Oct. 24 Webinar to Discuss All Angles of the Complex World of PBM Contracting

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Atlantic Information Services’s Oct. 24 webinar to offer comprehensive overview of complex world of pharmacy benefit contracting.

Atlantic Information Services is pleased to announce its Oct. 24 Webinar, “Negotiating Pharmacy Benefit Contracts: Strategies for Health Plans and Employers,” a fast-paced panel discussion looking at all angles of the complex world of pharmacy benefit contracting: PBMs, pharmaceutical manufacturers, health plans, employers and other purchasers.

As the role of PBMs has evolved from prescription drug claims processors to full-service benefit managers, negotiating a PBM contract has become more complex than ever, and it’s crucial that the contract language is clear to all parties. Pricing terms can be confusing and therefore misunderstood by plan sponsors, which can be further confounded by ongoing changes to how pharmaceutical prices are calculated and reported. PBMs also offer a wide range of services, from claims adjudication to drug utilization review, and plan sponsors should know upfront what they’re being charged for those services and what they’re getting for their money.

In a roundtable discussion featuring Brian Anderson, a consultant with the San Diego office of Milliman, Eugene P. Samuels, a health care attorney and general counsel for Envision Pharmaceutical Services, and William Sarraille, a senior member of the Healthcare Practice group in the Washington, D.C., office of Sidley Austin, attendees of this Oct. 24 webinar will get reliable answers to these and other big-dollar questions:

  • What are the different types of PBM contracts available (e.g., traditional, 100% pass-through, fully transparent)? Which are most appropriate under what circumstances?
  • How do plan sponsors and PBMs define the term “transparency?” How can they reach an agreement that reflects both interpretations?
  • What fees do PBMs typically charge, and what is included in those payments? What additional fees may be charged and for what kinds of enhanced services?
  • What pricing schemes or changes in the market could prompt payers to update their contracts?
  • What are the commonly used pricing methodologies to determine ingredient costs? How are they evolving? For example, what is a maximum allowable cost list, and should MAC lists be negotiated into the contract?
  • What performance guarantees are found in an effective PBM contract?
  • How can plan sponsors negotiate the right to audit in their contracts? What can the PBM provide to the plan sponsor on an ongoing basis to avoid a full audit?
  • What contracting strategies can be used to reduce costs and improve transparency?
  • How can plan sponsors ensure that the contract reflects what the PBM proposed?

For more details and registration information on “Negotiating Pharmacy Benefit Contracts: Strategies for Health Plans and Employers,” visit http://aishealth.com/marketplace/c2p36_102412.

About AIS
Atlantic Information Services, Inc. (AIS) is a publishing and information company that has been serving the health care industry for more than 25 years. It develops highly targeted news, data and strategic information for managers in hospitals, health plans, medical group practices, pharmaceutical companies and other health care organizations. AIS products include print and electronic newsletters, websites, looseleafs, books, strategic reports, databases, webinars and conferences. Learn more at http://www.AISHealth.com.

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Shelly Beaird-Francois
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