The Fine Print of Affordability: What Employers and PBMs Need to Know About Cost-Shifting Strategies

Pricing: Free for Members and Non-Members

Course Description

Copay accumulator, maximizer, and alternative funding programs (AFPs) have rapidly grown in number and adoption as employers and PBMs seek to offset specialty drug costs. While these programs reduce plan liability, they can also increase administrative complexity, disrupt access, and raise patient financial exposure. This session will unpack how each model functions within pharmacy benefit design and examine operational, regulatory, and clinical implications.

Additionally, this session will explore the operational design and contracting flow among PBMs, plan sponsors, and manufacturers; review real-world evidence and outcomes reported in recent literature; and highlight practical insights from PBM and health-system experiences. Discussion will also address best practices for employers and payers evaluating implementation, including ACA, ERISA, and summary plan description (SPD) considerations.

Target Audience

Pharmacists who practice in managed care settings.

Learning Objectives

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

  1. Describe the structure and financial flow of copay accumulator, maximizer, and alternative funding programs within PBM and employer benefit models.
  2. Review real-world outcomes and published evidence regarding patient access, adherence, and total liability associated with these programs.
  3. Discuss best-practices and compliance principles to advise employers and health plans on implementation, including SPD amendment, ACA grandfather status, and fiduciary risk.

 

Course summary
Available credit: 
  • 1.25 ACPE
    The Academy of Managed Care Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
Course opens: 
04/20/2026
Course expires: 
12/31/2027
Cost:
$30.00

Patty Taddei-Allen, PharmD, MBA, BCACP, BCGP, FAMCP

Clinical Assistant Professor
University of Florida

Billy Schnell, PharmD

Manager, Clinical Strategy and Services
Abarca Health

Disclosures

Faculty/Reviewer/PlannerReported Relevant Financial Relationships 
Patty Taddei-Allen
Faculty		Disclosed no relevant financial relationships.
Billy Schnell
Faculty		Disclosed no relevant financial relationships.
Bethany Holderread
Peer Reviewer		Disclosed no relevant financial relationships.
Brooke Whittington
Planner		Disclosed no relevant financial relationships.

 

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

ACPE UAN: 0233-0000-26-005-H04-P • Activity Type: Knowledge-Based
Contact Hours: 1.25
Release Date: April 20, 2026 •  Expiration Date: December 31, 2027
Activity Fee: Free for Members and Non-Members

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 2026. 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

  • 1.25 ACPE
    The Academy of Managed Care Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Price

Cost:
$30.00
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