APFM Section 1 Module 3: PBM
Module Description
Pharmacy Benefit Managers, or PBMs play a large role in the health care system, and more specifically in formulary management. This module will review the different core functions of a PBM as well as the benefits and challenges of utilizing rebates.
Target Audience
This program is designed for mid-level managed care pharmacists and managed care professionals working in formulary management or considering a transition to formulary management.
Learning Objectives
At the completion of this activity, participants should be able to:
- Review the role of pharmacy benefit managers (PBMs) and health plans in formulary management and the different types of PBM models.
- Discuss the basic principles of rebates, including their purpose, structure, and parties involved.
- Identify the benefits and potential drawbacks of utilizing rebates and their impact on health costs and patient access.
Faculty/Author:
Kristen Tripicchio, PharmD
Research Director
Formulary Insights
Advisory Board
Shawn Barger, PharmD
Lead Director, Medicare Formulary Development and Management
Password
Aimee Loucks, PharmD, BCPS
Director Clinical Pharmacy Services
Kaiser Permanente Washington
Lisa Mahan, PharmD, MS, MTM
Clinical Program Senior Manager
Cigna Healthcare
Kristen Patti, PharmD
Manager, Clinical Drug Evaluation & Policy
Blue Cross Blue Shield of Michigan
Reviewers
Steve Kheloussi, PharmD, MBA, FAMCP
Director, Professional Affairs
AMCP
Katherine Tieu, PharmD
Clinical Account Manager
Capital Rx
Drake Reiter, PharmD
Director, Pharmacy Operations
Priority Health
Financial Relationship Disclosures:
Faculty/Reviewer/Planner | Reported Relevant Financial Relationships |
Kristen Tripicchio, PharmD Faculty | None |
Shawn Barger, PharmD Planner | None |
Aimee Louckes, PharmD, BCPS Planner | None |
Lisa Mahan, PharmD, MS, MTM Planner | None |
Kristen Patti, PharmD Planner | IngenioRx |
Steve Kheloussi, PharmD, MBA Reviewer | None |
Drake Reiter, PharmD Reviewer | None |
Katherine Tieu, PharmD Reviewer | None |
- AMCP Staff have disclosed no relevant financial relationships.
- If applicable, relevant financial relationships have been mitigated and documented.
- Content has undergone a peer review to ensure content validity.
Accreditation:
ACPE UAN:0233-0000-24-068-H04-P • Activity Type: Knowledge-Based
Contact Hours: 0.75
Release Date: December 13, 2024 • Expiration Date: December 13, 2027
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.
Available Credit
- 0.75 ACPEThe Academy of Managed Care Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
- 0.75 Certificate of Completion