This is the Only Government Programs Event You Need to Attend

How many Government Programs events do you attend a year?

IIR's 7th Annual Government Programs Summit is the one-stop-shop for all things government programs, merging together regulatory compliance and financial calculations to maximize revenue potential. We're delivering the most government officials AND experts from pharma and biotechs — all under one roof! They'll provide policy answers to strategic, compliance, operational, technical and tactical issues on all things government programs. 

Download the Agenda for Full Speaker and Session Details

PLUS! Calculate liability and optimize accuracy and accountability at the newly included full-day summit on Gross-to-Net! Invite your GTN and finance peers to join and experience true collaboration by breaking down interdepartmental silos through candid conversations and networking you can only have onsite at the event!

Register online to join us this March 23-25, 2015 in Arlington. Use the code XP2051BLOG now and save $400!

Is It Time to Establish Your Own Specialty Pharmacy?

Welcome to the Specialty Pharmacy Collaboration Summit podcast series.

Below is a teaser from our recent podcast with Kevin Colgan, Associate Vice President of Specialty Pharmacy, University HealthSystem Consortium (UHC)

Access the complete podcast and transcript here.

Can you tell us a little bit about UHC?

Kevin: UHC is a consortium of 120 academic medical centers across the United States. We provide those members with many different services. We provide them with benchmarking services, group purchasing services through our supply chain program and we also supply them with specialty pharmacy services.

There’s a lot of interest among hospitals and health systems in establishing their own specialty pharmacies and one of the obvious reasons is the revenue opportunities. Can you talk a little about what the revenue implications are for these organizations?

Kevin: I was one of those who started a specialty pharmacy a few months ago (at Rush University Medical Center) before I started my current position at UHC.  I think if you look at it from a macro perspective, you see that by the year 2020, we’re looking at 50% of total US drug expenditures being consumed by specialty pharmaceuticals for just 3-4% of the population. If we just look back at the last 20 months where we’ve had 52 new molecular entities approved by the FDA, we would find that 21 of those are specialty pharmaceuticals. If we look just at oncolytics, we’d see the lowest cost drug is $5500 a month and the highest cost drug is $13,200 a month. The point is that anytime you have this high of cost with a drug therapy, you’re going to have revenue opportunities and implications. So, I think that’s an important piece.

I think the other important piece is that, still, many of these drugs are infusion therapies. If you look at an ACO model, you’re at risk for those Medicare Part B infusion therapies. So, you are not only looking at revenue, but you’re also managing risk.You have to manage risk by following evidence-based guidelines and ultimately doing what’s in the best interest of the patient.

I think the biggest incentive for hospitals, though, goes beyond all the additional revenue. It’s, frankly, just about improving care and the cost of care.

One of the big issues we have with current systems is fragmented care. I recently had a patient who, when her plan changed over, found that her co-pay for Humira was $1100. She couldn’t afford it, quit taking her therapy for three months and started having breakthrough symptoms. We found – even though we weren’t filling the prescription – that we could apply a co-pay assistance card. We worked with her specialty pharmacy and did that so she could afford her prescription.

So, again, fragmented care is a big problem. We have patients that, in an ACO environment, will be hospitalized if they aren’t taken care of under one roof. So, we see that as the overwhelming reason to move forward with the specialty pharmacy initiative at UHC.

Click here to access the complete transcript and podcast.

Kevin will be joining us at the Specialty Pharmacy Collaboration Summit for the presentation “Pharmacy Practice Accreditation and Health-System Specialty Pharma” on Monday, September 15th. It is not too late to register! And remember, blog readers save $100 off the current rate with the code: XP1968BLOG - Register here.

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

 Download the Agenda for Complete Session Details

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!

MDRP 2013 Keynote Presentation: OIG Work Updates

This week we'll be featuring MDRP 2013 event posts from our content partners, Huron Life Sciences. Today's author, Rajiv Mehrotra, recaps our day 3 Keynote Presentation on OIG Work Updates 

The last day at the 2013 MDRP Annual Summit saw Mr. David Tawes from the OIG present on the “Recent OIG Work Involving Prescription Drug Pricing and Payments”. The presentation discussed the recent work and analyses that the OIG is performing especially around the Medicare Part B program.

As part of its recent work, the OIG looked at the current Medicaid Drug Rebates Program and evaluated how a similar program might work in a Medicare Part B setting with respect to rebate recoupments (unlike Medicaid, Medicare has no requirement for manufacturers to pay rebates for prescription drugs). To perform the analysis, the OIG included 60 drugs that accounted for 85% of Part B expenditures (approx. $13.9 billion) in 2011 and performed a rebate calculation similar to the Medicaid Drug Rebate Program using AMPs or ASPs for these drugs. The analysis showcased that such a program could potentially provide anywhere from 21-26% recoupments of the Part B expenditures for these drugs using a Medicaid Drug Rebate Program structure.

Though this recommendation was not entertained by the CMS at this time (CMS could not devote the necessary resources for a Part B rebate program evaluation ) it, nonetheless, doesn’t take away from the fact that this is something really big that was suggested by the OIG and this could be a huge deal for manufacturers. Manufacturers should definitely keep an eye out if something like this or a variant thereof picks back up in the future.

This is a must-have presentation for manufacturers. For more information, either grab a version from the MDRP website or visit the OIG website at for more details. See you all next year!