Innovative Strategies for Managing Specialty Pharmaceuticals

Venue: The Melrose Hotel

Location: Dallas, Texas, United States

Event Date/Time: Oct 27, 2003 End Date/Time: Oct 29, 2003
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With specialty pharmaceutical treatments costing up to $300,000 per patient per year and chronic disease patients accounting for up to 65% of pharmacy spending it is critical for plan sponsors to identify strategies to manage these high cost low volume drugs. Leading health insurers Tufts Health Plan, Aetna, Inc, and Oxford Health Plan are among the few insurers currently following the progress of their own recent initiatives to manage these costs. The Institute for International Research is pleased to present these findings at our Innovative Strategies for Managing Specialty Pharmaceuticals conference, the second installment of our Pharmacy Cost Management Series. The mission of this conference is to provide health insurers with the tools to institute an effective management system and overcome the challenges associated with managing specialty pharmaceutical cost including drug utilization, and distribution as well as patient care, benefit structure and claims.

On Day One of the conference we provide two half-day workshops: The morning workshop focuses on strategies for specialty oncology pharmaceuticals and ways to design programs for managing cost and accountability. Contracting with specialty pharmaceutical vendors and pharmacy benefit manages is the concentration of the afternoon workshop where best practices for structuring pricing models and improving the RFP process are discussed by Oxford Health Plan's Director of Contracting.

Day Two opens with an overview on the subject of evaluating the roles and value of biotechnology therapy. The overview is followed by a presentation from BlueCross BlueShield of Tennessee on strategies for assessing organizational expenditures on injectables and how to evaluate your market prior to implementing any management tactics. The morning continues with two presentations examining different strategic approaches to integrating specialty pharmaceutical management. The first presentation from Regence Blue Shield discusses steps to putting together a plan from a conventional approach. The second presentation from Blue Cross Blue Shield of Texas is a case study involving the company's HMO and PPO hybrid plan of action. At the conclusion of these presentations presenters address questions submitted in advance by attendees and from the floor in an interactive panel discussion. The afternoon sessions start with a presentation from Aetna’s Pharmacy Management explaining how to control costs by modifying benefit designs. Amerihealth Mercy Health Plan follows with information on assuming operational and administrative responsibility for injectable drug management. Next, Medco Health's Vice President of Health and Specialty Pharmacy Management discusses keys to specialty pharmacy program success. Then, Horizon Blue Cross Blue Shield of New Jersey talks about determining accurate payments by capturing and tracking data. The day closes with Advanced Pharmacy Concepts' presentation on strategies to achieve cost savings through updating claims processes.

Day Three begins with a session from Tufts Health Plan's Senior Clinical Pharmacist on utilizing clinical resources for specialty pharmacy implementation and maintenance. Then a discussion on integrating ancillary care management services into specialty pharmaceutical management programs from Matria Healthcare. Followed by direction from RxPerts on how to effectively outsource cost management and accountability to specialty pharmacy vendors. The conference closes with a look at strategies for managing future costs by identifying market trends and monitoring the biotechnology pipeline from Tufts Health Plan.