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| Sample Newsletters | MarketPlace Publications & Meetings |
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AIS Pharmacy Benefit MarketplaceScroll down to read short descriptions of AIS's Pharmacy Benefit products. Newsletters
Listing Print an order form: If you do not wish to place your order online, click here to download a printable order form (PDF file), then submit your order via fax or mail, as directed on the form.
DRUG BENEFIT NEWS, unique information gathered in AIS's own surveys of HMOs and pharmacy benefit management companies. Timely news and data on the business of pharmaceuticals ... and practical cost management strategies from experts throughout the industry. Includes data on high-cost drug categories, inside info on what HMOs and PBMs are doing, and information that will help you benchmark results and experiences. 24 issues annually ($537 per year) or 2-month intro ($86 for 4 issues); both include print copy and e-mail delivery.
MEDICARE PART D COMPLIANCE NEWS, news and strategies on implementation and compliance with the Medicare drug benefit — marketing, enrollment, formularies, rebates, claims pricing, and fraud, waste and abuse. 12 issues annually ($467 per year) or 2-month intro ($71 for 2 issues); subscriptions include print copy and e-mail delivery of the newsletter, biweekly "Part D E-Letters" and access to a special Part D Web site for easy access to all original documents.
SPECIALTY PHARMACY NEWS, a monthly
newsletter with news and strategies for managing high-cost biotech and
injectable products, designed to help health plans, PBMs, providers
and employers manage costs more aggressively and deliver biotechs and
injectables more effectively. Contains information on benefit design,
provider contracting, reimbursement, network building, claims management,
formulary decisions, and other pharmacy management issues. 12 issues
annually ($495 per year) or 2-month intro ($84 for 2 issues); both include
print copy and e-mail delivery.
2000-2007 SURVEY RESULTS: PHARMACY BENEFIT TRENDS & DATA, a valuable book and CD resource that features the complete results — plus analyses — of AIS’s quarterly survey of pharmacy benefit management companies, from the first quarter of 2000 to the second quarter of 2007. It contains hundreds of charts, tables and graphs on costs, benefit design, utilization and PBM market share, plus a complete directory of PBMs, PBAs, SPPs and related companies. An accompanying CD contains all of the raw survey data in spreadsheet form. ($1,175)
AIS’s PHARMACY BENEFIT SURVEY RESULTS, a unique resource containing the raw data from AIS’s quarterly survey of PBMs — that tracks growth and consolidation in the industry, and trends in costs, utilization and benefit design. Every four months, a new Excel spreadsheet is available to download, and includes data such as contact information, annual gross revenues, number of clients, number of prescriptions filled per year, and much more. ($150 per quarter)
GENETIC TESTING AND DIAGNOSTIC TOOLS IN THE PHARMACY BENEFIT examines the evolving presence and impact of genetic testing on health plans and the pharmacy benefit industry. It provides insight on coverage implications, pending legislation and government regulation, and some of the science behind the tests. ($84) PDF version available.
GUIDE TO MEDICARE REFORM LAW: OVERVIEW AND HIGHLIGHTS FOR HEALTH PLANS, HOSPITALS AND PROVIDERS, summaries and explanations of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 — in an easy-to-read format with a detailed table of contents for each of the 12 titles of the Act. ($84)
MANAGING CANCER CARE: STRATEGIES TO IMPROVE OUTCOMES AND LOWER COSTS examines recent developments from companies leading the way in the complex oncology management field. This valuable report takes a look at some of the management strategies and pricing methodologies that health plans have been instituting in hopes of reining in costs, as well as the federal government’s role in reimbursement. ($69) PDF version also available.
MEDICARE PART D: A COMPREHENSIVE ANALYSIS OF CMS RULES distills from thousands of pages of CMS regulations and guidance the major rules, guidelines and deadlines you need to comprehend the complex Medicare drug benefit program. It includes nine detailed chapters on sponsors, eligibility and enrollment, formularies, CMS enforcement and much more. ($124)
ONCOLOGY DRUG MANAGEMENT: A WHITE PAPER ON MARKETPLACE CHALLENGES, OPPORTUNITIES AND STRATEGIES, a white paper by pharmacy benefit expert Chris Nee. Filled with data and illustrations that clearly explain the oncology drug management industry’s history and current climate, this white paper includes case studies of various reimbursement scenarios and practical advice on how to design a cost-effective oncology drug program. ($156) PDF version also available.
PART D APPEALS & GRIEVANCES: STRATEGIES FOR MINIMIZING COMPLIANCE RISKS examines key issues surrounding Part D appeals and grievances. This report, based on a January 25, 2007, audioconference, shares expert advice on how to structure an effective appeals and grievances procedure — one that will help you avoid becoming a target of CMS enforcement. ($137) PDF version also available.
