Drug Pricing in Pharmacy & PBM Contracting—What Does it all Really Mean?

ACPE UAN #:   0233-0000-16-026-H04-P

Release Date:  Thursday, April 21, 2016

Expiration Date:   Thursday, April 21, 2019

Activity Type:  Knowledge-based  

Contact Hours:   1.25

Activity Fee:  Member:  $15.00  Non-Member:  $30.00

As an accredited provider, AMCP strictly adheres to the ACPE Standards for Commercial Support and other relevant guidelines and standards to ensure the independence of continuing pharmacy education (CPE) activities.  It is AMCP’s intent that all CPE activities be independent, objective, balanced, evidence-based and free of any commercial bias.   

Target Audience: This repurposed session from the AMCP Annual Meeting 2016 is designed to provide insights and solutions for pharmacists who practice in managed care settings, to help them maintain and enhance their knowledge, skills, and abilities. 

Activity Overview

Questions abound when it comes to drug pricing, including pharmacy benefit manager (PBM) contracting and discount/rebate arrangements. Have you ever wondered how contracts, discounts and rebates work between pharmaceutical companies, pharmacies, PBMs and drug wholesalers? What type of language should be used in contracting?

In addition to answering these questions, this session will review pricing models and data used by private PBMs and state pricing programs such as Medicaid. The session will also discuss pharmacy drug pricing/discount compliance audits and provide best practices in contracting. 

PLEASE NOTE: Medi-Span does not use PBM data for drug pricing.

Learning Objectives:  

  1. Explain the difference between pricing models used in pharmacy benefit manager (PBM) and pharmacy contracting.
  2. Identify at least two best practices in pricing models.
  3. Describe the challenges and opportunities involved in specialty pharmacy contracting with respect to drug pricing and rebate programs.

Schedule of Educational Activity

This CPE online activity consists of a pre-recorded audio/slide presentation, a pre-test (to establish prior knowledge, not required to pass), a post-test with a score of 70% or higher, and a specific online activity evaluation. 

Faculty Relevant Financial Relationships Disclosure: AMCP asks everyone who is in a position to control the content of a continuing pharmacy education activity to disclose all relevant financial relationships with commercial interests. If AMCP determines that a conflict of interest exists as a result of a financial relationship you have (or that your spouse/partner has), we will need to take appropriate steps to resolve the conflict of interest.

  • Francis B. Palumbo, PhD, JD reports having no financial relationships with any commercial interests during the past 12 months.
  • Lee H. Rosebush, PharmD, RPh, MBA, JD reports having no financial relationships with any commercial interests during the past 12 months.
  • AMCP staff report no relevant financial relationships pertinent to this activity: Puneet Singh, PharmD and Ruby Singh, PharmD, BCPS.

Method and CPE Requirements:   

Participants should claim continuing pharmacy education (CPE) credit for this online activity, only if they have not claimed credit for the live activity presented at the AMCP Annual Meeting 2016. 

CPE credit will be processed through the AMCP Learn portal and reported directly to CPE Monitor.  Please allow 24-72 hours for processing and posting in your NABP account.

To receive CPE credit for an AMCP Learn online activity you must:

  • View the entire pre-recorded audio/slide presentation.
  • Successfully complete the post-test with a score of 70% or higher (The post-test may be taken up-to three times, and will provide feedback.)
  • Complete a specific online activity evaluation.

System Technical Requirements/Viewing Requirements: System Requirements Courses and learning activities are delivered via your Web browser and Acrobat PDF. For all activities you should have a basic comfort level using a computer and navigating the web site.  View the minimum technical and system requirements for online educational activities.

Credit Information

Activity Number Credit Amount Accreditation Period
ACPE UAN #0233-0000-16-026-H04-P 1.25 Contact Hours April 21, 2016 - April 21, 2019