Thursday, June 26, 2014

ASCO to Help Cancer Docs Evaluate Treatment Value

Below is an article from Modern Healthcare - a media partner for the upcoming Summit for Oncology Management. To learn more join us July 21-23 in Philadelphia, register now and save 15% when you use the code: XP1914BLOG - or sign up for email updates.

Via Modern Healthcare: The American Society of Clinical Oncology's algorithm to help oncologists evaluate the clinical benefits, side effects and costs of a cancer drug or therapy will be fine-tuned over the summer and should be available for public comment by the fall, said Dr. Lowell Schnipper, chair of the society's Value in Cancer Care Task Force.

That was just a small portion of a much larger discussion at ASCO's annual meeting about what needs to be done in order to get soaring cancer care costs under control. Assessing the value of cancer therapies was a major topic, with sessions looking at issues like whether or not patients are getting what they pay for, the ethical obligations faced by physicians and what if anything can be done to help drive down the costs. Although there have been important advances in cancer therapies over the past few decades, drugmakers are more frequently creating generic versions of previous innovations which often sell at higher prices.

The ASCO task force started meeting with consultants and other value experts earlier this year to begin developing the cost-comparison tool, in response to growing concerns over the rise in new, more expensive cancer drugs that provide only incremental benefits for patients.

“We want innovation,” Schnipper said, “But at the same time, we don't want our patients and their families to go bankrupt for a treatment that only offers a few additional months of life.”

Annual global spending on cancer drugs is approaching $100 billion, and the average cost per month for a brand-name oncology drug is approximately $10,000, nearly double from what it was a decade ago, according to recent estimates from the IMS Institute for Healthcare Informatics.

According to an analysis in the journal Mayo Clinic Proceedings:
• One melanoma treatment costs upward of $120,000
• Three doses of a prostate cancer medication have an estimated $90,000 price tag and
• A lifelong treatment for chronic myeloid leukemia averages around $70,000

Experts say more needs to be done - by physicians, pharmaceutical companies and government - government - to fix what one economist called “the perverted prices” of cancer drugs.

At this year’s conference, Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society, said “We have an obligation to improve the system, there’s no way the current one is going to sustain the costs”. He predicted that the rise in costs and the projected impact on U.S. health spending will get the attention of policymakers.

Rena Conti, assistant professor of health policy and economics at the University of Chicago, presented new research during a session at the conference. She determined, the largest predictor of a new drug’s price is how a similar drug was priced the previous year. “Benefit matters,” She said, “But we’re seeing launch price inflation, even in relatively crowded therapeutic classes.”

Conti suggests that adjustment to physician payment policies would help this situation. “Physicians have a financial incentive to use really high-cost cancer drugs even when the potential benefit for the patient may not be much more,” she said. Their revenue is based on the difference between the price they pay for a drug and how much insurers will reimburse them.

Hospitals also face perverse incentives. Schnipper said hospitals get paid for how many patients they admit, procedures they do and how much chemotherapy they give. “That is not a prescription for cost control,” he said. “We all know that something has to change.”

Read the complete article on Modern Healthcare now.

Wednesday, June 25, 2014

Assess the Value of Specialty Drugs with Robert Popovian, Senior Director, Pfizer | Last Chance to Save $700 is this Friday

Last Chance for MAXIMUM Savings is this Friday, June 27th
Register Now to Save up to $700 with the code: XP1968BLOG

Assess the Value of Specialty Drugs with Robert Popovian, Senior Director, Pfizer

Managing costs and determining the value of specialty drugs is key in understanding if the specialty model is sustainable. Hear from Robert Popovian, Senior Director, US Government Relations, Pfizer at IIR’s all-new Specialty Pharmacy Collaboration Summit, as he addresses the optimal methodologies to assess the value and cost proposition of specialty drugs in the evolving payment policy environment.

Learn How To:
• Define quality measures for specialty medicines
• Ensure global payment models which encapsulate all costs and outcomes including those for pharmaceuticals
• Develop measures of quality and value that are relevant to patients

Download the brochure for the full agenda and speaker details.

Don’t miss out! This Friday, June 27th is your last chance to save up to $600! Plus take an EXTRA $100 off when you use the code XP1968BLOG. Click here to register or call 888-670-8200 to register.

Tuesday, June 24, 2014

Where is CMS Heading?

Over the year, a lot has changed in healthcare. As the final rule continues to hang on the horizon, what is needed for all of the players in the healthcare industry to implement change quickly? Learn more from CMS at MDRP 2014 to make sure you have adequate information to launch your program changes efficiently.