PBM CONTRACTING AND TRANSPARENCY ISSUES AND MODELS examines which contracting strategies have been successful, and which have failed or have contributed to confusion among pharmacy benefit clients. It details the decisions that factored into many contract negotiations, both in the public and private sectors, and pays particular attention to the role of transparency in these negotiations. ($84) PDF version also available.
PBM TRANSPARENCY: WHAT RECENT NEWS EVENTS MEAN FOR PAYERS, PBMs AND OTHER STAKEHOLDERS examines key developments and issues surrounding the PBM industry’s march toward greater transparency. Based on a November 30, 2006, audioconference, this report shares advice from three experts with different perspectives on the industry, on how you can make sense of, prepare for and take advantage of recent trends in PBM transparency. ($137) PDF version also available.
PRESCRIPTION DRUG REBATES AND EVOLVING REIMBURSEMENT METHODOLOGIES is a primer on the basics of drug rebates — how they have evolved over the years and continue to change. It examines how the health care industry has reacted to new reimbursement methodologies, and details strategies that have been successful, as well as ones that have increased confusion or conflict. ($84) PDF version available.
SPECIALTY PHARMACY: STAKEHOLDERS, STRATEGIES AND MARKETS, a comprehensive picture of the specialty pharmacy marketplace. Includes hard data and statistics on the vendors serving this health care sector, the products involved, and the strategies employed by payers for managing and delivering these products to members. ($312) CD version also available.
STATUS OF 104 DRUGS ON 30 HMO FORMULARIES provides information on some of the most widely prescribed pharmaceutical products (including some of the most popular injectables that are beginning to be covered under the pharmacy benefit) on 30 different HMO formularies as of February/March 2005. It will give you valuable insights you can put to use in establishing or modifying your own formulary. ($69) PDF version also available.
Meetings are listed
below in reverse chronological order, PART D ENFORCEMENT PITFALLS: HOW TO IDENTIFY AND ELIMINATE FRAUD AND ABUSE IN YOUR DOWNSTREAM ENTITIES, a CD of a 90-minute audioconference
held on March 13, 2008. Find out urgent new compliance challenges Part D plans face in light of CMS’ recently finalized regs that increase sponsor responsibilities for downstream entities … and learn steps you can take to identify and eliminate fraud and abuse at the various contact points for beneficiaries. Hear from Susan Hayes, principal and founder of Pharmacy Outcome Solutions and Steve Arbaugh, principal with ATTAC Consulting Group, LLC. ($329)
ORAL ONCOLOGY DRUGS: HEALTH PLAN STRATEGIES FOR AN EVOLVING MARKET, a CD of a 90-minute audioconference held on February 28, 2008. Find out what strategies plans are (or should be) using to manage oral oncology drugs, and what trends insurers should prepare for — from Lee N. Newcomer, M.D., senior vice president of oncology for UnitedHealthcare, Randy Falkenrath, senior vice president of specialty pharmacy and business development for UnitedHealth Pharmaceutical Solutions (UHPS), and Thomas McNulty, Pharm.D., chief clinical officer for Ancillary Care Management, Inc. (ACM). ($329)
“DRUG MIX” STRATEGIES FOR HEALTH PLANS AND PBMs: WAYS TO LOWER Rx COSTS AND WIN BUSINESS, a CD of a 90-minute audioconference held on February 13, 2008. Three leading pharmacy experts — Jake Cedergreen of Express Scripts, Helen Sherman of The Regence Group's RegenceRx and Tim Watson of Pharmaceutical Strategies Group — provide strategic insights on how health plans and PBMs can develop an effective drug mix, and thereby differentiate themselves in the marketplace. ($329)
EFFECTIVE HEALTH PLAN STRATEGIES FOR MANAGING EPOETIN PRODUCTS, a CD of a 90-minute audioconference held on September 27, 2007. Find out how health plans are managing drugs like Epogen and Procrit to assure best health outcomes for patients, and best financial outcomes for their own bottom lines. Speakers are: Helen Sherman, R.Ph., Pharm.D., senior director of pharmacy services and chief pharmacy officer at The Regence Group's RegenceRx, and Michael Joslin, chief operating officer of CareCore Oncology and executive vice president of CareCore National, LLC. ($322)
SPECIALTY INFUSION MANAGEMENT: EFFECTIVE STRATEGIES FOR HEALTH PLANS, a CD of a 90-minute audioconference held on July 18, 2007. Find out how health plans are managing infusibles, and how new drugs in the pipeline and proposed federal legislation could severely impact the bottom lines of commercial and Medicare health plans. Speakers are: David Willcutts, chief executive officer at Ancillary Care Management, Inc., and Bruce Rodman, M.B.A., vice president, health information policy for the National Home Infusion Association. ($322)
