AIS Webinar to Identify Pros, Cons of Exclusionary Formularies for Health Plans, Purchasers

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In an upcoming webinar from Atlantic Information Services, participants will learn about strategies and considerations around adopting exclusionary formularies.

With the “generic wave” reaching its final crest in 2015, fewer opportunities will soon exist for the preferring of brand-name drugs to generate rebate revenue. In an effort to maximize rebates — and share them with plan sponsors — PBMs are putting manufacturers in exclusive positions and removing other clinically comparable agents from their formularies. But some plan sponsors question whether changing their existing formulary structure is worth the potential member disruption. The Nov. 13 webinar from Atlantic Information Services, Inc. (AIS), “Adopting PBM Formulary Exclusions: Pros and Cons for Health Plans and Purchasers,” will provide details behind Express Scripts’ exclusionary strategy and share what a Mercer consultant is advising self-funded plan sponsors (of any size) regarding formulary design and exclusions.

During 60 minutes of expert presentations followed by 30 minutes devoted to individual questions, participants will hear from David Dross, a partner and national pharmacy practice leader at Mercer, and Adam Kautzner, Pharm.D., vice president of drug trend and formulary solutions at Express Scripts Holding Co. They will address key questions such as:

  •     What savings opportunities exist with formularies that utilize standard exclusions?
  •     What are the various exclusionary models in the marketplace today? Why are some plan sponsors choosing to build around the exclusionary model? What does that involve?
  •     How can plans adopt an exclusionary formulary without major member noise? What clinical process and communication strategy did Express Scripts employ to avoid client and member disruption?
  •     What are some key questions plan sponsors should ask of their PBMs when considering whether to opt in or out of the standard exclusions? If they don’t opt in, what is the estimated impact to their annual rebate revenue?
  •     What specific clinical protocols need to be implemented to achieve significant cost savings while also enabling members to receive coverage for the medication they truly need? What can plans do to ensure specialty access to medications for chronically ill members?

Visit for more details and registration information.

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

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Shelly Beaird-Francois
Atlantic Information Services
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