full conference program - Pharmacy Benefit Management Institute

Transcription

2016
Conference Brochure
February 29 – March 2, 2016
The Westin Mission Hills Golf Resort & Spa Hotel
Palm Springs, California
PBMI
Drug Benefit
Conference
21st
Annual
Creating
a Community
Creating a Community for
forImproving
Improving
Quality
of Care
Quality of
Care
21st Annual PBMI
Drug Benefit Conference
Message from the Executive Director
It is my pleasure to invite you
to beautiful Palm Springs, California for
our 21st Annual Drug Benefit Conference February 29 – March 2, 2016. Our meeting continues to
bring together health care experts from across the nation to share their insights of proven strategies
for managing the pharmacy benefit. It also attracts business leaders, decision makers, and health
care stakeholders who attend our conference to educate themselves on the latest and best
practices in pharmacy management.
The Pharmacy Benefit Management Institute’s (PBMI’s) mission is to create a collaborative community for improving quality of
care, and we want you to join us at our annual conference to become a part of this community. We’ll hit the ground running
with an innovative opening keynote by Dr. Daniel Kraft. Dr. Kraft, a progressive physician, will examine rapidly emerging, game
changing, and convergent technology trends and how they are and will be leveraged to change the face of health care and the
practice of medicine in the next decade.
Conference attendees will enjoy many choices of educational sessions spanning the pharmacy management continuum. Take a
look at the exciting speaker line up we have in store for you.
I am also pleased to announce that we’re enhancing the conference experience to include two activities for those of you looking
to burn some additional calories before sitting in the conference sessions each day. Be sure to join us on day two for a fun
early morning 5K Run/Walk. Then on day three, reenergize yourself with a yoga class before the last day of sessions.
Whether it’s your first time attending, or you are a frequent conference attendee, we look forward to seeing you in Palm Springs!
Jane Lutz, Executive Director, PBMI
Hotel Accommodations
It’s not just California, it’s Palm Springs — a desert oasis. Come join us and experience the picturesque mountain views
at the Westin Mission Hills Golf Resort & Spa hotel. The hotel includes two champion golf courses that you can enjoy.
From shopping to biking, to the Palm Springs Aerial Tramway, you are sure to find fun activities.
Conference attendees are responsible for making their own hotel reservations at the host property.
PBMI has reserved a block of rooms at the conference rate of $225* per night plus taxes.
This rate expires February 5, 2016 at 5:00 pm Pacific Time.
*Cancellation policy is 72 hours to avoid any penalties.
Attendees have two options to reserve a hotel room:
•Online: https://www.starwoodmeeting.com/events/start.
action?id=1508210531&key=39DB45
•Call: 1-877-253-0041 Please reference PBMI Conference
as the group name.
2
Note: This is a two-story resort. Only stairwell access is
available to the second floor. If you would like first-floor
accommodations, please notify the booking agent at
the time of your reservation.
2016 Keynote Speaker
Daniel Kraft, MD
Dr. Kraft has over 20 years of experience in clinical practice, biomedical
research, and health care innovation. Daniel chairs the Medicine track for Singularity University and
is Founding Executive Director for Exponential Medicine, a program which explores convergent,
exponentially developing technologies and their potential in biomedicine and health care. His various
TEDTalks have over 1 million views.
Following undergraduate degrees at Brown University and medical school at Stanford, Dr. Kraft
was board certified in the Harvard combined Internal Medicine and Pediatrics residency program
at the Massachusetts General Hospital and Boston Children’s Hospital. He went on to complete
Stanford fellowships in hematology/oncology & bone marrow transplantation, and extensive research in stem cell biology and
regenerative medicine. He has multiple scientific publications (Nature and Science) and medical device, immunology, and
stem cell related patents through faculty positions with Stanford University School of Medicine and as clinical faculty for the
pediatric bone marrow transplantation service at University of California San Francisco.
Dr. Kraft recently founded Bioniq Health, focused on enabling connected, data driven, and integrated personalized medicine.
He is also the inventor of the MarrowMiner, an FDA approved device for the minimally invasive harvest of bone marrow, and
founded RegenMed Systems, a company developing technologies to enable adult stem cell based regenerative therapies.
Dr. Kraft is an avid pilot and has served in the Massachusetts and California Air National Guard as an officer and flight surgeon
with an F-16 fighter Squadron. He has conducted research on aerospace medicine published with NASA, and was a finalist
for astronaut selection.
Dr. Kraft’s experience and vision in many ways epitomizes the kind of out-of-the-box thinking that is shaping, not only the
future of health care, but also the future of wellness, prevention, and biopharma.
