AMCP Talks: Incorporating Value Framework Assessments in Coverage and Reimbursement Decisions

Pricing: Free for Members and $30 for Non-Members

Please note that this session is not accredited for continuing pharmacy education credit.

Course Description

Value frameworks and assessments are increasingly used as a resource for evaluating the value of pharmaceuticals and other health technologies in coverage and negotiation processes. These frameworks are designed to help health care decision-makers determine the comparative effectiveness and value of a medication or intervention. These frameworks continue to evolve and are designed for different decision-making applications and target audiences.

According to a recent survey of payers, the most important factors when selecting a framework to inform decision-making are the metrics and outcomes, comparative clinical effectiveness information, methodologic rigor, and transparency. Although payers agree on these important factors, their decision-making processes and incorporation of value assessment information in these decisions can differ vastly. This session aims to explore:
• payer decision-making processes and structures,
• current sources and use of value assessments in these decisions,
• future value assessment information needs, and
• the potential impact of the Inflation Reduction Act.

Join us to hear, from various payer perspectives, real-world strategies for incorporating and assessing value in their coverage and reimbursement decision-making. You won’t want to miss this session!

Target Audience

Pharmacists who practice in managed care settings.

Learning Objectives

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

  1. Explain how value framework assessments are utilized in managed care practice.
  2. Describe at least two strategies payers use to incorporate value frameworks into decision-making.
  3. Identify opportunities for bolstering the relevance and usefulness of value framework assessments for payer decision-making.
Course summary
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Pat Gleason, PharmD
Assistant Vice President
Prime Therapeutics
Eagan, MN

Jessica Hatton, PharmD, BCACP
Associate Vice President, Pharmacy
Dayton, OH

John M. O'Brien, PharmD, MPH
President & CEO
National Pharmaceutical Council
Washington, DC

Brenden O'Hara, RPh, BCACP
Team Leader, Provider Engagement Pharmacy Initiatives
Blue Cross NC
Cary, NC


Kimberly Westrich, MA
Director, Value & Access Strategy
Xcenda/Amerisource Bergen
Carrollton, TX

Please note that this session is not accredited for continuing pharmacy education credit.


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