Benefit Design and Marketing for Individual Health Insurance Products: “Life Stage” Strategies for Health Plans; New HSA ‘Grab Bag’ Guidance: Bottom-Line Impact on Health Plans, Employers and Banks; Winning Strategies for MA Plans and PDPs Under the Mid-July Medicare Law


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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 28, 2007
Health Plan Strategies for Managing the Wave of New Drugs in the 2007 Pipeline

Health plans and PBMs face huge challenges in 2007 with more than 2,000 new drugs in development (many in the final stages of approval) and 400 biologic therapies in the final stages of clinical trials. The oncology category alone has more than 175 experimental biologics waiting in the wings. The introduction of just one blockbuster drug can have a tremendous impact on health plans and PBMs, and 2007 could present multiple challenges of this nature. How are health plans and PBMs preparing for 2007's twin imperatives of providing broad access to needed new drugs while controlling drug spending?

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

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What are the most anticipated new drugs and biologics this year, and how will they affect your drug spending? In anticipation of the wave of new drugs that will hit the market in 2007, what strategies are health plans counting on to limit the use of expensive and unproven new products, while still making them available when truly needed?

Two pharmacy benefit experts analyze the 2007 Rx pipeline and offer concrete advice on how PBMs and health plans can manage effectively the new drugs (in such key areas as diabetes and asthma, as well as cancer) and important new indications for existing drugs that are anticipated. Specifically, they provide practical answers to these and other big-dollar questions:

  • What major new drugs and biologics are likely to require careful management in 2007?
  • How will these new drugs impact pharmacy spending?
  • Which of these new drugs are “me toos,” and which might offer real advances?
  • How can evidence-based formularies protect against overspending on “me-too” new drugs?
  • How quickly will the new drugs appear on plan formularies?
  • How should health plans and PBMs respond to demand generated by direct-to-consumer advertising?
  • How can Rx payers use generic drugs and over-the-counter formulations to mitigate the costs of the upcoming new brand drugs?

 

Speakers

JAKE NICHOLS, Pharm.D., is director of clinical affairs for the University of Massachusetts Medical School's Clinical Pharmacy Services. This pharmacy group is the sister organization of MedMetrics Health Partners, Inc., the only pharmacy benefit management (PBM) company founded by a medical school. Dr. Nichols and his group provide MedMetrics with clinical pharmacy programming services. Dr. Nichols also has served as director of clinical operations for the Boston Area Walgreens Patient Care Centers, where he oversaw programs that provided patient counseling through standardized and comprehensive patient education.

JOSEPH GIFFORD, M.D., is chief medical officer at Regence Blue Shield. Dr. Gifford is responsible for cost and quality of health care services, including PBM services provided by RegenceRx, for 1.1 million members in Washington state. He has extensive experience in the information technology sector, as well as on both the provider and payer sides of health care services. Prior to joining Regence BlueShield, Dr. Gifford co-founded a health care media software company and served in an Internet company spun off from Sun Microsystems. He was residency-trained in internal medicine at the University of Washington after receiving his M.D. degree from the University of California at San Diego.

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

 

Designed Especially For

Pharmacy directors, medical officers, clinical services directors, financial executives, marketers, consultants and contracting executives at:
  • Managed care organizations
  • PBMs
  • Pharmaceutical and biotech firms
  • Large employers
  • Retail pharmacy chains

 

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