Friday, August 29, 2014

One Last Thing Before that Out Of Office Goes Up…


Enjoy your day off AND extra savings! Register for any of the following IIR events and receive a 25% discount off the standard rate*

Mention code LABORDAYBLOG when registering for each or any of the following:

Register here for IIR’s Specialty Pharmacy Collaboration Summit event taking place September 15th-17th, 2014 in Boston, MA, visit the website for full details.

Register here for IIR’s 19th Annual Medicaid Drug Rebate Program Summit event taking place September 15th-17th, 2014 in Chicago, IL, visit the website for full details.

Register here for IIR’s FDA/CMS Summit for Payers event taking place December 11-12, 2014 in Washington D.C., visit the website for full details.


Have any questions? Email Jennifer Pereira.

*This promotion is only valid August 29- September 1st, 2014. Offer cannot be applied retroactively to confirmed paying registrants and cannot be combined with any other discounts or promotions. All registrants and guests are subject to IIR approval.





Thursday, August 28, 2014

Your First and Only Chance to Hear the FDA & CMS Address Payers and Pharma Under One Roof

 
Introducing the FDA/CMS Summit for Payers


The Full Agenda is Now Available | Download Now! 
 
 
Hear the challenges and opportunities on key issues in order to succeed in a patient-centric environment. Plus:

• Get face-to-face access to the top regulatory thought leaders and policy makers from FDA and CMS
• Hear about critical trends and changes so you can create successful strategies for dealing with FDA and CMS
• Walk away with practical, real life lessons from some of the most experienced payers and healthcare executives on how they are dealing with the changes
• Benchmark your operational, regulatory and strategy against all the major health plans

Meet Regulators from FDA and CMS:

• Janet Woodcock, MD, Director, Center for Drug Evaluation and Research, FDA
• John K. Jenkins, MD, Director of the Office of New Drugs, Center for Drug Evaluation and Research, FDA
• Tamara Syrek Jensen, JD, Deputy Director, Coverage and Analysis Group (CAG), CMS
• Niall Brennan, Acting Director, Offices of Enterprise Management (OEM), CMS


Collaborate with C-Level Healthcare Leaders:

• Dr. Trent T. Haywood, MD, JD, Chief Medical Officer & SVP, Office of Clinical Affairs, Blue Cross and Blue Shield Assc.
• Dr. Claire Levesque, Chief Medical Officer for Commercial Products, Tufts Health Plan
• Dr. Richard Migliori, MD, Executive VP, Medical Affairs, Chief Medical Officer, UnitedHealth Group
• David Polakoff , MD, M.Sc, Chief Medical Officer & Associate Dean, Commonwealth Medicine Director, Center for Health Policy and Research, University of Massachusetts Medical School   
• William Winkenwerder, Jr.,  Former CEO, Highmark, Inc.
• Kevin Volpp, MD, PhD, Founding Director, Center for Health Incentives and Behavioral Economics, Leonard Davis Institute


Register now with the code XP1917BLOG and take an additional $100 off the current rate - $500 in total savings. Register here.




Tuesday, August 26, 2014

AMP Final Rule - How Should You Prepare?


Chris Coburn, Senior Vice-President, CIS & Erika Scholl, Senior Manager, GP Consulting, CIS discuss how to prepare for the final AMP Rule now, in terms of reengagement, bona fide service fee assessments, and recalculations, so that the transition is as smooth as possible this winter. Join Chris at MDRP 2014 for his highlighted session below...



A What, When, Why and How Guide to the Complexities of Recalculations and Restatements; Complying with Guidance and Protocols and Minimizing Risks

Recalculations and restatements have become common for manufacturers, but they still pose significant compliance risks. Various events can trigger the need for a recalculation, and the resulting change or correction in methodology or data can impact the accuracy of historically reported prices, which in turn can create pricing changes that ripple across programs. When performed correctly, a recalculation/ restatement demonstrates that a manufacturer is proactively identifying and mitigating identified issues and errors within its government programs. However, when the proper procedures are not followed, this can further complicate and aggravate already problematic issues that put the manufacturer in greater risk of noncompliance. To further complicate matters, each agency has its own guidance and expectations related to recalculations that are not often officially documented. In this session, we explore the ins and outs of recalculations and offer insights on how to effectively communicate with the agencies and how to minimize your compliance and financial exposure.

Session topics include:
• Common triggers for a recalculation
• Guidance and protocols across programs and agencies
• Key financial and compliance risks
• Management response and planning
• Methodology considerations and key data components
• Known roadblocks in data and systems
• Internal and external resource needs

Chris Cobourn, Senior Vice President, Compliance Implementation Services (CIS)


Register for MDRP 2014 now and as a blog reader, receive $100 off when you use the code: XP1958BLOG - Register here





Monday, August 25, 2014

Announcing FDA/CMS Summit for Payers | Download the Brochure

With healthcare spending exceeding 18 percent of GDP and 30 cents of every healthcare dollar lost to waste, it's about time we looked into the potential to streamline, improve, and perhaps transform our current system.