Agenda-at-a-Glance
Sunday, February 28, 2016
4:00 pm to 8:00 pm
Early Onsite Registration
Monday, February 29, 2016
8:00 am to 7:00 pm
Registration
10:30 am to 12:00 pmPre-Conference Workshops
(2 sessions)
1:00 pm to 1:15 pm
Opening Remarks
1:15 pm to 2:15 pm
General Session–Keynote Speaker
2:15 pm to 3:15 pm
General Session
3:15 pm to 3:45 pm
Break–Educational Forum Café
3:45 pm to 4:45 pm
Educational Session (3 sessions)
4:55 pm to 5:40 pm
General Session
5:45 pm to 7:15 pmOpening Networking Reception–
Educational Forum Café
Tuesday, March 1, 2016
6:15 am to 7:30 am
5K Run/Walk
7:30 am to 8:30 am
Breakfast–Educational Forum Café
8:30 am to 9:30 am
General Session
9:30 am to 10:15 amPBMI Excellence Awards Ceremony
and 2016 Specialty Drug Benefit
Report Findings
10:15 am to 10:45 am Break–Educational Forum Café
10:45 am to 11:45 am Educational Session (3 sessions)
11:45 am to 1:15 pm Lunch and Educational Forum Café
1:15 pm to 2:15 pm
2:25 pm to 3:25 pm
3:25 pm to 3:45 pm
Break–Educational Forum Café
3:45 pm to 4:45 pm
General Session
4:45 pm to 6:15 pmNetworking Evening Reception–
Educational Forum Café
Wednesday, March 2, 2016
6:00 am to 7:00 am
Yoga Class
7:30 am to 8:30 am
Breakfast–Educational Forum Café
8:30 am to 9:30 am
General Session
9:40 am to 10:40 am Educational Session (3 sessions)
10:40 am to 11:00 am Break–Educational Forum Café
11:00 am to 12:00 pm General Session
12:00 pm to 12:15 pm Closing Remarks
3
2016 Conference
Highlights
Get the Pharmacy Management Education that You Need
With more than 20 sessions, you’ll gain insight into practical and proven strategies for effectively managing the drug benefit.
The conference will include three tracks that focus on the following themes:
•Track 1 — Business: Understand and engage in best business practices to promote a sustainable drug benefit
•Track 2 — Clinical Management: Maximize the clinical value of the prescription drug dollar, promote patient safety,
and enhance member outcomes
•Track 3 — Specialty and Compounds: Anticipate and plan for new and ongoing developments in the fast-growing specialty
drug pipeline
In order to provide more content, we have combined some presentations thematically into single sessions. These are denoted with
“Talk 1” and “Talk 2” on the conference program descriptions.
Design your perfect learning strategy: follow a specific track or mix and match—you choose. See pages 5-11 for the full program.
Conference Goals
After participating in the conference, attendees will be able to understand and act on:
•Best practices from accountable care organization (ACO) models and medication management programs
•Appropriate management strategies for the specialty drug benefit (including new drug therapies, transparency, and biosimilars)
•Effective strategies for managing compounded medications
•Key issues in the workers’ compensation arena (including legislation and preventing opioid abuse)
•Effective approaches for managing the traditional drug benefit (including medication adherence, transition of care, and
integration of pharmacy, medical, and lab data)
Participate in a Pre-Conference Workshop (2 available)
We are pleased to offer conference attendees two pre-conference workshops on the first day before the actual conference begins.
Both workshops are free of charge and offer another educational opportunity for you to get the most out of your PBMI conference
experience.
Workshop A: The Total Medical Costs of the Hepatitis C Virus in Commercial
and Managed Medicaid Populations
Sponsored by Primrose Healthcare Celebrity Ballroom A, B, & C
Henri Cournand, CEO and President, Primrose Healthcare
Rebecca Johnson, Healthcare Management Consultant, Milliman, Inc.
This workshop will be held February 29 from 10:30 am to 12:00 pm (see workshop description on page 5).
Workshop B: Delivering the Right Information to the Point of Care
Sponsored by Surescripts Celebrity Ballroom F, G, & H
Joseph DeLisle, MS, MBA, Senior Business Management Analyst, Surescripts
Earn Free Continuing Education Credit
4
PBMI offers continuing education credit for pharmacists and pharmacy technicians (Accreditation Council for Pharmacy
Education). Participants attending the conference can select from 11 sessions and may earn up to seven (7) contact hours
of CPE credit. Each session identified with CE is worth 1.0 contact hour.
28 Sunday
February
4:00 pm to 8:00 pm
Early Onsite Registration
29 Monday
February
Registration
8:00 am to 7:00 pm
10:30 am to 12:00 pm
Pre-Conference Workshop Sponsored by Primrose Health Celebrity Ballroom A, B, & C
Henri Cournand,
The Total Medical Costs of the Hepatitis C Virus in Commercial and Managed
CEO & President,
Medicaid Populations
Primrose Healthcare
According to the Centers of Disease Control and Prevention (CDC), there were approximately
Rebecca Johnson,
29,700 new cases of hepatitis C virus (HCV) in 2013.
Healthcare
Management
Recent claims based studies confirm the significantly higher total medical cost utilization of
Cournand
Johnson
Consultant, Milliman, Inc.
HCV positive patient populations over non HCV patients.
Strategies focused only on management of anti-viral drug costs may be misplaced and miss the bigger picture perspective and
underlying cost drivers for this population.
During this informative workshop, the presenters will take a deep dive into the results of a recent study and share why treating
the whole HCV patient, not just the HCV infection, is integral in helping to control costs.
Lunch is included and will be served at noon.
Pre-Conference Workshop Sponsored by Surescripts Celebrity Ballroom F, G, & H
10:30 am to 12:00 pm
Delivering the Right Information to the Point of Care
Joseph DeLisle, MS, MBA,
PBMs have a wealth of valuable benefit and medication adherence information that can be used by providers
Senior Business Management
to make better care decisions. Unfortunately, providers often don’t have access to this information during patient
Analyst, Surescripts
visits. By linking Electronic Health Records (EHRs) to PBMs, providers have access to clinically relevant,
actionable, and real-time information while the patient is in the office. These new services are a natural
DeLisle
extension of the e-prescribing workflow.
This session will discuss how:
• Patient Medication Benefit Check provides real-time patient specific cost and coverage details to maximize a patient’s
pharmacy benefit by identifying lower cost options.
• CompletEPA automates prior authorization processing within the e-prescribing workflow.
