivering Beyond Value

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

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Patients, payers, and policy makers are demanding value. “Value” seems to be the most recent buzzword used by payers, PBMs, and manufacturers when talking about improving care and lowering prescription drug costs but what does that really mean?

PBMs are working with manufacturers to deliver results, including keeping the drug trend lower than the cost of inflation and delivering more than $1.8B in savings in 2017 through the national preferred formulary or other innovative programs, but that’s not enough. Value is not just about trend but it’s about better overall health care and in order to ensure future affordability, we need to look beyond value. During this session Everett will share his views related to value, innovation, technology and the need for continued and deeper collaboration between our industries.

11:30 am – 12:00 pm

Trends in Drug Benefit Design

Kevin Host, President & Chief Operating Officer, PSG & Artemetrx Solutions

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As drug costs continue to rise, employers also continue to cite managing their specialty and overall drug benefit cost trend as their number one priority. During this session, Kevin will share the trends coming out of the payer community in terms of how they are structuring pharmacy benefit designs. He will discuss the increasing pressure payers are putting on their PBMs, how PBMs are shifting their business practices to demonstrate value, and what value means to their clients.

The following are a few of the key topics that will be addressed:

  • Managing cost is key;
  • Addressing transparency concerns;
  • Increasing the use of incentives to encourage healthy employee behaviors;
  • Benefit design opportunities and the impact of specialty; and
  • What this means for manufactures.