In today's rapidly evolving healthcare environment, qualify patient care is critical and requires seamless coordination & communication among all stakeholders in the healthcare continuum. The days of working in silos are over.

IIR's invites you to the brand-new FDA/CMS Summit for Payers, which will focus on how health plans can better interact with government to remain compliant, adaptive, and successful.

The meeting will focus on relevant legislation, regulation, and accompanying guidelines, and will be composed of policy makers from FDA & CMS together with payers, providers and pharmaceutical manufacturers. Each stakeholder will discuss and share their perspective on how businesses and government can work together to drive positive policy change through collaboration.


Your first and only chance to hear the FDA and CMS address payers and pharma under one roof

• Janet Woodcock, MD, Director, Center for Drug Evaluation and Research, FDA
• John K. Jenkins, MD, Director of the Office of New Drugs, Center for Drug Evaluation and Research, FDA
• Tamara Syrek Jensen, JD, Deputy Director, Coverage and Analysis Group (CAG), CMS
• Niall Brennan, Acting Director, Offices of Enterprise Management (OEM), CMS

Hear real life case studies and benchmark your strategies against major health plans and game changers

• Dr. Trent T. Haywood, MD, JD, Chief Medical Officer & SVP, Office of Clinical Affairs, Blue Cross and Blue Shield Assn.
• Dr. Claire Levesque, Chief Medical Officer for Commercial Products, Tufts Health Plan
• Dr. Richard Migliori, M.D, Executive VP, Medical Affairs, Chief Medical Officer, UnitedHealth Group
• David Polakoff , M.D., M.Sc, Chief Medical Officer & Associate Dean, Commonwealth Medicine Director, Center for Health Policy and Research, University of Massachusetts Medical School   
• William Winkenwerder, Jr.,  Former CEO, Highmark, Inc
• Kevin Volpp, MD, PhD, Founding Director, Center for Health Incentives and Behavioral Economics, Leonard Davis Institute

Your Ecosystem is evolving...are you part of the paradigm shift?

Register now and save $400 - Plus take an EXTRA $100 off when you use the code XP1917BLOG | That is $500 in total savings!  Register.

See you in D.C. this December!




Wednesday, August 20, 2014

Last Chance to Save for Specialty Pharmacy Collaboration Summit is Friday | Look Who's Attending

This Friday, 8/22 is Your Last Chance to SAVE $200 – Plus take an EXTRA $100 off when you use the code: XP1968BLOG | Total savings of $300!
 


IIR's all-new Specialty Pharmacy Collaboration Summit is just 3 weeks away! This collaborative summit is designed to facilitate networking and integration between all key stakeholders in the evolving specialty pharmacy value chain. Join us and our growing list of leading pharmaceutical manufacturers, health plans, and specialty pharmacies below on September 15-17 to hear industry experts address key challenges in the specialty pharmacy ecosystem, including:

1. Patient Adherence
2. Managing Costs and Determining Value of Specialty Drugs
3. Distribution of Specialty Drugs and Channel Management
4. Sustainability of the Specialty Pharmacy Mode


Sample of Attending Companies:
• Accredo Health Group
• Aetna
• Amgen
• Armada HealthCare
• Avella Specialty Pharmacy
• Axium Healthcare
• BioRx
• Blue Cross Blue Shield Association
• Boston Medical Center
• BriovaRx
• Brookings Institution
• Center for Pharmacy Practice Accreditation
• Community Specialty Pharmacy Network
• Dana Farber Cancer Institute
• Denver Health Medical Plan
• Diplomat Specialty Pharmacy
• Duke University Medical Center
• Express Scripts
• Facet Technologies
• Genomic Health
• District of Columbia, Division of Clinicians Pharmacy
• Hemophilia Alliance
• Independent Health Association
• IU Health Cancer Centers
• Johnson & Johnson
• Legacy Pharmacy
• MassHealth
• Moore Associates
• NCPA
• Pfizer
• Physician Plus Insurance
• Rush University Medical Center
• Sanofi
• Skywalk Pharmacy
• Summit Pharmacy
• Teva Pharmaceuticals
• Tufts Health Plan
• UBC Express Scripts
• UMass Medical School
• University HealthSystem Consortium (UHC)
• URAC
• Walgreens
• Wedgewood Pharmacy
• Woori Pharmacy

Don't forget! This Friday, August 22nd is your last chance to save up to $300! Click here or call 888-670-8200 to register. Please be sure to use code: XP1968BLOG to maximize your savings!