• Medication Management for Adherence delivers PBM adherence summaries and patient specific messages directly
into the provider’s workflow.
Lunch is included and will be served at noon.
1:00 pm to 2:15 pm
General Session Ambassador Room
Opening Remarks
Jane Lutz,
Executive Director, PBMI
The Future and Health of Medicine: Where Can Technology Take Us?
Dr. Daniel Kraft
From the perspective of a leading physician, scientist, and innovator, Dr. Kraft examines rapidly
emerging, game changing, and convergent technology trends and how they are and will be
leveraged to change the face of health care and the practice of medicine in the next decade.
Lutz
Kraft
General
Session Ambassador Room
2:15 pm to 3:15 pm
Wall Street’s Outlook on the PBM Industry
George Hill,
In this session, George Hill will share the latest insights into the PBM landscape from a Wall Street perspective. Attendees will
Director Equity Research
learn about the issues affecting PBMs, and their role in the health care supply chain.
Analyst, Deutsche Bank
3:15 pm to 3:45 pm
Note: Not all speaker photos available at time of printing.
Break – Educational Forum Café
Celebrity Ballroom D & E
Monday continued on next page.
5
3:45pm
to 4:45 pm
Breakout Sessions (Choose one of three)
Track
1
Business
Celebrity Ballroom A, B, & C
Jennifer
K. Fuhrmann-Berger,
PharmD, Vice President of
Clinical Services, BeneCard PBF
Samuel J. Kenish, CEBS,
Administrator, Teamsters Local
830 Employee Benefit Funds
The Power of Partnership in Managing the Cost of Health Care in Today’s Marketplace
Health care costs continue to rise at rates higher than inflation and the Institute of Medicine estimates the
United States health care system has wasted roughly $750 billion, 30% of health care costs, in recent years.
Find out how one union moved away from traditional delivery models for case and disease management and
effectively collaborated with its medical insurer and PBM to produce better health outcomes for its members
and two consecutive years of lower than anticipated spending.
Track
2
Clinical Management
Celebrity Ballroom F, G, & H
Getting the Most Out of Your Benefit Dollars:
Successful Retail Health Care and Medication Adherence Strategies CE
Talk 1 – The Shift to Retail Health Care: Leveraging for Patient Engagement and Payer Advantage
Michael
Jacobs, RPh,
Health benefit plans are changing, payer marketing efforts are directed toward a new type of consumer, and
Senior Director, Health &
personal accountability has entered the realm. Today’s health care consumer wants access and delivery of
Wellness Payer Relations,
many health care services to be convenient, reasonably priced, and fit into their daily lifestyle. Creating a
Wal-Mart Stores, Inc.
benefit plan and delivery system to meet all of these needs may not be possible, but there are many things
we can do. During this session Michael Jacobs will share what has been learned, and discuss how to engage
consumers in their own health care, learn of patient perceptions and beliefs, link into those perceptions, and
possibly even save some money while aligning goals and improving health.
Talk 2 – Strategies to Improve Medication Adherence and Help Keep People at Work
Kristin
Begley, PharmD,
During this session, Dr. Begley will discuss and explain strategies to increase adherence and will share
Vice President of Strategic
published research to support the efficacy of these strategies. This presentation will focus on direct ideas
Initiatives and Sales, Truveris
a plan sponsor can put in place to move the needle on adherence and make the pharmacy benefit more
effective at controlling overall costs.
Track
3
Kenish
Specialty and Compounds
Jacobs
Begley
Ambassador Room
Medical and Pharmacy in the Specialty Space – A Deeper Look CE
Talk 1 – Specialty Pharmacy Myth Busters: Know the Facts About the Medical
Casandra
L. Stockman,
Pharmacy Landscape
PharmD, Vice President,
True or False: Cancer medications are the most expensive medications covered under the medical
Medical Pharmacy Strategy,
benefit. False! Learn what is and how to manage other myths in this informative session.
Magellan Rx Management
As specialty drug costs continue to escalate there is an even more heightened sense of urgency
Kristen M. Reimers, RPh,
Stockman
Reimers
around getting ahead of the trend and better managing the costs while optimizing outcomes for
Vice President, Medical
patients. What is often overlooked is the management of specialty drugs on both the medical and pharmacy benefit. Medical
Pharmacy Strategy,
pharmacy drugs make up half of specialty spend. Join us and see how you compare to payers across the country as we bust
Magellan Rx Management
the myths of specialty drugs paid under the medical benefit and provide smarter ways for you to stay ahead of the trend.
Talk 2 – Connected Care: A Holistic Approach to Specialty Pharmacy
Suzanne
Tschida, PharmD,
According to a recent study conducted by IMS Health, specialty spend is expected to outstrip
BCPS, Vice President,
traditional drug spend as early as 2018. Traditional medication management approaches from
Specialty Benefit & Outcomes
health plans and specialty pharmacies have included utilization management, formularies, and
Strategy, OptumRx
contracting strategies. The approach needs to evolve and leverage technology and data across
Michael Zeglinski, RPh,
Tschida
Zeglinski
the various health care silos – medical, pharmacy, disease management, behavioral, patient
Senior Vice President,
reported biometric data, and wellness – to intelligently provide comprehensive care. During this session, OptumRx will share new
Specialty, OptumRx
approaches that leverage unique technologies (such as a live video consulting pharmacy service, extensive education videos,
and a platform that can identify issues in a timely manner based on medical and pharmacy data), extensive clinical and support
programs, and physician engagement tools, for a complete picture of an individual patient and the best way to engage with them.
