In an effort to lower out-of-pocket costs for patients, manufacturers, insurers and plan sponsors have the opportunity to align on reimbursement goals and develop partnerships to ensure value to the patients and lower health care expenditures. Gain a multi-stakeholder perspective into value-based pricing structures and opportunities for stakeholder alignment.
- Gain insight into value-based pricing agreements and reimbursement trends
- Discuss the pharmaceutical drug price, spending, and affordability debate from varying stakeholder perspectives
Chief Medical Officer
UPMC Health Plan
Chief Executive Officer
Since 2012, List prices for Insulin in the United States have doubled. Mike Mason, Vice President, Lilly Diabetes has testified in the United States House of Representatives congressional hearings, in an effort to address the factors that led to list price increases for Insulin. In this session, explore future policies aimed at increasing affordable access to diabetes medication.
- Explore congressional hearing testimonies and policy proposals to address high insulin prices
- Gain insight into how Eli Lilly’s patient assistance programs improve patient education, affordability and access for uninsured patients, people in the coverage gap of Medicare Part D, and those with high deductible insurance plans
- Explore opportunities for cross-stakeholder partnerships between pharma, PBM, employer and health plan to improve patient access to reduce out-of-pocket costs for patients
- Explore the role pharma plays in determining insulin prices in international markets
Vice President, Lilly Diabetes, Senior Vice President, Connected Care and Insulins
Eli Lilly and Company
Prescription drug costs have been a major concern for public and private payers and is now a major campaign theme for the 2020 elections. Public scrutiny of drug prices has led to political discussions aimed at changing the way drug pricing models are structured and regulated. The CMS final rule that required drug manufacturers to provide the list price of their products in direct-to-consumer ads and the elimination of drug rebates were both examples of efforts to establish regulations targeting the price and affordability of prescription drugs.
- Unpack the latest proposals, recommendations, and regulations being brought to the table around pricing and affordability of drugs
- Explore which changes may be most likely given the current political, economic, and regulatory climate
- Examine proposed changes to drug importation laws and its impact on pricing strategy
Senior Advisor to the Secretary for Drug Pricing Reform
U.S. Department of Health and Human Services (HHS)
Explore how to strategically design a copay program as part of an organizational initiative to provide patient services and address affordability challenges. In this session, share considerations to take into account related to the nuances that may affect product effectiveness and evaluate the different aspects of product attribution by payer makeup and more.
- Understand how to do an analysis of risk exposure for copay programs for a specific type of product depending on the payer make up and site of service
- Explore different payer make ups and how drugs are administered and dispensed, and understand the impact of copay on gross-to-net
- Consider what competitors are doing and identify ways to differentiate your company/brand
Executive Director, Head Patient and Specialty Services Strategy, Operations and Finance
Director, Specialty Access Solutions, and Patient Support Oncology
Co-pay programs are susceptible to a variety of risks that can significantly diminish program effectiveness if not properly addressed. Marketplace tactics designed to extract maximum dollars from manufacturer offers, ill-intentioned pharmacies processing fraudulent co-pay program claims, and the ever-changing regulatory landscape all contribute to the need for a thorough risk mitigation strategy. This discussion will focus on:
- Becoming educated on how various risk factors impact a brand’s program based on its product profile
- Designing and operating a sound risk detection process that systematically identifies problems
- Putting controls in place to proactively guard against future risks
Affordability solutions and copay programs have long been seen as popular and highly effective tools for brands. By contrast, adherence programs which are often highly effective in their own right, typically fail to meet the expectations of brand marketers due to their inability to “move the needle” on overall brand persistency. In this presentation, we will review the state of affordability and adherence interventions, as well as demonstrate a unique integration of the two to create a “supercharged affordability solution”, that marries the scale of copay programs to the effectiveness of adherence solutions.
Vice President, Corporate Strategy
Across the nation, patients with chronic diseases and rare diseases are facing access and affordability challenges for their treatments. In this panel, hear firsthand from patient advocates about these challenges and how we can help patients overcome barriers and manage out-of-pocket costs.
- Discuss current and potential issues that may impede access to care, such as copay accumulator programs, copay cards, and charitable foundation support
- Discover how collectively, we can help patients access the care they need and help patients manage their out-of-pocket costs
- Explore policy solutions that can enhance access to treatment
- Uncover what the patient community is doing on the advocacy front in reaction to copay accumulators and what they are doing to overcome affordability barriers
Free drug programs are crucial, especially for those that do not qualify for copay assistance. Discover how your peers are designing their programs to mitigate costs while assisting patients.
- Discuss the qualification requirements of different patient populations for free drug programs
- Discover ways drug manufacturers are managing the quantity of patients enrolled in their programs
- Explore how the design of free drug programs may differ for rare disease drugs
Director, Patient Support Programs
Director, Market Access and Patient Services