Paying for Cures: How Can We Afford it?

ACPE UAN #:   0233-0000-16-003-H04-P

Release Date:  Wednesday, April 20, 2016

Expiration Date:   Wednesday, April 20, 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

High-cost curative specialty drugs pose a new dilemma for payers. Manufacturers claim these “cures” offer lifetime benefit and therefore provide high value. Payers grapple with their budget impact due to high unit costs and high prevalence diseases. Managed care pharmacists have limited tools to manage these. Traditional utilization management tools may limit access or increase patients’ cost burdens. Payers face large upfront costs for health benefits occurring long after coverage terminates with little chance of realizing the downstream benefits and cost savings. 

This session utilizes current case studies to present possible solutions to optimize clinical benefit and manage costs in the utilization of curative specialty drugs. We will present current best practices in the U.S. and abroad, and propose some innovative alternative management strategies. We will conclude with an interactive audience survey and discussion to understand the opportunities and challenges of the different management strategies using the audience response technology. 

Learning Objectives:  

  1. Describe the current best practices for managing high-cost specialty drugs both domestically and globally.
  2. List alternative strategies for managing high-cost specialty drugs.
  3. Discuss the relative merits of the different strategies with respect to budget impact, value, and patient access.

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.

Mike Drummond, PhD reports:

  • Mapi Group (Consultancy):Consultant
  • Dymaxium Inc: Major Stock Shareholder
  • Merck Research: Consultant
  • Novo Nordisk: Grant Support

Newell E. McElwee, PharmD, MSPH reports:

  • Merck: employee & stock holder
  • Pfizer: former employee & stockholder

John Watkins, PharmD, MPH, BCPS reports having no financial relationships with any commercial interests during the past 12 months.

Kai Yeung, PharmD, PhD 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 #0233-0000-16-003-H04-P 1.25 Contact Hours April 20, 2016 - April 20, 2019