Through comprehensive reporting, analysis, and insights, the health care industry can stay on top of market trends, mitigate cost,
improve outcomes, increase adherence, and better engage patients.
General
4:55
pm to 5:40 pm
A View of the National Health Care Landscape – from a Large Insurer’s Perspective
Richard J. Migliori, MD,
In this general session, attendees will hear the current state of the national health care industry from a large
Executive Vice President
insurer’s perspective including challenges and trends as well as impacts of new technology. Additionally,
and Chief Medical Officer,
attendees will learn about the importance of leveraging big data, clinical care, and consumer advocacy to
UnitedHealth Group
advance specialty pharmaceuticals.
Migliori
pm to 7:15 pm
5:45
Opening Networking Reception – Educational Forum Café
6
1 Tuesday
March
6:15 am to 7:30 am
5K Run/Walk
7:30 am to 8:30 am
Breakfast – Educational Forum Café
Location: Meet by Tennis Counts, Building F for check-in
General
8:30 am to 9:30 am
From Hep C to Cancer: Driving Fair Drug Prices Without Reinventing the Wheel CE
Steve Miller, MD,
Record-high drug prices, which are out of reach for many patients and unsustainable for payers, threaten to
Senior Vice President and
break the health care system. Pharmaceutical companies have more than 7,000 drugs in the development
Chief Medical Officer,
pipeline – many of them aimed at large patient populations such as those with high cholesterol, Alzheimer’s,
Express Scripts
and cancer – that could keep drug trend growing by double-digits each year. Express Scripts last year led the
Miller
charge in challenging exorbitant pricing on a hepatitis C treatment. In this provocative session, Dr. Steve Miller
will challenge conventional wisdom about payments for care in cancer, one of the most devastating and costly conditions. By once
again uniting behind a common cause and an uncommon approach, he believes PBMs and payers can increase value and better
support patients when they need it most.
General
9:30 am to 10:15 am
PBMI Excellence Award Ceremony and 2016 Specialty Drug Benefit Report Findings
Jane Lutz,
Join us for our first PBMI Excellence Award Ceremony. Organizations will be recognized and
Executive Director, PBMI
presented with an award for exceptional contributions across the pharmacy continuum.
Sharon Frazee, PhD, MPH,
Following the ceremony, Jane Lutz and Sharon Frazee will provide highlights of the findings
Vice President of Research
from PBMI’s 2016 Specialty Drug Benefit Report.
and Education, PBMI
10:15 am to 10:45 am
10:45 am to 11:45 am
Business
Track 1
Lutz
Frazee
Workers’ Compensation: Politics, Legislation, and Preventing Opioid Abuse
Talk 1 – The Politics of Workers’ Compensation
Brian Allen,
State legislators throughout the country are continually challenged with providing cost-effective care for injured
Vice President of Government
workers while creating a business-friendly environment. Issues such as how to control prescription drug abuse
Affairs, Helios
and misuse, physician dispensing, compounded medications, and closed formularies add to the challenge.
The trend to legalize marijuana is also creating legislative and regulatory issues throughout the United States.
Allen
This presentation will discuss these and other pertinent legislative and regulatory issues affecting workers’
compensation. Participants will learn about current and pending legislation and various special interest influences that impact
the development of laws and rules affecting the workers’ compensation system. This insight will demonstrate what the various
changes mean for the industry and how industry stakeholders can affect political change to their advantage.
Rochelle Henderson, PhD,
Talk 2 – Preventing The Problem Before It Becomes One: Strategies to Identify
Chronic Opioid Users
Senior Director Research,
The misuse and abuse of narcotic medication has significant financial impact. In workers’
Express Scripts
compensation, the use of long-acting opioid medications can lead to costs exceeding $100,000
Dan Hunt, DO,
per worker. Using unique and comprehensive analyses identifying characteristics associated
Corporate Medical Director,
Henderson
Hunt
with chronic opioid use in a newly injured worker population, opportunities to monitor opioid
Accident Fund Holdings, Inc.
prescribing utilization can be put in place before problems begin. Accident Fund Holdings, Inc., working with their PBM, enacted
a suite of management solutions to manage narcotic utilization. Accident Fund armed themselves with tools that hit every touch
point – from injured worker to physician – resulting in lower costs and safer treatment for injured workers. During this session,
results from this innovative program will be unveiled and discussed.
Tuesday continued on next page.
NEW FOR 2016
Attend PBMI’s Inaugural Excellence Award Ceremony
PBMI instituted a new Excellence Award program for 2016. This new award replaces the Rx Benefit Innovation Award and
will recognize organizations for excellence across the pharmacy management continuum in areas of: cost containment,
quality improvement, and quality of care. Award recipient(s) for 2016 will be recognized during the PBMI Drug Benefit
Conference on Tuesday, March 1, 2016, at 9:30 am in the Ambassador Room.
7
Track
2
Clinical Management
Libby
Johnson,
Managing the Pharmacy Drug Plan Spend: A Client’s Perspective
Director, Client & Business
During this session Keith Bruhnsen, University of Michigan Drug Plan, and Libby Johnson,
Analytics, PSG Consulting
PSG Consulting, will highlight unique strategies implemented by the plan to manage their
Keith Bruhnsen,
growing drug trend. The presentation will include market information and plan results for
Assistant Director and Manager
managing pharmacy drug trend in an ever-evolving marketplace.
