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Drug maker copay waiver programs are more common for specialty pharmaceuticals, but are used increasingly often for brand-name drugs — and with a big impact. For example, Pfizer Inc. gives patients with commercial insurance a copay card for its statin Lipitor. A company Web site explains that “if your insurance copay is $35 or greater, you can instantly receive $15 toward your copay, up to 12 times per year ($180 in savings).” Some health insurers worry that copay subsidy programs are promoting less healthy drug alternatives, like rescue inhalers for asthmatics rather than controller medications. Others say such programs entice members to switch to expensive brand-name medications and remain on them even after the subsidy program ends. In addition, drug companies may be passing copay costs on to payers by raising overall drug prices. And it’s difficult to assess the actual impact since payers often cannot tell how patients pay for cost-sharing amounts. Hear Michael Cartier, chief clinical officer at Twinsburg, Ohio-based PBM Envision Pharmaceutical Services, Inc., and George Van Antwerp, general manager of pharmacy solutions at Silverlink Communications, Inc., provide valuable insights and practical advice on how health plans can track and counteract copay subsidy programs. You’ll get all the details on strategies you can design and implement immediately, including:
MICHAEL CARTIER is the executive vice president of Twinsburg, Ohio-based PBM Envision Pharmaceutical Services, with responsibility for trade relations and clinical strategy. Prior to his position at Envision, he was the founder and president of Innovative Pharmaceutical Marketing, a consulting firm that provides services to managed care organizations, pharmacy benefit managers, medical groups, and the pharmaceutical industry. Prior to forming Innovative Pharmaceutical Marketing, Dr. Cartier was president and chief operating officer of Intergrated Pharmaceutical Services, the pharmacy benefit management subsidiary of Foundation Health Systems. In that position, he was responsible for all aspects of IPS's business; including sales and marketing, operations, manufacturer and pharmacy provider contracting and clinical programs/disease management. Dr. Cartier has over 25 years experience in managed care pharmacy practice. Prior to joining Foundation, he served in various pharmacy management positions at Maxicare and Health Net. He received his Doctor of Pharmacy Degree from the University of Southern California and completed a post-doctoral residency at Presbyterian Intercommunity Hospital in Whittier, California. GEORGE VAN ANTWERP is general manager of pharmacy solutions at Silverlink Communications, Inc. Mr. Van Antwerp is an expert in the PBM sector, working with over 10 different PBMs at Silverlink and previously holding senior director and consulting positions at Express Scripts, Inc. and Ernst & Young. At Express Scripts, he increased mail-order utilization, led generic efforts, launched numerous products and improved program profitability. Mr. Van Antwerp’s insights about health care can be found on his blog, Enabling Healthy Decisions. He has an MBA and a Masters of Architecture from Washington University and a BS from the University of Michigan. Moderator: Jill Brown, managing editor of Drug Benefit News. Pharmacy, clinical services and medical directors; strategic planners; product development, contracting and marketing executives; and financial and operations executives at
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