Asembia

Coverage, equity, and value-based payments are critical areas of focus for the Biden administration’s health care agenda leading up to the midterm elections, according to 3 experts from Avalere.

Biomarker testing is having growing importance to ensure that patients are started on the correct therapy for the best outcomes, said Sneha Sharma, PharmD, director, specialty clinical solutions, Magellan Rx.

Addressing rural care is a way of addressing health inequities, and the Biden administration’s recent investment in rural care reflects its commitment to addressing health equity, said Ryan Urgo, MPAP, managing director, health policy, Avalere.

Panelists discussed results of a survey conducted among 171 benefits leaders representing more than 40 million covered lives.

The pandemic drove telehealth usage, but it has challenges that might prevent doctors from prescribing new therapies, said Doug Long, MBA, vice president, industry relations, IQVIA.

Adam Fein, PhD, of Drug Channels Institute, and Doug Long of IQVIA discussed trends in the specialty pharmacy market in the United States.

Representatives from employers, pharmacy benefit managers, and others discussed methods of improving pharmacy access and affordability in health plans.

Value-based payments were a benefit during the pandemic, but it remains to be seen if patients are interested in keeping those changes in care delivery as the pandemic recedes, said Jayson Slotnik, partner, Health Policy Strategies, Inc.

Scott Gottlieb, MD, and Adam Fein, PhD, discussed potential fallout of the FDA Aduhelm approval and lessons learned from the COVID-19 pandemic.

In his talk, "340B at 30 and the Impending Cliff on the Road to 40," Tim Paine outlines how the program came to be and what needs to happen to improve future implementation.

There are several pieces of legislation that could have an impact on drug rebates, explained Tracy Russell, senior director, government affairs, CoverMyMeds.

The approval of aducanumab (Aduhelm) was very controversial. There are 3 promising Alzheimer disease drugs in the pipeline with trials evaluating the efficacy, and there is a huge unmet need for these therapies, said Ray Tancredi, RPh, MBA, CSP, divisional vice president, specialty pharmacy development and brand Rx/vaccine purchasing, Walgreens.

Avalere is presenting at Asembia’s 2022 Specialty Pharmacy Summit, and Ryan Urgo, MPAP, managing director, health policy, discusses possible drug pricing policy options on the table for the Biden administration to consider in a midterm election year.

Numerous topics will be addressed at this year's Asembia Specialty Pharmacy Summit, held in-person in Las Vegas from May 2 through 5, including updates on cell and gene therapies and insights on the future of the industry.

Erika Glenn, Division Head of Sales, Care Management, CVS Health, addressed some of the latest innovations in predictive modeling and data analytics being leveraged by her organization in the management of patients with chronic conditions at the Asembia 2021 Specialty Pharmacy Summit in Las Vegas.

A panel at Asembia 2021 Specialty Pharmacy Summit in Las Vegas addressed challenges in the treatment journey of patients with rare diseases, efforts to improve access to gene therapies, and cost and value considerations for stakeholders.

Oncology drugs are a huge driver of cost, but there’s a lot of innovation happening in the space to improve care and outcomes for patients, said Michelle Booth, PharmD, director of specialty clinical solutions at Magellan Rx Management.

Specialty pharmaceuticals have a lot of promise, but patients have to go through hoops to get them. Technology can improve interoperability and create a better patient experience, said Jim Adams, chief innovation officer, AllianceRx Walgreens Prime.

Panelists from a session at Asembia 2021 Specialty Pharmacy Summit in Las Vegas discussed considerations for manufacturers, specialty pharmacies, and payers entering the rare disease and gene therapy market.

The state of value-based contracting in specialty pharmacy was addressed in a panel discussion at Asembia 2021 Specialty Pharmacy Summit in Las Vegas, with speakers touching on the essentials of such agreements, how to optimally integrate them, and future considerations for the pharmaceutical marketplace.

Specialty pharmacy was well positioned during the pandemic because it has a history of embracing digital solutions, said Heather Bonome, PharmD, director of pharmacy at the accreditation agency URAC.

Some policy reforms can help incentivize more use of value-based contracts, but overall an area that needs more work is value-based contracts with pharmaceutical companies, said Steven Peskin, MD, executive director, director of population health, Horizon Blue Cross Blue Shield of New Jersey.

After the public health emergency is over, there will likely remain incentive to keep some administration of specialty therapies at home, in a less acute setting of care, said Lance Grady, market access practice director, Avalere Health.

Panelists of the opening session at Asembia 2021 Specialty Pharmacy Summit in Las Vegas address emerging shifts in specialty pharmacy, its impact on the health care system, and future implications post pandemic.

At the fully in-person meeting of the Asembia 2021 Specialty Pharmacy Summit, held in Las Vegas, Nevada, attendees will get multiple sessions looking into the future of specialty pharmacy, as well as sessions on hot topics like telehealth and health equity.

Horizon Blue Cross Blue Shield of New Jersey has been involved in a number of value-based cancer care initiatives that will be highlighted during an upcoming Asembia session, said Steven Peskin, MD, MBA, executive director, director of population health, Horizon Blue Cross Blue Shield of New Jersey.

In 2 sessions at the Asembia 2021 Specialty Pharmacy Summit, George Van Antwerp, MBA, managing director, Deloitte Consulting, will provide a look at the future of specialty pharmacy and health equity in pharmacy.

Healthcare is very comfortable with treating a disease, but it’s not as good with handling cures. However, the advent of gene therapy and precision medicine means more and more expensive cures are coming down the pipeline, said panelists on the last day of Asembia’s 15th annual Specialty Pharmacy Summit, held April 29 to May 2 in Las Vegas, Nevada.

Out-of-pocket (OOP) costs remain a problem, and even patients who are receiving co-pay assistance worry about these expenses. Unfortunately, charitable foundations that provide financial assistance are under increasing strain as demand rises, with funds running out of money quickly, explained Ayesha Azam, senior director of medical affairs, Patient Access Network Foundation.

Analyses of real-world data have broadened the understanding of multiple sclerosis (MS) and provided a snapshot into patient conditions and healthcare costs in the years leading up to and the years after an MS diagnosis, explained Bruce Pyenson, FSA, MAAA, Principal, Consulting Actuary, Milliman, Inc, during a session highlighting findings of a recent Milliman white paper at Asembia’s 15th annual Specialty Pharmacy Summit, held April 29 to May 2 in Las Vegas, Nevada.