Budget Impact Models: How Payers Can Build and Validate

Title:  Budget Impact Models: How Payers Can Build and Validate

ACPE UAN #:  0233-0000-17-049-H04-P

Release Date:  October 17, 2017

Expiration Date:  October 17, 2020

Activity Type:    Knowledge-based

Contact Hours:  1.5

Activity Fee:  Member:  $15        Non-Member: $30

Target Audience: Pharmacists who practice in managed care settings.

Activity Overview

Budget impact models (BIMs) can be built and used by payers for many decisions, including changes to the formulary. There are significant advantages to building a site-specific BIM, including use of actual utilization and relevant claims data to input into the model. This factor greatly increases the predictive validity of the model. Second, the end user can expand the scope of the BIM to areas of interest beyond newly approved drugs.  This session offers a primer on creating a site-specific BIM. Join us as we discuss the basics of BIMs for different scenarios (e.g.; specialty drugs, non-specialty drugs, and rare diseases), how one payer incorporates BIMs into formulary decision making, and how to critique and validate BIMs.

Learning Objectives:  

At the completion of this activity, participants should be able to:

1. Identify key elements to include when building a budget impact model (BIM), and how these change based on specialty drug, non-specialty drug, or rare disease.

2. Describe how a payer can incorporate budget impact modeling into its formulary decision-making process.

3. Discuss methods for identifying and mitigating bias within a BIM and showing validation through claims data.

Schedule of Educational Activity

This activity consists of an audio recording, pre-test assessment questions (not required to pass or continue), post-test questions (required to pass with a score of 70% or higher) and a specific activity evaluation. 

CPE Requirements:   

Participants should claim continuing pharmacy education (CPE) credit for this home study activity only if they have not claimed credit for the live activity presented at AMCP Nexus 2017. 

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

To receive credit for an online activity you must:

  • Review the full content of the activity.
  • Successfully complete the post-test (required to pass with a score of 70% or higher, it may be taken a maximum of three times).
  • Complete a specific 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 websites.  View the minimum technical and system requirements for continuing education online learning activities.


The Academy of Managed Care Pharmacy (AMCP) is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

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.


Lesley-Ann Miller-Wilson ,MS, PhD, MBA | Senior Director, Health Economics and Value Assessment | Sanofi | Kingwood, Texas

Credit Information

Activity Number Credit Amount Accreditation Period
ACPE UAN #0233-0000-17-049-H04-P 1.5 Contact Hours October 17, 2017 - October 17, 2020