Prescription Drug Plan,
University of Michigan
Track
3
Johnson
Bruhnsen
Ambassador Room
Results of a Hepatitis C Medication Management Program CE
Steven
G. Avey,
Hepatitis C has captured tremendous media attention due to the financial burden it has caused payers in the
Vice President, Specialty
U.S. with the new treatment options. This presentation will focus on several features of a high quality hepatitis C
Programs, MedImpact
management program that provides access to those people infected with the hepatitis C virus. The presentation
Healthcare Systems, Inc.
will include results from one such program including savings numbers.
Avey
11:45
am to 1:15 pm
Lunch – Celebrity Plaza
pm to 2:15 pm
1:15
Business
Track
1
Corey
Belken, PharmD,
Vice President, Artemetrx
Specialty Drug Solutions
Amy Moore,
Senior Vice President,
Healthcare Bluebook
Strategies for Increasing Transparency in Specialty Pharmacy CE
Participants will learn the value of greater transparency for specialty drugs through the medical
benefit. Patient savings, provider choice, and quality of care are covered to share the value of
transparency tools for health plans and members. Specific examples will be explored using drugs
like Remicade and Neulasta. In addition, general strategies for taking action and affecting the
Belken
Moore
specialty spend quickly will be discussed. Case studies and results will be presented to offer
practical steps that payers can apply using data, technology, and improved management. The speakers will share perspectives
from various real-life examples. Session participants will take away a sense of what is working and what is not, empowering
action beyond just theories and data.
Track
2
Clinical Management
Improving Overall Health Outcomes: Two Approaches that Work
Talk 1 – Leveraging PBM Services to Improve Transitions of Care on Discharge
John
McNulty, BS Pharmacy,
This presentation will focus on a transition of care case model being used in coordination with an insurance
Pharmacy Operations Manager,
provider/PBM, to serve the needs of identified special populations post discharge from acute care hospitalization.
Salem Health
John McNulty will share results of over two years of data from the initial pilot program and outline details of
how the program has been successfully expanded to serve other specific patient groups.
Ally, PharmD, MBA,
Talk 2 – Helping Health Plans Compete in a Value-Based System: A Focus on Improving Quality
AJ
As health care evolves, quality outcomes are the new focus for reimbursement. New payment models are shifting
Vice President, Argus Health
toward value-based care and pricing, which is tied directly to quality care measures. To achieve simultaneous
objectives of increasing revenue and reducing expense while also improving clinical outcomes, health plans are
seeking innovative solutions that go beyond the traditional PBM model. Argus Health will demonstrate the value
of integrating pharmacy, medical, and lab data to improve quality measures. Innovative solutions that integrate
these multiple sources of data can provide additional insights through convergent analytics to help plans invest
resources more wisely. Utilizing case study results, the presenters will demonstrate how convergent analytics
can be used to design patient and provider engagement programs that drive better care decisions and outcomes.
Track
3
McNulty
Ally
Ambassador Room
Emerging Issues in Specialty Pharmacy CE
Talk 1 – Controlling the Specialty Drug Trend
Randy
Falkenrath, MBA,
The cost of specialty drugs will reach $200 billion by the end of 2016. Estimates range from 13% to 25% in
Customer Advocacy Advisor,
annual cost growth through 2020 (source: Understanding Specialty Drug Forecasts, 2015, Milliman). During this
RJ Health Systems
session, attendees will learn about cost containment strategies for the fastest growing expense for payers.
Talk 2 – A Current View of Biosimilars in the U.S. Market: Initial Experience, Near Term Pipeline,
James
Langley, MBA,
Falkenrath
and Implications for Benefit Design
Chair – Life Sciences and
This presentation will focus on providing attendees with a current assessment of biosimilars in the U.S. market including:
Healthcare Practice,
• Initial experience based on the introduction of Zarxio including pricing, clinical experience, and positioning
Mead Consulting Group
• Biosimilar applications pending with the FDA
• Pipeline analysis by therapeutic category
• Biosimilar adoption trends and emerging plan designs
Tuesday continued on next page.
2:25
pm to 3:25 pm
Track
1
Business
Erik
Krisle,
Research Manager,
Leavitt Partners
Robert W. Dubois, MD, PhD,
Chief Science Officer,
National Pharmaceutical
Council
ACO Readiness: Maximizing the Value of Medications CE
During this session, the speakers will present the results of a national survey and an in-depth
qualitative study of the pharmaceutical practices of accountable care organizations (ACOs). The
research investigates ACO adoption of various medication management practices and capabilities,
the challenges associated with adopting medication management practices and capabilities, and
the relationship between adoption of those practices and capabilities and ACO performance on
financial and quality metrics. Results of the study have implications for how ACOs could deploy
resources and investments relative to medication use in order to achieve the “Triple Aim.”
Track
2
Clinical Management
Dubois
Gartner
von Ebers
Coffee
Newland
The Future of Medication Therapy Management Services:
Jim
Gartner, BS Pharmacy,
P4P and Emerging Care Models CE
MBA, Senior Vice President,
Payers ranging from commercial insurers and employers to managed Medicaid plans and even
Enterprise Health Partner
accountable care organizations are increasingly looking to MTM services as a strategy to achieve
Service, CareSource
their goals—namely, achieving better member outcomes while appropriately managing costs.
Paul von Ebers, MBA,
This panel is comprised of payer representatives and industry experts with varying perspectives
President and CEO,
on the future of MTM services and innovative care models. Panelists will discuss MTM as an
Prospective Health, LLC
evolving segment of the health care industry. MTM services are being implemented in both
David Coffee,
Medicare populations and non-traditional populations as a way to impact quality metrics. This
Manager, Clinical Pharmacy
panel will discuss how health plan payers are also implementing unique MTM models and
Programs, Medica Health
engaging unique care models to drive better results.
