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APFM Section 2 Module 5: Special Considerations and Hot Topics
Module Description
Managed care is an ever-evolving landscape with new ideas, products, and innovations. This module will review various special considerations and hot topics that many formulary management pharmacists will encounter. It includes topics such as various FDA accelerated approval pathways, biosimilars, digital therapeutics, and high-investment therapies and their implications on formulary management. It will also review health disparities and how patient perspectives may be incorporated into decision-making. Lastly, this module will summarize value-based care modules and their impact on outcomes-based reimbursement and population health management.
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:
- Define different FDA accelerated approval pathways and their implications on formulary management.
- Discuss considerations for incorporating biosimilars, digital therapeutics, and high-investment therapies into a formulary.
- Recognize health disparities and their influence on healthcare access and affordability.
- Identify methods for collecting and integrating patient feedback into formulary management practices.
- Summarize value-based care models and its impact on outcomes-based reimbursement and population health management.
Faculty/Author:
Spenser Smith, PharmD
Senior Clinical Pharmacist
Blue Cross Blue Shield of North Carolina
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 |
| Spenser Smith, 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:0233-0000-24-074-H04-P • Activity Type: Knowledge-Based
Contact Hours: 1.75
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
- 1.75 ACPE
The Academy of Managed Care Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. - 1.75 Certificate of Completion