Point-of-Care Assessment of Response to High-Cost Specialty Therapy: Real World Experience in Outcomes-Based Contracting

ACPE UAN #:   0233-0000-16-027-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

Outcomes-based contracting has long been proposed as a measure to reward innovation, based on actual performance of treatments and interventions in patient populations. However, the perceived and actual challenges in implementation have prevented many innovative contracts from leaving the drafting table, causing many to wonder if outcomes-based contracting will become a widespread reality. How can manufacturers and payers more easily come to full agreement on clinical metrics, reward and risk terms, and data collection? 

This session will explore the historical implementation challenges in outcomes-based contracting, including the perspective of a managed care organization. Faculty will present a real-world case study of a point-of-care, response-to-therapy contracting model, and discuss lessons learned from the clinical and economic considerations used in designing the model. 

Learning Objectives:  

  1. Explain the rationale and societal promise of outcomes-based contracting programs to the health care industry as a whole, and the specialty pharmaceutical industry specifically.
  2. Discuss the socioeconomic and business benefits to patients, providers, payers, specialty pharmacies, andmanufacturers of a response-to-therapy innovative contracting program.
  3. Identify the clinical and economic considerations in designing an outcomes-based contract as well as potential   outcomes, and per member per month or per member per year cost savings to a payer.
  4. Describe clinical algorithms and utilization management pathways for automated non-responder risk assessment.

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.

  • Fred Brownfield, BSPharm reports having no financial relationships with any commercial interests during the past 12 months.
  • Sal Rafanelli, RPh reports:

         o    BiologicTx: Employee (Self) Salary

  • Nathan White, CPC  reports:

         o     eMAX Health: Employee

         o     NucleusX Market Access: Employee (Self) Salary

  • 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 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 #0233-0000-16-027-H04-P 1.25 Contact Hours April 21, 2016 - April 21, 2019