For a limited-time only, we’re offering health plans a special VIP $595 offer* expiring on Friday, August 22, 2014, to attend IIR’s all-new Specialty Pharmacy Collaboration Summit. To register, email Roxana Siu, Marketing Manager at rsiu@iirusa.com. Be sure to mention code: XP1968HPSOCIAL

 
*$595 Offer Eligibility Rules and Regulations: Offer applies only to Health Plan executives. $595 offer is for the whole conference and expires on August 22, 2014. Tiered pricing is valid through expiration date. New pricing takes effect at specific dates indicated. All fees must be paid in full by expiration date or your price will increase to the next level tier. Offer cannot be applied retroactively to confirmed paid registrants. Offer cannot be combined with any other discounts or promotions. All registrants and guests are subject to IIR approval.





The Impending Changes of Health Care Reform


The Impending Changes of Health Care Reform | Jesse Mendelsohn, Director of Global Customer Services & Support, Model N, sat down to discuss the preparation of systems and processes to accommodate the impending changes of the Health Care Reform.

At MDRP 2014, join one of our esteemed keynote speakers Mark McClellan, MD, PhD, Senior Fellow and Director, Health Care Innovation & Value Initiative, Brookings Institution, Former Commissioner, FDA, Former Administrator, CMS - as he dives deeper into this topic with his session titled - Health Care Reform and the Future of Medicaid


Make sure you join one of the 2014 event sponsors, Model N at MDRP this September 15-17 in Chicago - Blog readers save $100 when registering with the code XP1958BLOG | Register Today!




Monday, August 18, 2014

7 Reasons Why You Need to Attend MDRP in September


Government rules and regulations affect every department at a pharmaceutical company and within the past few years, interconnectedness between government programs, commercial contracting, finance and legal departments has become more evident, and more important. This year's looming rules and regulatory changes from CMS, HRSA, and OIG and the impact of the ACA could completely change the way you conduct government-related operations.

IIR's Medicaid Drug Rebate Program Summit has become THE authoritative MDRP event for everything government pricing, rebates and regulation, because it brings together all the pieces you need to succeed-regulatory updates, 550+ MDRP executives, and 20+ solution providers across three days.

Specifically here are 7 reasons reasons no MDRP Executives can miss out:

1. Get essential regulatory and ask questions of key federal and state government officials such as HRSA, OIG, CMS & more

2. Direct access to 13 State Rebating Representatives
o Realize millions in potential savings through face-to-face meetings with States by signing up for the exclusive Dispute Resolution Meetings and leave Chicago with money back for your company

3. Overcome challenges in the current legal landscape and ensure compliance with government program mandates affecting manufacturers in the new Legal & Compliance Track

4. Earn both Continuing Legal Education (CLE) and CPE credits for the first time

5. Understand the true impact of the ACA and Medicaid reform with 2 Industry Keynote speakers

6. Hear from Texas, Utah, Illinois and more in the State Spotlight session in the Price Calculation and Contracting Strategy Track

7. Sharpen Your GP Skills in Four Focused Pre-Conference Summits



This is the largest government pricing and reimbursement event in the industry-and its the only event your peers buzz about. Click here to save your seat now or call 888-670-8200. Be sure to use Priority Code: XP1958BLOG to save $100.





Thursday, August 14, 2014

Evolving Roles of Specialty Pharmacies | Is the Model Sustainable?

Welcome to the Specialty Pharmacy Collaboration Summit Podcast Series. Speaking with us today is Nick Calla, VP of Industry Relations, Community Specialty Pharmacy Network (CSPN)


What are the evolving roles of community-based specialty pharmacies?

Nick: Well, we look at the community-based specialty pharmacies. Really our goal within our network is really to have these pharmacies really stand side-by-side with the larger central fill specialty pharmacy. There really is no intention to quote/unquote “overtake” the larger central fill pharmacy, but really more to truly have a voice and a space and to treat those difficult-to-treat patients that need that personal touch, that face-to-face counseling in order to be successful on therapy.

So, as I mentioned in my previous comments, what we are really looking to do is to expand the role of these pharmacies and really to use them as an adjunct to the patient that is not going to be successful in a less touch model and needs the higher touch that these pharmacies can provide in order to be successful as a therapy.


Again, as I mentioned before, as this specialty pharmacy environment expands and more and more products flood the market, I think that there is going to be plenty of room for all of these different stakeholder pharmacies to be successful.


Is the specialty pharmacy model sustainable?
 

Nick: Yes, I absolutely think the specialty pharmacy model is sustainable. As I mentioned before, I think you need to expand. I think more pharmacies need to quote/unquote “get accredited” to become part of professional organizations such as NASP in order to be truly successful in this space. But, in this world of accountable-tier organizations and again the really huge pipeline in what are considered specialty products, which are really more niche in nature and more along the longs of personalized medicine. A higher-touch model, if you will. 

