Health care stakeholders are in the midst of radical change, with a shift to value-based care and an increase in stakeholder consolidations and acquisitions. Larger commercial entities continue to form with the increased acquisitions of specialty pharmacies and hub service providers by PBMs, health plans, and wholesalers. In this session, explore specialty pharmacy and distribution trends reshaping the industry. As part of this cross-stakeholder discussion, explore how each stakeholder views the current landscape and uncover strategies to work together to improve the patient journey.
- Examine payers’ growing influence on patient support services and network designs
- Explore opportunities to advance cross-stakeholder collaborations to deliver better patient care
- Explore innovative distribution models to design an effective channel strategy
Vice President Industry Relations
Vice President, Head of Market Access and Government Affairs
Chief Medical Officer, Commercial and Medicare Services
UPMC Health Plan
Recent anti-kickback investigations of several drug companies include a focus on their patient assistance programs, co-payment cards, drug pricing, and charitable donations. As a result, teams are reviewing compliance guidelines, processes throughout the product lifecycle, and overall strategy of their programs to safeguard against potential risks. Hear from senior legal and compliance officers on how to appropriately structure your patient service compliance program and internal operations to provide patient support.
- Enhance cross-functional compliance integration to ensure product launch success
- Examine all aspects of a patient service program to mitigate risk and ensure compliance
- Customize patient support service compliance strategies for rare and orphan disease populations
Executive Vice President, Chief Business Officer, General Counsel
It is imperative to understand the patient experience in order to leverage a patient-centric approach within patient support service design and channel operations. Hear firsthand experiences patients’ with specialty therapy management, specialty pharmacy visits, encounters with patient support services and access assistance, as well as key concerns regarding data sharing and compliance.
- Explore best practices when implementing patient support services that enhance the patient experience with education, adherence, and access
- Identify a successful channel strategy that optimizes the patient experience and ensures access to therapies in a timely manner
- Examine key concerns around data sharing to ensure patient services compliance and mitigate internal risk
- Discover how patients are using digital to engage with patient groups, pharmaceutical organizations, and pharmacies to enhance services
COPD Patient and Patient
Plan sponsors have shifted pharmacy benefit designs to implement more co-pay accumulators and maximizers. The challenges that arise include high out-of-pocket costs for patients, high list prices for specialized therapies, and hidden rebates retained by plan sponsors. How can manufacturers limit the use of accumulators and maximizers and ensure patients with serious conditions receive the medications they need at an affordable cost? Implement key channel strategies to ensure patient access to specialty therapies.
- Analyze the current landscape of co-pay accumulator and maximizer models
- Examine the gross-to-net impact of accumulators
- Discuss current patient access challenges and consequences of cost-shifting pharmacy benefits
- Discuss state and legal challenges to accumulator programs
- Gain insight into the future of co-pay accumulators and maximizers
In order to determine the optimal distribution model, manufacturers must conduct a comprehensive channel assessment to inform decisions regarding which distribution model best supports brand objectives. In this session, explore key considerations to take into account when establishing a distribution model and network design.
- Discuss the risks and benefits behind open, managed, limited, and closed networks
- Identify a network strategy that supports the patient journey through wrap around services
- Understand how the evolving health care landscape and integration among payers and providers may impact the product dynamics
Senior Director, Specialty Channel Strategy
Senior Director and Team Leader, US Trade Account Management
Senior Director, Trade and Channel Development
When bringing a new therapy to market, product teams must conduct a comprehensive product profile in order to inform key decisions regarding which distribution model and best supports brand objectives. Explore key considerations to take into account when establishing a distribution model and network design to support a specialty product launch.
- Identify a network strategy that supports the patient journey through wrap around service
- Conduct a successful product profile review to determine key partnerships, data, and services that meet the specific needs of your product characteristics
- Map the patient journey to identify an effective distribution strategy
- Discuss ways that channel selection can address product/portfolio needs surrounding storage, delivery, and product integrity
Executive Director, Global trade, GPO and Distribution
The introduction of gene therapies, biosimilars, orphan, and generic drugs into the specialty channel has required the industry to establish innovative contracting models to ensure product access to eligible patients. The models have taken the form of non-traditional payment and distribution models. Explore contracting strategies that aim to meet the need of patients, payers, and providers to collectively enhance patient outcomes and establish a balanced solution for all stakeholders.
- Understand the unique distribution and dispensing models integrated across both payers and providers
- Uncover non-traditional payment models to inform specialty pharmacy contracts
- Identify potential patient access and reimbursement hurdles for unique products and develop strategic plans to address market access challenges
- Examine therapeutic class to establish contracting approaches to optimize product commercialization
- Determine core pharmacy activities versus enhanced services within a specialty pharmacy contract
Executive Director, US Market Access, Specialty and Channel
Senior Director, Specialty Pharmacy US Market Access
Senior Director, Access Services US Market Access
When designing a specialty network, manufacturers must create a data governance structure to gather and analyze network data. Product teams must first determine the scope of the data, what data will be gathered in SPP contracts, and how to implement these data points to establish insights and reporting of the data. This Master Class takes a deep dive into various ways that data can be procured to ensure the best product performance, patient journey tracing, and advanced analytics.
- Understand the optimal timing for engaging with a data aggregator
- Identify key elements to include and request in a data agreement
- Develop data best practices during the onboarding process
- Hear tips to ensure success from the start when live data starts flowing from specialty partners
- Explore data quality monitoring and maintenance practices
- Develop confidence in data so as to lead to opportunities for advanced analytics
Vice President, Specialty Pharmacy Services