Access to Medicines: Formulary Policies and Costs

Dear Colleagues:
We are very pleased to welcome you to our Health Policy Lunch
Seminar, Access to Medicines: Formulary Policies and Cost. Since the
passage of Medicare Part D, there has been a tremendous amount of
activity and debate at both the policy and operations levels. While there
remain unresolved issues associated with Medicare Part D, the initial
confusion that was so evident for some beneficiaries and insurers has
somewhat diminished and the program has been settling into its own
routine, under the guidance of many dedicated and interested parties
from both the private and public sectors.
Today marks the inaugural seminar in a series that will address a
variety of important and timely health policy issues related to
pharmaceuticals. We are very pleased to have such a diverse panel of
experts including members of the government, patient advocacy groups,
employers, and professional pharmacy associations. We are currently in
the process of planning for our next seminar to be hosted some time in
the Spring of 2007.
We would like to take this opportunity to recognize Pfizer
Pharmaceuticals for their generous unrestricted support of the seminar
series. We hope that you will enjoy and participate in the discussion,
and that you will plan to attend our future seminars.
Sincerely yours,
Francis B. Palumbo, PhD, Esq
Executive Director,
Center on Drugs and Public Policy
Access to Medicines: Formulary Policies and Cost
C. Daniel Mullins, PhD
Chair and Professor
Pharmaceutical Health Services Research
November 8, 2006
Keynote Speaker
Juliette Cubanski, PhD, MPP, MPH
Principal Policy Analyst with the
Henry J. Kaiser Family Foundation
Panelists
Jennifer Bright, MPA
Vice President of State Policy for the
National Mental Health Association
Judith A. Geisler, RPh
Acting Director, Division of
Finance and Operations
Centers for Medicare and Medicaid Services
John R. Miller
Executive Director of the MidAtlantic
Business Group on Health
Scott R. Smith, RPh, MSPH, PhD
Director of Pharmaceutical
Outcomes Research
Center for Outcomes & Evidence
Agency for Healthcare Research and Quality
Kasey K. Thompson, PharmD
Director of the Practice Standards
and Quality Division
and Director of Patient Safety
American Society of Health-System Pharmacists
David Yoder, PharmD, MBA
Divisional Vice President of Pharmacy
for Elder Health
Access to Medicines: Formulary Policies and Cost
November 8, 2006
Juliette Cubanski, PhD, MPP, MPH
Juliette Cubanski is a Principal Policy Analyst with the Henry J. Kaiser
Family Foundation in Washington, D.C. The Foundation is a non-profit,
private operating foundation dedicated to providing information and
analysis on health care issues to policymakers, the media, the health
care community, and the general public.
As an analyst on the Foundation’s Medicare Policy Project since 2004,
Dr. Cubanski focuses primarily on health policy issues related to
Medicare, long-term care, and health coverage for low-income elderly
and disabled populations.
She is extensively involved in the
Foundation’s efforts to monitor and analyze the implementation of the
Medicare Modernization Act of 2003, with a primary emphasis on
assessing how Medicare’s new prescription drug benefit will affect
beneficiary access to and spending on drugs.
Dr. Cubanski has focused her research and professional experience in
the policy areas of Medicare and Medicaid, private health insurance
coverage, and health care access and financing, both at the national
and state levels. Her doctoral research at Harvard University examined
policies to reduce Medicare prescription drug spending and the potential
impacts of the Medicare-approved Prescription Drug Discount Card
Program, which was enacted as part of the Medicare Modernization Act.
Prior to her work at Harvard, she was the principal coordinator for the
California Health Policy Roundtable Project of the Center for Health and
Public Policy Studies at the University of California, Berkeley, where she
organized panel discussions to examine health care policies in California
and health policy proposals being considered by the California State
Legislature. Dr. Cubanski has authored numerous policy briefs on
Medicare, Medicaid, and strategies to cover the uninsured. She was
elected to membership in the National Academy of Social Insurance in
2005 and is also a member of AcademyHealth.
Dr. Cubanski earned a Ph.D. in health policy at Harvard University, a
Masters of Public Policy and a Masters of Public Health from the
University of California, Berkeley, and a Bachelor of Arts degree from
the University of California at Los Angeles.