At MDRP 2014 get essential regulatory updates from key federal government officials. From the Center for Medicaid Services (CMS) you will receive updates on:
  • MDRP Compliance & Current Reporting – Kim Howell, Department Director, Division of Pharmacy, Department of Health and Human Services, CMS 
  • Medicare Part D Proposed Rule – Tracey McCutcheon, Deputy Director, Medicare Drug Benefit Group, CMS
Download the complete agenda.
And make sure you join us September 15-17 in Chicago to prepare for the AMP Final Rule and deconstruct Part D and 340B Mega Rule.

Remember as a blog reader you can save an EXTRA $100 off the current rate when you register with the code: XP1958BLOG

Register now.

Wednesday, June 18, 2014

MDRP Pre-Conference Summits Announced | Last Chance to Save $500 is this Friday

Acquire best practices from industry peers and experts to ensure effective rebate calculations during the pre-conference day summits at the 19th Annual Medicaid Drug Rebate Program Summit. These full and half day summits have been specifically tailored to address your individual areas of expertise, regardless of whether you are a beginner or veteran in the industry.

Plus! This year, we've added two new summits to address the anticipated impact and implications of the AMP Final Rule, along with a Generics manufacturers focused summit to navigate the difference between brands and generics calculation when complying with government rebate rules.

The Pre-Conference Summits include:

NEW! AMP Final Rule Regulatory Impact
Chairperson: Alice Valder Curran, Partner, Hogan Lovells LLP
NEW! Portfolio Management for Generics Manufacturers
Chairperson: Robert La Porte, Director, Government Pricing & Compliance, West-Ward Pharmaceuticals
UPDATED! 340B Compliance for Pharma Manufacturers
Chairperson: Christopher Hatwig, MS, RPh, FASHP, VP, Apexus/340B Prime Vendor Program
Back by Popular Demand! MDRP 101
Chairperson: Miree Lee, Principal, M. Lee Consulting, LLC     

Download the brochure for the complete summit and session details.

These summits are part of the Platinum and Gold Passes, which gives you access to the full three days of the Medicaid Drug Rebate Program Summit — the best value! This Friday, June 20th is your last chance to save up to $500! Click here to register now or call 888-670-8200. Be sure to use Priority Code: XP1958BLOG

Don't miss out on the largest government pricing and reimbursement event in the industry! No other event provides you with access to this many government agencies who directly impact your business. Click here to save your seat now.

I look forward to meeting you in Chicago this September.

Tuesday, June 17, 2014

Hear from CMO of BCBSA on Rising Cancer Care Costs

 America's National Institute of Health predicts that spending on all cancer treatment assuming a 5 percent annual increase in these costs raises the projection to $207 billion.

Due to an aging population, increased cancer diagnosis, rising cancer care expenses, and a demanding payer market, new strategies need to be addressed for pharmaceutical companies to maintain, commercialize, and increase oncology access in the marketplace. It is imperative to learn from experts who are able to deliver affordable cancer care, while improving quality and bend the cost curve downward

At IIR’s Annual Summit for Oncology Management taking place July 21-23 in Philadelphia, you will hear from Dr. Trent Haywood, MD, JD SVP Office of Clinical Affairs and Chief Medical Officer at BlueCross BlueShield Association, a trend-setter in this space. Dr. Haywood will be discussing the so-called “cancer conundrums”, focusing on the current issues and challenges your industry is facing and shed light on some of the successful strategies that have worked for BCBSA.

Download the brochure to view Dr. Haywood’s sessions and more.

Register now to meet and collaborate with all the key stakeholders across the oncology management landscape including BCBSA, Aetna, Astellas Pharma, Eli Lilly and more! Save $200 by Friday, 6/20. Please use your code XP1914BLOG

Dr. Trent Haywood, MD 
 As the BCBSAs’ chief medical officer, Dr. Haywood supports the innovation of Blue Cross and Blue Shield companies in communities around the country as they improve the choices of healthcare quality and patient safety for their members. He is responsible for the Office of Clinical Affairs, which includes the Center for Clinical Effectiveness, Center for Clinical Practices, and the Center for Clinical Value. Collectively, the Office of Clinical Affairs supports opportunities between Blue Cross and Blue Shield companies and stakeholders to improve the choices of affordable, high quality healthcare provided to members.

Monday, June 16, 2014

MDRP 101

MDRP TV - How to Prepare

Last year, Miree Lee, Principal of M. Lee Consulting, LLC sat down with us to discuss how you should prepare for 2014 – How do you think her forecast for 2014 held up? Join Miree at MDRP 2014 to hear her full day pre-conference summit MDRP101…

MDRP 101 with Miree Lee, Principal, M. Lee Consulting, LLC

Back by popular demand, whether you’re new to the MDRP Program or need a review of the basics to better understand the changes, this workshop spells out complex regulation in easy to understand terms. Come and network with other like-minded professionals and increase your knowledge of the MDRP Program and Government Programs as a whole from some of the best teachers in this space.

