Winning Strategies for MA Plans and PDPs Under the Mid-July Medicare Law; Health Plan Strategies for Using Predictive Modeling in Underwriting


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Visit AISEducation.com for more news and strategic information for today's business leaders
 
Audio CD and written materials of
AIS's audioconference on
February 13, 2008

“Drug Mix” Strategies for Health Plans and PBMs: Ways to Lower Rx Costs and Win Business

Offering the optimal “drug mix” —  which reflects which medications are utilized and in what volumes — has become increasingly important for PBMs and health plans hoping to lower Rx payers’ drug costs. Developing an optimal drug mix can assure high-quality prescription benefits while avoiding unnecessary costs. PBMs and plans that adopt strategies to positively impact drug mix should have a competitive advantage over those whose sole focus is on achieving aggressive drug pricing, discounts and fees.  But how should pharmacy benefit executives develop and implement strategies to achieve the right mix of generics and preferred brands? And how do vendors and plans convince potential clients that their drug mix will achieve the desired goals?

Sponsored by Atlantic Information Services, Inc., publisher of Drug Benefit News, Specialty Pharmacy News and Health Plan Week

Speakers
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Drug mix measures how well a pharmacy program drives utilization to generic or lower-cost brand drugs. Evaluating a PBM’s ability to positively impact drug mix should become a factor in the selection of a pharmacy benefit management partner, as many of the traditional pricing factors have become less differentiated in recent years. Vendors and plans that can demonstrate an ability to improve drug mix should have an advantage over competitors that base their offerings only on factors such as drug pricing, dispensing fees and administrative fees.

The key question becomes how to achieve an optimal drug mix that provides sufficient choice to members while also driving utilization to lower-cost drugs. Three leading pharmacy experts will provide strategic insights on how health plans and PBMs can develop and utilize the optimal drug mix. Among the key topics they will cover are:

  • How an optimal drug mix can result in significant savings
  • How drug mix has become a  factor in selecting a pharmacy benefit manager
  • What PBMs and plans must do — and NOT do — to develop the best drug mix
  • What types of member incentives are most effective in driving optimal drug mix
  • How plan sponsors can evaluate drug mix
  • How contractual mechanisms can ensure accountability for achieving drug-mix goals
  • How other factors, including drug pricing and discounts, must be evaluated by plans and PBMs at the same time as drug mix

Speakers

JAKE CEDERGREEN joined Express Scripts, Inc. in 2003. He leads the product strategy and analytics functions for the PBM. Mr. Cedergreen works collaboratively with Express Scripts sales, finance and operations teams to drive value to plan sponsors and patients. His experience at Express Scripts includes pricing, analytics, market intelligence, benefit design and product positioning. Prior to joining Express Scripts, Mr. Cedergreen was business/finance manager for Washington University Medical Center and Barnes-Jewish Hospital in St. Louis. At Washington University and Barnes-Jewish Hospital, Mr. Cedergreen was responsible for hospital and physician level financial analyses, business development and procurement for the department of surgery. He graduated with masters’ degrees in both business administration and health administration from University of Missouri, Columbia. He received his bachelor’s science from the University of Illinois, Champaign. 

HELEN SHERMAN, R.Ph., Pharm.D., is senior director of pharmacy services and chief pharmacy officer at The Regence Group's RegenceRx, a not-for-profit PBM whose evidence-based research program makes it a national leader in assessing the value of medications, reducing pharmacy trends and increasing generic utilization. Regence serves about 2.6 million members of Blue Cross/Blue Shield plans in Oregon, Washington state, Utah and Idaho. Dr. Sherman, who joined RegenceRx in 1996, is responsible for the company's scientific review process, and also develops educational information/tools for consumers and doctors and facilitates benefit design. She has more than 20 years of experience in managed care, retail, hospital, home care and community research settings. Dr. Sherman earned her bachelor's degree in pharmacy from Oregon State University and her Pharm.D. from Purdue University, and she is a member of the Academy of Managed Care Pharmacy.

TIM WATSON, Pharm.D., is principal of Pharmaceutical Strategies Group. Dr. Watson has extensive experience in the pharmacy benefits arena, including management experience with several leading PBMs, consulting experience with Deloitte & Touche, and now as a principal and co-owner of a large pharmacy benefits consulting firm. He is a frequent contributor to leading trade journals, and is author of AIS's best-selling book PBM Formulary Strategies and Their Impact on Payers, published in 2003. He has provided pharmacy consulting services to some of the largest employers and plan sponsors in the country. Dr. Watson received his Pharm.D. from the University of Arizona.

Moderator: Neal Learner, managing editor of AIS’s Drug Benefit News

 

Designed Especially For

Executives, product developers, business development and marketing directors, financial managers, pharmacy directors, medical officers, clinical services directors, consultants and contracting executives at:

  • Health plans
  • PBMs
  • Pharmaceutical companies
  • Pharmacy retailers
  • Large employers
  • Public employee retirement plans

 

Shipping Information

Audio CDs and written materials are shipped via UPS. Please give us your street address when you order (UPS does not deliver to PO boxes). You should receive your order within 5-7 business days.* Shipping cost is $5.

Rush Orders: Please call us at 800-521-4323 to place a rush order.* We will overnight your order for an additional charge of $30, or you can give us your FedEx or UPS account number and we will charge the shipping to your account. Rush orders placed after 3:00pm EST will not be shipped out until the next business day.

*Please note that shipping of CDs and materials will begin within three weeks of the conference.

 

Written Materials

Listeners will also receive practical written information to supplement information covered by the audioconference speakers.

 

For further information call 800-521-4323 or e-mail customerserv@aispub.com


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