Access to Medicines: Formulary Policies and Cost
November 8, 2006
Jennifer Bright, MPA
As Vice President of State Policy for NMHA, Jennifer Bright coordinates
strategy and advocacy tools to assist the association’s 340 affiliates in
influencing state and local public policy on appropriations, Medicaid, and
a host of other issues relative to mental health. With more than ten
years of experience in state government relations and public policy, she
has assisted corporate, association and non-profit organizations in
designing strategies to monitor and influence policy development on a
wide range of issues in state and local governments. Before joining
NMHA staff, Ms. Bright was Senior Vice President of Stateside
Associates, a state and local government consulting firm. She received
her bachelor’s degree in Political Science from Trinity College,
Washington, D.C., and a Masters of Public Administration, focusing on
Policy
Analysis, from
The
George
Washington
University.
Access to Medicines: Formulary Policies and Cost
November 8, 2006
John R. Miller
In 1992 John Miller joined the Washington, DC metropolitan hospital
association, the Healthcare Council of the National Capital Area
(HCNCA), as Director of Member Services and Special Projects. While at
the Healthcare Council, Mr. Miller managed affairs for 11 Management
Divisions of this association of over 50 hospitals in the Washington, DC
region. Mr. Miller also assumed the responsibility of Executive Director
of the Wellness Council of the National Capital Area, an association of
businesses promoting healthier lifestyles for employees and their
families. In 1996 HCNCA received a national award for collaboration
from the American Society of Association Executives.
In 1997, Mr. Miller left HCNCA to found the Network to Improve
Community Health (NICH), a non-profit organization that forms
partnerships
among
businesses,
hospitals,
health
insurers,
pharmaceutical companies, physicians, public health agencies, and
community groups. John continues to serve as Executive Director of
NICH, bringing together this large, often competing group to collaborate
on the one thing they have in common: a desire for healthier workers,
citizens, and community members.
In 1999, Mr. Miller took on the additional responsibility of Executive
Director of the MidAtlantic Business Group on Health, an association of
business health benefits professionals.
Members include Marriott
International, T Rowe Price, Legg Mason, McCormick Spice Company,
and about 20 more.
Access to Medicines: Formulary Policies and Cost
November 8, 2006
Scott R. Smith, RPh, MSPH, PhD
Scott R. Smith is a Senior Fellow at AHRQ in the Center for Outcomes
and Evidence where he is the Director of the Pharmaceutical Outcomes
Research programs. Dr. Smith is a registered pharmacist with a
master's degree in public health from the University of Illinois and a
doctorate in pharmaceutical sciences with a cognate in epidemiology
from the University of Michigan in Ann Arbor. At AHRQ, Smith also
directs the “Developing Evidence to Inform Decisions about
Effectiveness (DEcIDE) program, which is funded through the Medicare
Modernization Act and is the nation's largest network devoted to
therapeutic effectiveness research. In addition, Smith is a member of
the Centers for Education and Research on Therapeutics (CERTs)
Steering Committee. CERTs is a national demonstration program coadministered by AHRQ and the FDA whose mission is to conduct
research and provide education that advances the optimal use of drugs,
biologicals, and medical devices. Formerly, Smith was a tenured
Associate Professor at the University of North Carolina in Chapel Hill
where he maintains adjunct faculty appointments in the Schools of
Pharmacy and Public Health.
Access to Medicines: Formulary Policies and Cost
November 8, 2006
Kasey K. Thompson, PharmD
Dr. Kasey Thompson serves as the Director of the Practice Standards
and Quality Division and Director of Patient Safety at the American
Society of Health-System Pharmacists (ASHP) in Bethesda, Maryland.
Dr. Thompson has published numerous articles and book chapters on
medication-use safety and quality. He is co-editor along with Dr. Henri
R. Manasse, Jr., of the 2005 textbook: Medication Safety: A Guide for
Health Care Facilities. Dr. Thompson has given presentations nationally
and internationally; and has served on numerous advisory committees
for the federal government, and other public and private sector
organizations.