Join us at MDRP 2014 in Chicago, September 15-17 - Register by this Friday 6/20 to save $400 but take an EXTRA $100 off with the code XP1958BLOG - $500 in total savings!

Thursday, June 12, 2014

Clinical Pathways, ACOs, COAs: Introducing 'Value' in Cancer Care

Below is an article from AJMC - a media partner for the upcoming Summit for Oncology Management. To learn more on topics like this, sign up for email updates. 

Via AJMC: Although advancements in medical science have greatly improved overall life expectancy and the ability for many to survive a cancer diagnosis, a recent study predicts that cancer care alone will cost the American health system $157 billion by 2020. It is well known that a major driver of these surmounting costs is the rising cost of chemotherapy and other treatments, in addition to the variation in how these treatments are used across the health care system.  However, there are several ways that providers, payers, and patients can work together to establish a more medically and financially effective cancer care model that also reduce costs and inefficiencies in the system.

Develop “clinical pathways” to reduce inappropriate use

For many cancers, there are multiple drugs that can be equally effective in treating a patient’s condition, but the price of these treatments can differ in cost by tens of thousands of dollars. Currently, oncologists are responsible for purchasing their own chemotherapy drugs, processing and maintaining them in a specialized pharmacy-like set up, and then administering them to their patients. Insurers then reimburse the oncologists for the cost of the drugs plus a margin to defray the price of maintenance and administration. Since oncologists receive a share of their income from the margins on the drugs they prescribe, insurers assert that there is an incentive to prescribe the pricier drugs, even when lower cost options of equal effectiveness exist.

Source: The Hill

Wednesday, June 11, 2014

4 Key Challenges in the Specialty Pharmacy Ecosystem

 Is the Specialty Pharmacy Model Sustainable?

At IIR's all-new Specialty Pharmacy Collaboration Summit on September 15-17, 2014 in Boston, join leading pharmaceutical manufacturers, health plans, and specialty pharmacies as they participate in in-depth sessions, roundtables and panel discussions to address the four key challenges in the specialty pharmacy ecosystem:

1. Adherence
Excellus, Bluecross Blueshield, Denver Health Medical Plan, Tufts Health Plan
Hear from experts in a payer specific panel as they shed light on commercial plan strategies and priorities.

2. Managing Costs and Determining Value of Specialty Drugs
Robert Popovian, Senior Director, US Government relations of Pfizer will address the optimal methodologies to assess the value and cost proposition of specialty drugs in the evolving payment policy environment 

3. Distribution of Specialty Drugs and Channel Management
 Sanofi + Dana-Farber Cancer Institute, Harvard University
Develop distribution strategies to sustrain commerical success and learn how to postition withing the channel to gain a competitive adcantage with Richard Peters, MD, PhD, Division Medical Officer, Sanofi and Sylvia Bartel, VP Pharmacy, Dana-Farber Cancer Institute, Harvard University

4. Sustainability of the Specialty Pharmacy Model
National Association of Specialty Pharmacy + Independent Health
Gary Cohen, BSPharm, RPh, CSP, CEO, National Association of Specialty Pharmacy and Mike Reilly, President, Pharmacy Benefit Dimensions, Independent Health join together to discuss what the future holds for specialty pharmacy

Download the brochure for the full agenda and speaker details

Don't miss out! Register now to save up to $600! Plus take an EXTRA $100 off when you use the code XP1968LINK - $700 in total savings! Click here to register.

See you in Boston!

Tuesday, June 10, 2014

AstraZeneca and Cigna in Evolutionary Partnership to Support Patients

Are you looking for an example of how data and technology are changing the healthcare delivery model? An innovative program announced June 2nd pairs Big Pharma with health insurer Cigna.

“Predictive Risk Modeling” is used to identify Cigna members who are most likely to benefit from treatment with the “aggressive LDL-C lowering” statin Crestor, a drug that is marketed by AstraZeneca.

When asked of the new partnership, Cigna said it is “the first of its kind” and represents a “targeted approach to helping high-risk patients with high cholesterol” receive value-based care.

Under the programs terms, Cigna said its member customers who are at increased risk for atherosclerotic cardiovascular disease – ASCVD – and need to aggressively manage their LDL cholesterol can be prescribed and receive Crestor “without requiring prior authorization.”

