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| Opening Page | Managing Costs | P4P Trends | Outlook 2006 | HSA Regulations | Future Care | ||||||
| Final Presentation Agenda |
Review the results of PBMI's annual employer prescription drug benefit survey reported in The Takeda Prescription Drug Benefit Cost and Plan Design Report.
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This presentation deals with ways in which to control Rx costs through creative benefit designs which strive to create consumer involvement in the drug decision making process. Many Rx benefit recipients currently have little knowledge regarding drug prices or choices among drugs in the same categories. Next Generation Rx plan designs need to create consumer involvement and responsibility in order to control costs.
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Across the health care value chain, consumerism is catalyzing participants' evolution form "entitled beneficiaries" to "discriminating purchasers." This presentation will describe consumer-directed strategies that employers are adopting for managing their prescription benefits.
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This presentation will examine Rx copay trends-amounts, differentials, structures-over the past two years, and discuss how an appropriate copay strategy can impact the effectiveness of cost management programs such as generic substitution and mail-order utilization. It will feature exclusive data collected in AIS's quarterly survey of PBMs and our twice-yearly survey of employers. It will discuss the variety of copay structures in practice right now in different types of populations, the theories behind them, and the challenges in implementing them. It will also provide current employee premium cost-sharing data to use as a basis for comparison in the future, as many experts believe that employer-sponsored health plans will be increasing their member cost sharing over the next year.
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This presentation will include information regarding current payment methods, new benefit design models, industry trends and insights into reimbursement models. We will also cover issues surrounding the current pharma reimbursement environment.
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"Accountability in Prescription Benefits" will explore emerging pharmacy cost management strategies in the context of the evolving PBM industry. Considerations will be presented with a focus on PBM auditing, contract assessment, and performance benchmarking with potential alternatives discussed.
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There are many emerging choices available to give you command of your pharmacy program. This presentation will explore options you have for driving your program to best match your company's strategic direction.
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Sandy discusses alternative solutions address operating a prescription drug program in today's environment, including: Fully-insured pharmacy carve-out programs to transfer all risk; Managed PBM program to optimize core functions of the process; and Independent auditing program to act as your watchdog and monitor costs.
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A significant compilation of relevant prescription cost and benefit data is made available, with analysis given as to the causes of data disparities between various sources, and the impact of selected data trends. This presentation is also available as a live "webcast" as indicated below.
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This session will focus on discussing the entire spectrum of Prescription Drugs within the context of the current Managed Health Care System in the United States. Specific methods and tools utilized by Employers to ensure Quality Care at Lower Costs for their members, to be discussed are: 1. Outsourcing; 2. Use of Pharmacy Benefit Managers (PBMs) or Third Party Administrators (TPAs); 3. Formularies; 4. Profiling; 5. Provider and Member Education Programs; 6. Managment and Oversight of the Benefit; 7. Audits-benchmark and ongoing to ensure Service and Performance; Guarantees; 8. Rebate Analyses
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This presentation includes an inside look at PBM business practices; specifically, how PBMs derive revenue from drug manufacturers and pricing spreads from pharmacies. The presentation includes valuable tips on what to look for and avoid in contracting with a PBM. With this information, Plans will be in a much better position to negotiate the optimal contract.
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"Management Strategies for Specialty Drug Therapies" will focus on strategies for managing specialty drugs such as injectables, infusion therapies and other high cost drug therapies. The importance of program design will be discussed with a focus on medical versus pharmacy billing and care management.
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Description of Presentation: Pharmacy benefit costs are continuing in an upward spiral. This presentation will focus on where those costs are heading, as well as solutions to help control them while improving health outcomes.
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Managed care pharmacists and medical directors are faced with ever-increasing challenges related to pharmacy benefit management as more sophisticated drugs become available to treat previously untreatable or poorly treated diseases. Many of these new biotechnology agents must be administered by injection and have historically not been part of the pharmacy department’s responsibility nor have they been a high priority for managed care in general. This presentation provides an overview of how health plans are managing injectable drugs and the services offered by specialty pharmacy vendors to meet the needs of health plans.
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This presentation explores: the growing need for Pharmacy Benefit expertise; How PBMs operate; The role of Drug Manufacturers; and Strategic plan and solutions. Drug data drivers, drug alternatives, the PBM business model, PBM/Drug Manufacturers relationships and a Strategic Plan for purchasers are examined in this process. |
Audioconference with On-Line Presentation* A significant compilation of relevant prescription cost and benefit data is made available, with analysis given as to the causes of data disparities between various sources, and the impact of selected data trends. This live webcast involves an audiconference conducted by Ms. Thayer combined with review of the on-line presentation. * Both Webcasts are limited to the first 30 attendees that register to participate in that webcast. Simple online registration instructions are provided to all attendees. Please note registrants will incur their own long distance phone charges for the audioconference portion. |