AMCP's 27th Annual Meeting & Expo | April 7-10, 2014 | San Diego, CA

Monday, April 6 | 2:00 pm – 6:30 pm
Tuesday, April 7 | 7:00 am – 12:00 pm

$425 AMCP Member | $475 Non-Member

Register Today

The Fundamentals of Integrating the Specialty Drug Benefit Certificate Course is a two-part program. The first part, also called the “Fall Course,” is offered as a pre-conference session at AMCP Nexus, and the second part, also called the “Spring Course,” will be offered in conjunction with the AMCP 27th Annual Meeting & Expo; April 6-7, 2015. Upon successful completion of all Fall and Spring courses, candidates are eligible to receive an AMCP Certificate of Completion.

The program titled, "Building the Next Generation of Specialty Leaders," will be offered from Summer 2015 to October 2015. This portion of the program will be largely project-oriented and offer a series of web-based programs and readings. Participants will be selected based on an application basis. Upon successful completion of this portion of the program, candidates are eligible for an AMCP Certificate of Excellence.



Time Event Name Event Speaker(s)

MONDAY, APRIL 6

2:00 pm - 2:30 pm Check-in
2:30 pm – 4:00 pm [IS1] Clinical Pathway and Guideline Considerations in the Evaluation of Specialty Drugs

  • Description ▾

    ACPE UAN: 0233-0000-15-001-L04-P
    1.5 contact hours
    Knowledge-based

    When evaluating specialty drugs for formulary inclusion, the requirements for case management and utilization management programs must be identified. In addition, consideration must be given to patient safety implications.

    This session will discuss how specialty drug utilization management programs can ensure patients receive safe and cost-effective care throughout the treatment course.

    LEARNING OBJECTIVES:
    At the completion of this activity, participants should be able to:
    1. Summarize the significance of utilization management programs with regards to specialty drugs.
    2. Explain the importance of a “pre-service evaluation” (i.e., utilization management and prior authorization programs) in deriving the best outcome for all stakeholders including payers, providers and patients.
    3. Discuss how utilization management policies are developed to strike an appropriate balance between cost control and promoting individual access to effective treatments.


April Kunze, PharmD
Director, Formulary Development & Pipeline
Prime Therapeutics
Eagan, Minnesota

4:00 pm - 4:30 pm Networking Break
4:30 pm – 5:30 pm [IS2] Beyond the Pharmacy Walls: Building Blocks for Optimizing Specialty Drug Management

  • Description ▾

    ACPE UAN: 0233-0000-15-002-L04-P
    1.0 contact hour
    Knowledge-based

    Managed care organizations need leaders who understand the value of a medical and pharmacy integrated approach for specialty. An integrated approach requires understanding of departments, functions and individuals who will be key collaborators within a successful specialty pharmaceutical management program. In addition, the careful selection of the project implementation team and thoughtful approach to the critical path should not be underestimated.

    As a specialty pharmacy leader, this session will help you identify and engage your partners in your organization and create the basic structure for organizational readiness to optimize specialty drug management.

    LEARNING OBJECTIVES:
    At the completion of this activity, participants should be able to:
    1. Explain the importance of a dedicated project team comprised of clinical pharmacists, and information technology and business representatives formed to evaluate the current state of specialty management within an organization.
    2. Identify the individuals to engage in order to create a coordinated approach to specialty drugs.
    3. Summarize how one managed care organization has redesigned the benefit, process and workflow for specialty drug management in an effort to be more efficient.
    4. Identify the change management approaches to individual roles, inter-departmental workflow, health plan policies, and third party and vendor management.
    5. Explain how to overcome the barriers encountered by managed care organizations attempting to integrate specialty drug benefit management.
    6. Describe the global impact of managing specialty drugs on members, physicians, hospitals, and corporate public relations.


James R. Lang, PharmD, MBA
Vice President, Pharmacy Services
Blue Cross and Blue Shield of Michigan
Detroit, Michigan

5:30 pm – 6:30 pm [IS3] The Future of Specialty Coding and Billing

  • Description ▾

    ACPE UAN: 0233-0000-15-003-L04-P
    1.0 contact hour
    Knowledge-based

    To improve transparency among payers, providers and patients, it is vital that pharmacy managers provide leadership with understanding and implementing coding systems. Managed care organizations also need to create structure for managing multiple reimbursement mechanisms such as rebates, dose optimization, purchase discounts, contract validation.

    This session will describe today’s challenges with coding systems as they relate to utilization and management of specialty pharmaceuticals. Case studies will be presented to illustrate how managed care organizations typically process a specialty drug claim and how the process could be optimized in the future.

    LEARNING OBJECTIVES:
    At the completion of this activity, participants should be able to:
    1. Describe challenges faced with today’s coding systems as they relate to utilization and management of specialty pharmaceuticals.
    2. Identity methods to audit specialty drug billing across all channels.
    3. Describe how utilization management tools (e.g., prior authorization, step edits) can impact contracting, billing and payment system deficiencies.