Insurance Plans
Brand Newland,
Vice President of Business
Development, OutcomesMTM
Track
3
Krisle
Ambassador Room
Practical Strategies for Assessing and Managing Compounded Medications CE
Talk 1 – Sort Through the Rhetoric and the Noise: Is your Current Compound Management
Del
Doherty, PharmD, PhD,
Strategy Working?
MPH, Vice President Managed
After 18 months of implementing PBM strategies to manage the expenditure on compound medications, plan
Care, PersonalMed LLC
sponsors are still unsure about the effectiveness of such strategies and their impact on total cost of care and
Gary McCrory, RPh, CCN,
patient outcomes. This presentation uses retrospective pharmacy and medical claims data to examine the costDirector of Pharmacy Billing and
containment strategies implemented by PBMs in order to provide plan sponsors with practical tools to assess
Compliance, PersonalMed LLC
current management strategies and their impact on total cost of care and patient outcomes.
Talk 2 – The Rising Costs of Compounded Drugs in Health Plans: How to Manage Them
John
Grossomanides, PharmD,
Compounded drug utilization continues to increase and drive up drug trend costs for employers and health plans.
Manager Health and Wellness,
During this presentation, the speaker will address what ingredients and components are driving up costs, provide
Pricewaterhouse Coopers
insight into these cost drivers, and share strategies on how to control these high rising costs.
pm to 3:45 pm
3:25
pm to 4:45 pm
3:45
Joe Taylor, CEBS, RHU, HIA,
Vice President – ACO Practice
Leader, FluidEdge Consulting
Carl Rosenbaum, MD,
President Innovative Wellness
Alliance, Holy Redeemer Health
System & IWA
Prize Drawing Winners Announcement and General Session Ambassador Room
New Models of Care: Effective Pharmacy Management for ACO Models
An expert panel of stakeholders representing different points of view (physician and consultant)
in ACO practices will discuss effective pharmacy management for ACOs and how lessons learned
impact patient care, cost, and utilization. They will also discuss the future of the ACO model.
Topics include how PBM strategies impact ACO performance, contracting and carve outs,
polypharmacy management, the impact of new and expensive drugs, specialty drug management,
adherence to medications, controlled substance abuse as well as generic and brand drug utilization,
cost, and brand drug price inflation.
pm to 6:15 pm
4:45
Networking Evening Reception – Educational Forum Café
Doherty
Grossomanides
Taylor
Rosenbaum
Conference Mobile App sponsored by MedImpact
We are happy to provide attendees with a mobile application for quick access to the agenda,
details about the speakers, sponsors, and exhibitors, and up-to-date conference information.
Login details will be shared with conference attendees a few weeks prior to the meeting. This application is compatible
with iOS, Android, Blackberry, and other smartphone and tablet devices.
Note: Not all speaker
photos available at
time of printing.
9
2 Wednesday
March
am to 7:00 am
6:00
Yoga Class
am to 8:30 am
7:30
Breakfast – Educational Forum Café
Location: Monte Luna Lawn near Building 16
Prize Drawing Winners Announcement and General Session Ambassador Room
8:30
am to 9:30 am
How Do You Say “No” to Expensive Drugs: Management Approaches for High Cost Drugs CE
Steve Johnson, PharmD,
Specialty drug costs have been increasing 15% to 30% per year and are expected to continue at this rate for
Senior Director,
the foreseeable future. Costly new specialty drugs, such as those to treat hepatitis C and high cholesterol,
Health Outcomes,
look to be a powerful factor in the rise of pharmacy benefit costs.
Prime Therapeutics
Due to these innovative product entries and skyrocketing prices, it is incumbent upon pharmacy benefit
Johnson
managers to develop tools that can help deliver these important medicines to members for which they’re
appropriate, at the lowest possible cost. Development of utilization management (UM) approaches will be described, and also
some of the challenges. The uptake and impact of these management approaches will be presented.
am to 10:40 am
9:40
Business
Track
1
Effective Strategies for Specialty Vendor and PBM Contracting
Talk 1 – Why One Specialty Pharmacy Might Not be the Best Solution
Christine
Johnston,
Often plans try to solve their specialty pharmacy costs by selecting one preferred specialty
Senior Vice President of Account
vendor. However, true savings related to specialty pharmacy may be found in properly managing
Management and Analytics,
these patients rather than focusing solely on the acquisition cost. This requires plans to find the
IPC/EvergreenRx
right specialty pharmacy for their top therapeutic classes. IPC will present a unique process that
Karla Barnett, PharmD,
Johnston
allows plans to truly save on the overall cost related to members taking specialty medications.
Consulting Pharmacist,
IPC/EvergreenRx
Talk 2 – Why PBM Transparency and Pass Through Solutions May Not Matter
Scott
Haas,
This presentation will delve into each PBM economic silo to educate attendees on the metrics that actually
Vice President, Wells Fargo
drive the ultimate net cost and value delivered by PBMs. At the end of this presentation, attendees will have
Insurance Services USA, Inc.
a better understanding of current PBM pricing mechanics versus market-based alternatives.
Barnett
Haas
Track
2
Clinical Management
Electronic Prior Authorization: Leveraging the Latest Technologies to Improve Care
Gulzar
Virk, MBA,
Delivery and Determine Optimal Benefit Coverage
Product Manager, Physician
Prior authorization (PA) is a tool used to ensure that drug benefits are administered as designed
Connectivity, CVS Health
and that plan members have access to care that is medically appropriate and cost effective.