PART D DRUG REBATES: STRATEGIES FOR MINIMIZING A SERIOUS RISK OF FRAUD AND ABUSE, a CD of a 90-minute audioconference held on June 14, 2007. Learn how to identify and avoid fraud-and-abuse risks in drug-rebate negotiations, and stay in compliance with Part D requirements. Speakers are Gina M. Smith, of counsel in the Litigation Department of Ballard Spahr Andrews & Ingersoll, LLP; and Sam Rajan, R.Ph., vice president of clinical operations, and Daniel Best, director of manufacturer-trade relationships, at MemberHealth, a pharmacy benefit manager and national Medicare Part D sponsor. ($322)
EFFECTIVE ONCOLOGY MANAGEMENT STRATEGIES FOR HEALTH PLANS, a CD of a 90-minute audioconference held on March 20, 2007. Learn how to design flexible programs that manage out-of-control oncology drug costs without compromising patient outcomes — from Robin U. Smith, president of Biologics, Inc., and Al Heaton, director of pharmacy at Blue Cross Blue Shield of Minnesota. ($322)
HEALTH PLAN STRATEGIES FOR MANAGING THE WAVE OF NEW DRUGS IN THE 2007 PIPELINE, a CD of a 90-minute audioconference held on February 28, 2007. Jake Nichols, Pharm.D., clinical pharmacy programming consultant to MedMetrics Health Partners, Inc., and Joseph Gifford, M.D., chief medical officer at Regence Blue Shield, analyze the 2007 Rx pipeline and offer concrete advice on how PBMs and health plans can provide access to important new therapies while exercising prudent cost controls. ($322)
PART D APPEALS AND GRIEVANCES: STRATEGIES FOR MINIMIZING COMPLIANCE RISKS, a CD of a 90-minute audioconference held on January 25, 2007. Maureen Miller, an expert from Gorman Health Group and former senior policy analyst for HCFA, helps you go beyond the audit guide and learn how to structure an effective appeals and grievances procedure so that you don't become a target of CMS enforcement. ($292)
MANAGING RHEUMATOID ARTHRITIS: STRATEGIES FOR HEALTH PLANS, a CD of a 90-minute audioconference held on December 7, 2006. Find out promising ways to improve outcomes and reduce costs, which should trend even higher with expensive new RA drugs in the pipeline. Speakers are Helen Sherman, R.Ph., Pharm.D., director of pharmacy services at The Regence Group's RegenceRx, and Debbie Stern, R.Ph., vice president of managed care consulting firm Rxperts. ($292)
PART D COVERAGE FOR SPECIALTY PHARMACY DRUGS: RESOLVING COMPLEX PROBLEMS THAT REMAIN, a CD of a 90-minute audioconference held on October 26, 2006. Jennifer Bowman, a director of Avalere Health LLC, and Mary Jo Carden, RPh, JD, president of Carden & Associates, discuss how to navigate the complexities of Part D's impact on specialty pharmacy drugs — including advice on how to determine the correct coverage for “gray area” drugs that can potentially be covered under Part D or Part B. ($292)
MEDICATION THERAPY MANAGEMENT
PROGRAMS: HOW PLANS ARE WORKING
THROUGH THE CONFUSION, a
CD of a 90-minute audioconference
held on August 17, 2006. Learn practical
strategies for implementing medication
therapy management programs in Medicare
and commercial plans from two industry
leaders who have been working extensively
with MTMPs — William J.
Sullivan, principal consultant
and founder of Specialty Pharmacy
Solutions, LLC, and Eric J. Culley,
Pharm.D., manager of clinical
pharmacy services at Highmark Blue
Shield. ($292)
PART
D
FRAUD,
WASTE
&
ABUSE:
HOW
TO
COMPLY
WITH
CMS's
APRIL
25
GUIDANCE,
a
CD
of
a
90-minute
audioconference
held
on
May
11,
2006.
Keith
M.
Korenchuk,
a
partner
in
the
law
firm
McGuireWoods
LLP,
and
Debjit
A.
Ghosh,
a
senior
manager
in
the
Fraud
Investigation
&
Dispute
Services
branch
of
the
Health
Sciences
division
at
Ernst
&
Young,
discuss
strategies
to
help
you
comply
with
new
CMS
requirements
for
structuring
effective
FWA
compliance
programs
for
Part
D.
($292)
PART
D
VS.
PART
B:
HOW
TO
SOLVE
COMPLEX
COVERAGE
&
BILLING
PROBLEMS,
a
CD
of
a
two-hour
audioconference
held
on
April
27,
2006.
Gorman
Health
Group's
Babette
S.
Edgar,
Wendy
Weingart
and
Sharon
M.
Durfee
discuss
how
to
determine
the
correct
coverage
for
Part
B-only
drugs,
Part
D-only
drugs,
and
D
vs.
B
“crossover”
drugs,
so
you
can
head
off
compliance
problems
and
save
your
organization
from
lost
reimbursement.
($292)
STRATEGIES
FOR
THE
MAY
15
MEDICARE
PART
D
LOCK-IN,
a
CD
of
a
90-minute
audioconference
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