Craig Stern, Pharm.D., MBA, FAMCP, CSP
President
Pro Pharma Pharmaceutical Consultants, Inc.
Canoga Park, CA

TUESDAY, APRIL 7

6:30 am - 7:00 pm Check-in / Networking Breakfast
7:00 am - 8:30 am [IS4] Best Practices in Assessing and Managing Specialty Pharmacy Providers

  • Description ▾

    ACPE UAN: 0233-0000-15-004-L04-P
    1.5 contact hours
    Knowledge-based

    In order to optimize your specialty pharmacy network, important considerations are required – such as, utilizing best-in-class requirements and standards, reporting and performance guarantees, and linking with your provider contracting systems. Specialty pharmacy leaders need to ensure specialty pharmacy providers deliver on the promise of financial benefits and patient-level reporting including data on case management, patient outcomes and adherence, guideline monitoring and prior authorization details.

    Limited data analytics and clinical data has made it difficult to understand the true total cost of care and develop the best strategies for specialty drug management. Drawing from client engagement insights and best practices, the session will review key elements required to properly assess and implement an effective specialty drug management strategy.

    LEARNING OBJECTIVES:
    At the completion of this activity, participants should be able to:
    1. Identify the best-in-class specialty pharmacy provider analytic capabilities and contrast those to your current managed care organization’s analytic capabilities.
    2. Describe the metrics for measuring return-on-investment with specialty pharmacies.
    3. Discuss how to achieve transparency on provider contracting arrangements so that the appropriate specialty drugs are routed to your specialty pharmacy provider.


Natasha Sorokin, MPH
Pharmacy Consultant
Pharmaceutical Strategy Group
Plano, Texas
8:30 am - 8:45 am Networking Break
8:45 am – 10:15 am [IS5] Budgeting of Specialty Drugs: A European Perspective

  • Description ▾

    ACPE UAN: 0233-0000-15-005-L04-P
    1.5 contact hours
    Knowledge-based

    Accountable Care Organizations are encouraging a rethink of medical and pharmacy specialty drug management, especially when considering the risks and rewards are based on the potential of drugs to tame overall medical costs. Is managed care pharmacy poised to meet this challenge? Are your Pharmacy & Therapeutics or Health Technology Assessment Committees encouraging alternative payments and incentive/risk structures for new drugs and technologies? Do you have the tools for managing the risks?

    This session will explore these concepts, international perspectives in unique contracting and use global case study examples to demonstrate conditional and restricted reimbursement and how these are currently being applied.

    LEARNING OBJECTIVES:
    At the completion of this activity, participants should be able to:
    1. Summarize specialty drug trend drivers and cost management strategies.
    2. Identify strategies your managed care organization can employ to drive specialty utilization.
    3. Summarize some of the opportunities and challenges experienced in implementing incentives and risk structures.
    4. Discuss how to achieve a comprehensive view of costs, outcomes and standard metrics across all stakeholders to support risk-based contracting with manufacturers.


Sophie Murdoch
Vice President
Alliance Life Sciences Consulting Group, Inc.
Netherlands

10:15 am - 10:30 am Networking Break
10:30 am – 12:00 pm [IS6] Specialty Drug Reporting Considerations

  • Description ▾

    ACPE UAN: 0233-0000-15-006-L04-P
    1.5 contact hours
    Knowledge-based

    Specialty drug analytics are complicated by the need to combine medical drug claims and pharmacy drug claims that are often managed by health plans and pharmacy benefit managers independently. Understanding the limitations and challenges associated with these claims is essential in determining cost trends, estimating the impact of new programs and measuring the impact of current programs. Understanding how reporting specifications are written and collaboration between organizations is essential for comprehensive drug reporting and analysis.

    This session will provide updates on key issues associated with medical and pharmacy reporting, and analytics.

    LEARNING OBJECTIVES:
    At the completion of this activity, participants should be able to:
    1. Discuss the importance of integrating medical and pharmacy claims, as well as issues with electronic medical record data for specialty drug reporting.
    2. Identify the important financial components of specialty drug reporting.
    3. Identify the important clinical components of specialty drug reporting.


Steven V. Johnson PharmD, BCPS
Senior Director, Health Outcomes
Prime Therapeutics
Eagan, Minnesota



The Academy of Managed Care Pharmacy (AMCP) is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education (CPE).

Pharmacists can earn a maximum of 8 contact hours of CPE credit for the Fundamentals of Integrating the Specialty Drug Benefit Certificate Program Spring Courses. To obtain credit, pharmacists must attend a session in its entirety, participate in session-specific learning assessments, complete a session evaluation, and record their participation online no later than 11:59 PM ET on May 11, 2015.

Obtaining CPE Credit
Pharmacists interested in obtaining CPE credit for each of the sessions within the Fundamentals of Integrating the Specialty Drug Benefit Certificate Program Spring Courses will be required to confirm their attendance with AMCP staff at the start of the program. Approximately one week after the program, successful candidates will receive notification from AMCP to complete the program evaluation and process CPE credit via the AMCP website.

CPE Monitor
The CPE Monitor system became mandatory for all pharmacists, technicians, and CPE providers on January 1, 2013. If you have not yet obtained your National Association of Boards of Pharmacy (NABP) e-profile ID, please visit http://www.nabp.net/programs/cpe-monitor/cpe-monitor-service. If you have any questions about this system or your number, please contact NABP customer support at 847-391-4406 from 9:00 am to 5:00 pm CT.

Information about the amount of CPE credit pharmacists earn during the Fundamentals of Integrating the Specialty Drug Benefit Certificate Program Spring Courses is transmitted electronically by AMCP to NABP. Pharmacists who log-in to CPE Monitor will be able to access information about their CPE credit after June 7, 2015.