Tony Schueth, MS,
Today, however, it is very costly to administer PAs for employers, PBMs/payers, and providers,
Founder and CEO,
Virk
Schueth
and they can delay patient access to medication therapy for days or even weeks. During the
Point-of-Care Partners
presentation, the speakers will discuss the current prior authorization landscape and how PA can be integrated with prescriber
work flow, providing best practices and lessons learned from a two-year case study that successfully used prospective electronic
prior authorization (ePA) to dramatically simplify medication PA for patients, providers, and payers/PBMs.
Wednesday continued on next page.
Enjoy Daily Networking Opportunities
Take advantage of opportunities to network and establish relationships with peers and colleagues during the following venues:
•Breakout sessions designed for benefits generalists and managed care professionals
•Educational Forum Café with reference materials on topics to address your specific drug benefit needs from various exhibitors
•Networking receptions, breaks, and meals
Visit the Educational Forum Café
Be sure to check out our Educational Forum Café in the Exhibit Hall (Celebrity Ballroom D & E) to mingle, network, and
collect the latest product and service information from our exhibitors. Remember to get your Exhibit Hall Card stamped by
all participating exhibitors for a chance to win one of two $100 Visa gift cards or a grand prize. Prizes will be announced
during the General Sessions on Tuesday, March 1 and Wednesday, March 2. Winners must be present to win.
10
Track
3
Ambassador Room
Managing Specialty Medications CE
Talk 1 – Adherence Innovations Delivered Through Clinical Objective Science &
Kevin
Krock, PhD,
Predictive Analytics
Director of Research and
During this presentation, attendees will gain insights into innovative and objective clinical
Development, Precision
laboratory tests and predictive analytic tools capable of increasing drug compliance, reducing
Diagnostics
pharmaceutical waste/spend, and minimizing drug abuse, misuse, and diversion. Specialty and
Patrick Burns,
Krock
Burns
traditional drugs are entering the market at increasingly high prices. This, along with the
President,
national drug abuse epidemic, call for medication adherence monitoring and advanced analytics as key solutions in controlling
Principled Strategies, Inc.
costs and improving outcomes.
Talk 2 – Management of Specialty Medication Utilization and Cost –
Katie
Holcomb, FSA,
An Actuarial Perspective
Consulting Actuary, Milliman
This presentation will provide an overview of the current and future landscape for specialty
Todd Wanta, FSA,
pharmaceuticals, with an emphasis on site of care. It will focus on the results of a recent
Consulting Actuary, Milliman
specialty benchmarking study, which analyzed specialty utilization in both medical and pharmacy
Holcomb
Wanta
settings for the commercial market. The presentation will cover differences in spending by place
of service, top therapeutic classes, and changes in specialty product utilization and costs over time, as well as approaches for
optimizing site of care and managing costs. The presenters are actuaries who will focus on the financial perspective of these
issues, alongside some clinical input from a pharmacist.
10:40
am to 11:00 am
General Session Ambassador Room
11:00
am to 12:00 pm
The U.S. Pharmaceutical and Pharmacy Market: Trends, Issues, and Outlook
Douglas M. Long, MBA,
Get an expert’s view of what lies ahead for the pharmaceutical and pharmacy market. This session will
Vice President, Industry
highlight trends, issues, and future outlook in demographic sales, markets, and more. Find out which industry
Relations, IMS Health, Inc.
segments (brands, generics, and specialty) are growing or declining and how evolving trends may impact your
business. During this presentation Doug will:
1.Explain the trends, issues, and future outlook for the pharmaceutical industry.
2.List the disease states and areas of treatment that are expanding or declining.
3.Identify what evolving trends may impact the utilization of pharmaceuticals in community pharmacy practice.
4.Understand the potential health care savings by the responsible use of medicines.
12:00
pm to 12:15 pm
Closing Remarks
Long
Ambassador Room
NEW FOR 2016
Extracurricular Fun and Free Activities for Conference Attendees
5K Fun Run/Walk | March 1 | Check-in 6:00 am | Fun begins 6:15 am
On your mark, get set, go! We invite you to join us for a light run or brisk walk to jumpstart your morning for a full day of learning.
A complimentary T-shirt and bottled water will be provided. Be sure to select your T-shirt size online when you register for the event.
Location: Meet by the Tennis Courts, Building F for check-in.
Yoga Class | March 2 | 6:00 am to 7:00 am
Take a deep breath in and join us for an invigorating, yet relaxing yoga session on a beautifully landscaped lawn to help get you ready
for the last day of learning. Each participant will receive a complimentary yoga mat.
Location: Meet at the Monte Luna Lawn near Building 16.
About PBMI
PBMI is an independent research and educational organization dedicated to unraveling the complexities of pharmacy
benefit management. Since 1995, we have provided thought leadership, independent research, and valuable resources
that support evidence-based, actionable decision making by health care stakeholders. PBMI also provides a forum for
purchasers to exchange ideas and drive marketplace changes that improve pharmacy benefits and control costs.
To learn more, visit www.pbmi.com.
11
FREE Conference Workshop & Extracurricular Activity Registration
Please sign up online while completing conference registration or complete and return this form.
Fax form to 480-222-4229, or mail to: 2901 North Dallas Parkway, Suite 420, Plano, Texas 75093
Pre-Conference Workshop (2 available)
We are pleased to offer conference attendees two pre-conference workshops on the first day before the actual conference begins.
Both workshops are free of charge and offer another educational opportunity for you to get the most out of your PBMI conference
experience.