In a statement, Cigna said “As an integrated health services company, Cigna is able to use both medical and pharmacy information in predictive risk modeling to appropriately assess a customer’s overall health condition, this approach analyzes multiple clinical factors to identify customers most at risk for ASCVD related to high cholesterol. When a doctor prescribes CRESTOR, customers identified as being at higher risk will no longer be subject to “step therapy” – where a generic alternative is tried first…”

Philip de Vane, MD, AstraZeneca’s executive director of U.S. medical affairs, said this new arrangement represents “an evolutionary step in supporting patient health, and facilitating access to Crestor for high risk patients. Predictive risk modeling can be used to help support the right treatment for the right patient at the right time, and we are excited to be working with Cigna because they are the only insurance carrier or Pharmacy Benefit Manager (PBM) we have seen who has offered this capability.”

This new partnership is certainly worth watching, and is another example of how new thinking is creating new opportunities across the patient-pharma-payer spectrum.

Read the full Cigna news release here.

As an industry professional, do you expect more partnerships like this one to pop up? Or is this partnership model going to struggle for greater adoption?

Friday, June 6, 2014

CMS Announces Part D Update

 Hear First Hand from CMS on the Part D Final Rule

CMS has officially published it's Part D Final Rule for 2015 and went into detail on the coverage and reimbursement changes to the medicare advantage and the medicare prescription drug benefit programs. There are still many questions surrounding this regulation and on how this will affect the coverage gap and ultimately your rebates and forecasts.

At the upcoming MDRP 2014 this September, CMS will provide an update on the Medicare Part D Proposed Rule where you will get insights on:

• How to prepare for the subsequent rebates and forecasting involvement
• Future considerations for gab liability
• Part D reimbursement
• Coverage and reimbursement updates

Download the Brochure for the Full Agenda Details.
Register by June 20th and SAVE up to $400, but take an EXTRA $100 off with the code XP1958BLOG - $500 in total savings!

Register now to save!

Wednesday, June 4, 2014

Oncology Management Podcast Series with Bill McGivney

Welcome to the Oncology Management Podcast Series - Presented by IIR's Annual Summit for Oncology Management. Joining us today is Bill McGivney, Principal, McGivney Global Advisory LLC & former CEO, National Comprehensive Cancer Network

To begin, could you please comment on what appears to be a seemingly never-ending call to define value in healthcare?

Bill: To answer your question about the definition of value in healthcare, you know I really do continue to be amazed at the calls that come out of national committee meetings and publications, etc. to say that we continue to have to define and develop a national standard for what value is in the healthcare system. To me, it seems really simple. I mean, I’ve been around the healthcare system for almost 30 years now. The value is the clinical benefit derived by patients, specifically, for the expenditure of a specified amount of healthcare dollars. That’s pretty simple. Sometimes when people try to develop these long equations to which I’ve seen, it’s a gust of bodies when they have their conferences. I mean, I saw one once years ago and I just commented to the moderator of the session that one, the long equations for the definition of cost effectiveness was mind-numbing and two, it would never see the light of day. I was right on both accounts. 

So, I think my simple definition is pervasive in terms of this is what value is. It’s really, again, the clinical patient benefit that’s obtained for a specified expenditure of healthcare dollars.

Download the rest of the Podcast here.

To hear more from Bill, please join us at IIR’s Annual Oncology Management Summit, July 21-23 in Philadelphia, PA.

To save 15% off your registration rate, use the code: XP1914BLOG

Register Now!

Monday, June 2, 2014

MDRP 2014 Brochure Now Available - Plus 2013 Highlights

"I love MDRP, it is the Super Bowl of conferences for this space"

MDRP 2014 is back in Chicago this September and just in time to provide you with essential regulatory updates surrounding the impact of the ACA and AMP Final Rule.

Year after year, MDRP Chicago has continued to be THE authoritative MDRP event for everything government pricing, regulations, and rebates. It's the largest event in the space with the most speakers and government representation from CMS, HRSA, OIG, and more. Join 550+ MDRP executives at the event where the industry pauses to attend and get the most comprehensive educational experience over three days.

New for 2014!
• 2 Keynote speakers discussing the true impact of the ACA and Medicaid reform
• Legal & Compliance Track dedicated to overcoming challenges in the current legal landscape and ensuring compliance with government program mandates affecting manufacturers
• CLE Accreditation - Earn continuing Legal Education (CLE) credits
• Four pharma case studies from AstraZeneca, Mylan and GSK
• Pre-conference workshop dedicated to Generic Drug Manufacturers   

Download the 2014 Brochure

Register Now to Save up to $400! Plus take an EXTRA $100 off the current rate when you use the code XP1958BLOG – That is $500 in total savings.
This is the place to be in September. Stay ahead of the curve by getting the best networking, education, and technology at IIR's MDRP Summit. 
Enhanced by Zemanta