Dr. Thompson holds a Bachelor of Science degree in cellular biology
from Northeastern State University in Oklahoma; and Bachelor of
Science and Doctor of Pharmacy degrees from the University of
Oklahoma, College of Pharmacy. Dr. Thompson is also a graduate of
the ASHP Executive Residency in Association Management and
Leadership.
Access to Medicines: Formulary Policies and Cost
November 8, 2006
David Yoder, PharmD, MBA
Dr. Yoder is currently Divisional Vice President of Pharmacy for Elder
Health, a Baltimore based Medicare Advantage (MA-PD) and Prescription
Drug Plan (PDP) with business in Maryland, Pennsylvania, District of
Columbia and Texas. His responsibilities include formulary decisionmaking, clinical criteria development, oversight of Elder Health’s
Medication Therapy Management Program, PBM contract management,
and manufacturer relations.
Prior to Elder Health, Dr. Yoder was Vice President of Pharmacy for MidAtlantic Medical Services (MAMSI) and subsequently United Health Care
of the Mid Atlantic after MAMSI’s acquisition by United.
His
responsibilities there included P&T chairman, pharmacy network
contracting, manufacturer rebate contracting and responsibilities for
pharmacy call centers and the prior authorization unit. His previous
pharmacy experience includes home infusion, retail, mail order and
specialty pharmacies in the Maryland area.
Dr. Yoder received his PharmD degree from the University of Maryland
School of Pharmacy and an MBA from the University of Baltimore. He
currently is a Clinical Assistant Professor for the University of Maryland
at Baltimore Pharmacy School where he teaches a course on
management in integrated health systems. He is also a preceptor for
the University, taking 4th year pharmacy students for month long
rotations on managed care pharmacy. Prior to attending Pharmacy
School, Dr. Yoder spent 6 ½
years in the U.S. Navy stationed in San
Diego, California and Corpus Christi, Texas.
Dr. Yoder is a member of the Academy of Managed Care Pharmacy
(AMCP) and has served on various committees’ within the organization,
most recently on the Special Projects committee.
Dr. Yoder resides in Pikesville, Maryland where he enjoys gardening,
pinball machine restoration and cycling.
Access to Medicines: Formulary Policies and Cost
November 8, 2006
Pharmaceutical Health Services Research Department
The mission of the Pharmaceutical Health Services Research
Department (PHSR) is to improve health among diverse populations
through health services and other drug-related research, education,
service and community outreach.
The PHSR Department goes back to 1982, when the School of Pharmacy
developed a program in Pharmacy Administration. During the 1980s
and 1990s, the program experienced phenomenal growth and success.
As a result of the change in focus of our faculty members’ research and
teaching efforts, our graduate program name was changed to
Pharmaceutical Health Services Research (PHSR) under the auspices of
the Department of Pharmacy Practice and Science. In April of 2003 the
PHSR program became a separate Department within the School of
Pharmacy.
Access to Medicines: Formulary Policies and Cost
November 8, 2006
Center on Drugs and Public Policy
The goal of the Center on Drugs and Public Policy (CDPP) is to
contribute to informed debate of policy issues related to drug use in our
society. This is accomplished by a program of research and educational
activities carried out in a multi-disciplinary environment based in an
academic setting.
Drugs are very much a part of the nation's health care landscape. They
are used in every setting for every illness. Overall, when properly used,
drugs are the most cost-effective health care tool. Despite their
omnipresence, drugs only represent a small proportion of total health
costs and, hence, are often alternatively overlooked or given
disproportionate attention in the health policy arena. The CDPP seeks
to help overcome this neglect by concentrating on issues associated
with: health policy; health finance; pharmacoeconomics and outcomes
research; pharmacoepidemiology; drug law and regulation; drug use
studies; international pharmaceutical policy; and drug pricing.
CDPP routinely conducts and offers surveys, publications, data analysis,
manuscript review, managed care support, research and consultation,
database and literature searches, primary and secondary data collection,
prospective and retrospective analyses, symposia, conferences and
proceedings.
Access to Medicines: Formulary Policies and Cost
November 8, 2006
Unrestricted funding for this seminar was generously
provided by Pfizer Pharmaceuticals.
Look for our forthcoming seminar in the Spring of 2007.
Access to Medicines: Formulary Policies and Cost
November 8, 2006