Workshop A: The Total Medical Costs of the Hepatitis C Virus in Commercial
and Managed Medicaid Populations
Sponsored by Primrose Healthcare Celebrity Ballroom A, B, & C
Henri Cournand, CEO and President, Primrose Healthcare
Rebecca Johnson, Healthcare Management Consultant, Milliman, Inc.
Workshop B: Delivering the Right Information to the Point of Care
Sponsored by Surescripts Celebrity Ballroom F, G, & H
Joseph DeLisle, MS, MBA, Senior Business Management Analyst, Surescripts
NEW FOR 2016
Extracurricular Fun and Free Activities for Conference Attendees
5K Fun Run/Walk | March 1 | Check-in 6:00 am | Fun begins 6:15 am
On your mark, get set, go! We invite you to join us for a light run or brisk walk to jumpstart your morning for a full day of learning.
A complimentary T-shirt and bottled water will be provided. Be sure to select your T-shirt size online when you register for the event.
Location: Meet by the Tennis Courts, Building F for check-in.
Yoga Class | March 2 | 6:00 am to 7:00 am
Take a deep breath in and join us for an invigorating, yet relaxing yoga session on a beautifully landscaped lawn to help get you
ready for the last day of learning. Each participant will receive a complimentary yoga mat.
Location: Meet at the Monte Luna Lawn near Building 16.
FREE Pre-Conference Workshops
We are pleased to offer conference attendees two pre-conference workshops on the first day before the actual conference begins. These
workshops will be held February 29 from 10:30 am to 12:00 pm. Lunch is included and will be served at noon.
Please check which workshop you would like to attend.
qW
orkshop A: The Total Medical Costs of the Hepatitis C Virus in Commercial and Managed Medicaid Populations
Sponsored by Primrose Healthcare
qW
orkshop B: Delivering the Right Information to the Point of Care
Sponsored by Surescripts
12
Extracurricular Fun and Free Activities for Attendees
Please check which events you would like to attend.
q 5K Fun Run/Walk | March 1 | Check-in 6:00 am | Please select your T-shirt size: q S q M q L q XL q XXL
q Yoga Class | March 2 | 6:00 am to 7:00 am
Registration – 2016 PBMI Drug Benefit Conference
February 29 – March 2, 2016 • Westin Mission Hills Golf Resort & Spa Hotel • Palm Springs, California
Register online at www.pbmi.com and click on Conferences
or complete and return this form.
Fax form to 480-222-4229, or mail to: 2901 North Dallas Parkway, Suite 420, Plano, Texas 75093
Mr./Mrs./Ms. _______________________________________ Title __________________________________________
Organization ________________________________________ Email __________________________________________
Address __________________________________________________________________________________________
City/State/Zip ______________________________________ Phone ___________________________________________
PBMI MEMBERS—Login before registering online to get a 10% discount.
Before 2/5/16 After
2/5/16
Employers, Health Plans, and Union Groups
q $750
q $850
Best Value Join & Go For Nonmember Employers, Health Plans, and Union Groups*
q $699
q $799
PBMs, Industry Partners, Suppliers, Consultants, and All Others
q $1,395
q $1,495
Students (for eligibility, must register with student school email address)
q $199
q $199
* Join & Go Package includes a one-year PBMI Individual Membership ($150 value) with the member registration rate for the Conference.
Employers, health plans, union groups, and other plan sponsors of drug benefit programs are eligible for this option.
q Charge my credit card
q Bill me
q My check/money order for $ ______________________ is enclosed
Name on credit card ______________________________________ Signature ____________________________________
Card# ________________________________________________________________ Exp: __________/____________
Continuing Education Credit
Pharmacists
8 48 West Bartlett Road, Suite 3E, Bartlett, IL 60103
Phone: 630-540-2848 Fax: 630-540-2849
www.ProCE.com
The continuing education activities for pharmacists have been developed through
a joint providership of ProCE and PBMI. The 11 sessions offering ACPE credit
will be designated in the program announcement with a continuing education
CE icon. The release date for these activities is February 29, 2016.
ProCE, Inc. is accredited by the Accreditation Council for
Pharmacy Education as a provider of continuing pharmacy
education (CPE). Participants attending the conference CPE
activities may earn up to 7 contact hours of CPE credit.
Note: Some of the CPE sessions are being held concurrently. Conference registration fees cover the cost of CPE credit.
Statements of completion will be issued at www.ProCE.com upon successful
completion of the online CPE activity learning assessment(s) and activity
evaluation(s). All learning assessment(s) and activity evaluation(s) must be
completed no later than April 1, 2016. No partial credit will be given for any
individual session. Conflict of interest disclosures are required of all faculty
and shall be provided to all participants at the conference.
Registration Policies
Cancellations received before February 16, 2016 will receive a refund less a
$150 administrative fee. Registration fees paid after February 16, 2016 are
nonrefundable. If necessary, substitutions are acceptable. To transfer your
registration to a colleague, contact [email protected] before February 26, 2016.
Hotel Reservations
Conference attendees are responsible for making their own hotel reservations
at the host property:
The Westin Mission Hills Golf Resort & Spa Hotel
71333 Dinah Shore Drive
Rancho Mirage, CA 92270
See page 2 for full details and reservation options.
2901 North Dallas Parkway, Suite 420, Plano, Texas 75093
Phone: 480-730-0814 Fax: 480-222-4229 www.pbmi.com
© 2015, Pharmacy Benefit Management Institute
All Rights Reserved
11/2015

full conference program - Pharmacy Benefit Management Institute

Transcription

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