I definitely think that the model is sustainable. I think it will grow and expand over time.
 



To hear more from Nick, please join him at IIR's Specialty Pharmacy Collaboration Summit, September 15-17 in Boston. Also, you can save an EXTRA $100 off the current rate, $300 in total savings when registering by 8/22 with the code: XP1968BLOG - Register now.





Wednesday, August 13, 2014

Specialty Pharmacy Collaboration Summit Limited-Time Special Offer for Health Plans Only!














For a limited-time only, we’re offering health plans a special VIP $595 offer* expiring on Friday, August 22, 2014, to attend IIR’s all-new Specialty Pharmacy Collaboration Summit. To register, email Roxana Siu, Marketing Manager at rsiu@iirusa.com. Be sure to mention code: XP1968HPSOCIAL

Due to increasing healthcare costs brought on by health care reforms and the ACA, specialty pharmacies are critical in determining the sustainability of the specialty pharmacy business model. Payers, providers, pharma manufacturers, and even patients need to partner with specialty pharmacies to help fill the oversight gaps in compliance, manage costs and reimbursements, and to gain access to closed distribution channels. Specialty Pharmacies offer their product management and patient adherence services to address these challenges with minimal cost implications.

Don't miss out on the only event offering you the opportunity to benchmark against other health plans and partner directly with specialty pharmacies and pharma manufacturers.


Plus! With the partnering360 networking tool, easily connect with all key stakeholders in the specialty pharmacy value chain and achieve not only your personal objectives, but also your company's collaborative aims. Available exclusively to registered attendees, you will be able to pre-plan for the event, identify and schedule meetings with potential partners, and foster deeper peer-to-peer engagement via discussions.

Health Plans - don’t miss out on this limited-time $595 offer* to attend the entire conference! This offer expires Friday, August 22, 2014. Be sure to use code: XP1968HPSOCIAL. To register, email Roxana Siu, Marketing Manager at rsiu@iirusa.com.


*$595 Offer Eligibility Rules and Regulations: Offer applies only to Health Plan executives. $595 offer is for the whole conference and expires on August 22, 2014. Tiered pricing is valid through expiration date. New pricing takes effect at specific dates indicated. All fees must be paid in full by expiration date or your price will increase to the next level tier. Offer cannot be applied retroactively to confirmed paid registrants. Offer cannot be combined with any other discounts or promotions. All registrants and guests are subject to IIR approval. 





What is the Future of Medicaid Reform?

Welcome to the MDRP Podcast Series. Joining us today is Grace-Marie Turner, President, Galen Institute




What is the Future of Medicaid Reform?

Grace-Marie: Now, I am distressed that more states did not demand more flexibility with this program in exchange for expanding Medicaid. About half of the states have decided to expand it; about half have not after the Supreme Court re-wrote the ACA and made expansion of Medicaid up to 138% of poverty an option for the states. But I think about 24 states now are resisting expansion for a number of reasons.

First of all, Medicaid is –as I said – really a program desperately in need of reform. When I served on the Medicaid Commission in 2005/2006 we did hearings around the country to look at the Medicaid program – to learn about it – because it’s really 50 different programs because each state runs its own. We found so many instances in our hearings around the country in which people were desperately dependent upon Medicaid and yet it was not serving them. States continue to expand access to benefits, but they also continue to cut payments to providers. States – if they were given more flexibility – could make a significant amount of Medicaid dollars go much further to cover more people. But, they are absolutely constrained by having to go to the Centers for Medicare and Medicaid Services playing “Mother May I?” every time they want to make a change to their program.

So, I think that the states really missed an opportunity for more flexibility with Medicaid. There was just a waiver --- it looks like a waiver is going to be given to Indiana to promote or continue a program that former Governor Mitch Daniels created called: “The Healthy Indiana Program” that really does begin to move Medicaid into a much more modern model. I think that that is a platform that some other states may be looking at. But, I think there’s a lot of resistance to expanding the program because people are seeing increasingly – and a lot of studies are showing – that people can be worse off on Medicaid than being uninsured. It’s just criminal that we are putting tens of millions of more people on this program and not improving it.

So, I think states are going to increasingly resist expansion of Medicaid unless they get more flexibility to control the program themselves and be able to save money and be able to provide better benefits to their citizens often in giving them the option of private coverage. So, I think that the future of Medicaid is more governors demanding more flexibility and then giving the patients on Medicaid more options for private coverage. There is no reason that they should be segregated into this ghetto of a program when so many people really could do so much better if they had options for true private coverage – not necessarily the fake private coverage that many of the states plans pretend to offer.



To hear more from Grace-Marie, make sure you join her at MDRP 2014 this September 15-17 in Chicago where she will be giving the keynote address. As a blog reader, you can save $100 off the current rate with the code XP1958BLOG. Register now to save! 

See you in Chicago!