Latest Conference Content

Laura Beerman, director, customer segment analysis, Decision Resources Group, presented a discussion that highlighted the early results of accountable care organizations (ACOs). She said that while the Pioneer ACOs created a large initial buzz, their cost savings has varied widely.

In a panel discussion moderated by Neil Minkoff, MD, CEO of FountainHead HealthCare, panelists examined the current state of healthcare exchanges, both public and private. Panelists included Dennis Falci, MBA, director, US managed markets training, sales training and leadership development, Sanofi-Aventis SA; Thomas Kaye, director of consulting pharmacy, Prescription Formulary Exchange, LLC; and Sheri Sellmeyer, vice president, market analysis, HealthLeaders-InterStudy, a Decision Resources Group Company. They analyzed the current benefit models required by public exchanges, and the rising popularity of the private counterparts, offering a glimpse into the new healthcare marketplace now unfolding.

Health information technology (HIT) was the focus of a discussion led by Farzad Mostashari, MD, visiting fellow, Brookings Institution, former national coordinator for HIT, US Department of Health and Human Services. In his Managed Markets Summit 2014 keynote address, Health IT and Reform: The Road to Right Care, Dr Mostashari touched upon the obstacles and shortcomings in our nation's healthcare landscape, and asserted that more prominent usage of HIT would help to alleviate fiscal concerns and affect better outcomes in patient care.

Raulo S. Frear, PharmD, general manager, OmedaRx, says pharmacy benefit managers are aligning benefit designs for delivery system reform in a few ways. With respect to the delivery system reform, if you look at ACOs as a specific example, our experience has been that the ACOs are not really ready to talk about different benefit designs, Dr Frear says. They're still learning what it means to accept risk and that means risk across a lot more areas than just pharmaceuticals.

Ed Pezalla, MD, MPH, national medical director for pharmacy policy and strategy, office of the CMO, Aetna, says payers and health plans are preparing for patient-centered care by utilizing digital tools. Everything from virtual people to cost search tools are used to assist employed and general patient populations. Dr Pezalla says many of these tools will also be used in the public and private health insurance exchanges to help people make decisions as they purchase health plans.

Neil Minkoff, MD, CEO, FountainHead HealthCare, discusses the impact that formulary has on both employer and consumer choice in the health insurance exchanges.

Dennis Falci, MBA, director, US managed markets training, sales training and leadership development, Sanofi-Aventis SA, says it's no secret-Health Insurance Exchanges are a hot topic in health news.

Laurie Wesolowicz, PharmD, director, pharmacy services clinical, Blue Cross Blue Shield of Michigan (BCBSM), says that clinical evidence and other factors can drive formulary decision-making. Evidence can influence the value and coverage recommendations for drugs covered under the pharmacy (formulary) and medical benefits.

Farzad Mostashari, MD, visiting fellow, Brookings Institution, former national coordinator for health information technology (HIT), US Department of Health and Human Services, says we need to have payment reform to support the success of HIT.

Presenters in this talk focused on how the creation of health insurance exchanges (HIEs) and other federal and state regulations will impact the provision and administration of pharmacy benefits.

With nearly half of specialty spending occurring on the medical benefit in 2012, and seeing that specialty spending is predicted to account for 50% of total pharmacy spending by 2019, Mike Waterbury, president, ICORE Healthcare, specialty division of Magellan Pharmacy Solutions, reports that specialty drug costs will surpass traditional spending in the next few years.

According to Howard K. Crowley, head of pharmacy strategic initiatives, Aetna Pharmacy Management, a Towers Watson/ National Business Group on Health survey found that 29% of employers rank the rising costs of specialty drugs as a top challenge to keeping health benefit coverage affordable.

James Gartner of CareSource and Jessica Frank of OutcomesMTM shared the first-year results of a cooperative comprehensive medication therapy management (MTM) program that they implemented for nearly 1 million Ohio Medicaid members.

In medication use and improving patient outcomes, Susan Cooper, MPH, RPh, senior director, pharmacy services, HealthPartners, says her organization envisions prescription drug optimization going beyond addressing adherence. It seeks to improve the patient experience.

In a presentation entitled The PBM Has No Clothes: A (Public Sector) Proposal Is More Transparent Than You Think, Steffanie Mathewson, Esq, principal, Mathewson Research, described how the Freedom of Information Act (FOIA) and state sunshine laws make it easier for stakeholders to view and understand the strategic direction of major PBMs.

When it comes to managing chronic conditions and rare disease, the cost of treatment can be astronomical.

According to John Miller, executive director, MidAtlantic Business Group on Health, The National Business Coalition on Health (NBCH) is an organization that seeks to drive conversations about prescription drug benefit management (PBM) to value.

To build on the success and ideas generated at last year's inaugural event, Joslin Diabetes Center once again brought together numerous key stakeholders in the collective battle to conquer diabetes and to provoke thought, innovation, and action. Highlights from Diabetes Innovation, which took place on October 3-5, 2013, in Washington, DC, are available in a special report published by The American Journal of Managed Care.

As the prevalence of obesity continues to increase and treatment strategies evolve, pharmacists are not only in a position to advise on appropriate use of pharmacotherapy for obesity, but also to assist in improving outcomes from gastric bypass surgery.

Speakers at the ASHP Midyear Clinical Meeting ranging from ASHP President Gerald Meyer, PharmD, to Michael Lee, PharmD, of the Indian Health Service, argued that pharmacists are closer than ever before to achieving their goal of attaining provider status.

Genomic sequencing is rapidly increasing its value as a clinical tool in the diagnosis and treatment of many diseases, including cancer. In his presentation, Justin M. Balko, PharmD, PhD, from Vanderbilt University, provided a background on the current state of next-generation genomic sequencing (NGS), and the potential role that pharmacists play as this science continues to evolve.

New and experienced pharmacists are always on the lookout for ways to improve their careers. This presentation focuses on some key strategies for identifying new opportunities that allow new and experienced pharmacists to develop and apply their clinical skills.

Quality and performance measurement has become an integral part of the healthcare system. As pharmacists continue to increase their role and exposure as healthcare providers, they are well positioned to assist in identifying ways to improve the quality of care delivered and to play an integral role in the development of quality measures, according to Curtis Collins, PharmD, MS, BCPS (AQ-ID), FASHP, who spoke at the ASHP Midyear Meeting.

With the rise of targeted therapies, the days of letting doctors report informally on unexpected reactions to new cancer drugs are long gone. The change signals a larger role for phase IV, the post-marketing research step in the approval process.

One billion dollars. That can be the list price for bringing a new cancer-fighting agent from preclinical design through approval by the US Food and Drug Administration, according to Michael R. Grever, MD, of the Ohio State University.

llicit drug use continues to be a prevalent and growing problem in the United States, and the use of newer substances is on the rise. Because of the increasing prevalence and tweaking of compounds to avoid detection, the identification of drug abuse by practitioners often relies on signs and symptoms. In this session, presenters reviewed some of these agents, including their history and their impact on those abusing them.

Retired general and former secretary of state Colin Powell discussed his thoughts on the US healthcare system and the role pharmacists play within it during his keynote address at the ASHP Midyear Clinical Meeting.

In this session, a sustainable business model for pharmacists practicing in an accountable care organization environment was described by Kelly Boesen, PharmD, BCPS, and Sandra Leal, PharmD, MPH, CDE, FAPhA, of the El Rio Health Center in Tucson, Arizona.