Audio CD and written materials of AIS's audioconference on January 20, 2005

Health Plan Strategies for Managing Specialty Pharmacy Costs

The FDA drug pipeline is packed with new, expensive biotech drugs and injectables that will require complex storage, patient administration and claims adjudication. Get the details of innovative strategies health plans are employing to manage the cost of specialty pharmacy products.

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

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Low-volume, high-cost biotech or injectable drugs are being used increasingly to treat complex (often chronic) diseases. In many cases, their successes are legendary, and the FDA pipeline promises to produce many more in the years ahead.

The cost of specialty pharmacy products and services can reach tens of thousands of dollars per dose — up to $200,000 per patient per year. For members with chronic conditions like hemophilia, infertility, cancer and multiple sclerosis, they can cost $1,000 or more per member per month, consuming a large portion of the plan's medical and pharmacy budget.

In recent months, most health plans have come to the realization that they need to take definitive action to manage their specialty pharmacy costs. But mistakes are being made, and many health plans have yet to implement a concrete strategy. Let our experts teach you to:

Learn about effective strategies for managing specialty pharmacy products, services and vendors, including how to:

 

Speakers

DEBBIE STERN, R.Ph. is Vice President of Rxperts, a managed care consulting firm in Irvine, Calif., where she is responsible for designing and implementing comprehensive programs to meet the needs of managed care clients. She has recently devoted considerable time to projects related to specialty pharmacy for all segments of the health care industry. Stern will present thorough step-by-step recommendations for efficient planning and implementation of a strategy to manage specialty pharmacy costs. In addition to 12 years of managed care experience, she spent five years in the pharmaceutical industry and 10 years in retail pharmacy. Stern has a B.S. degree in pharmacy from the University of Cincinnati and is actively involved in the Academy of Managed Care Pharmacy, where she recently completed a two-year term on the Board of Directors.

SUZY SADLER, Pharm.D. is Manager of Clinical Pharmacy Operations at Mutual of Omaha, owner of Exclusive Healthcare POS plan with 35,000 members in Nebraska and Iowa. In August 2004, Mutual of Omaha implemented a new specialty pharmacy benefit designed to steer utilization to the MCO's contracted specialty pharmacy vendors. Sadler will discuss the specialty pharmacy issues faced by the health plan and its employer clients, and detail the MCO's primary actions and decisions regarding plan design, contracting and clinical programs. Sadler graduated from Creighton University School of Pharmacy in 2000. In 2001 she earned a MBA from University of Nebraska. Prior to joining Mutual of Omaha in February of 2003, her professional work experience was within the pharmaceutical industry.

Moderator: Lauren Flynn, editor of AIS's industry-leading biweekly newsletter Drug Benefit News, and contributor to AIS's monthly Specialty Pharmacy News.

 

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