[M2] Evaluating Coverage for Digital Therapeutics: A Case Study and Lessons Learned
Pricing: Free for Members and $30 for Non-Members
How do managed care programs assess coverage decisions for digital therapeutic products? What is the effectiveness of digital therapeutics, and what are potential utilization management strategies for them? What are current national utilization trends for digital therapeutic products?
Join faculty as they answer these questions and review a case study with real-world outcome data from a Medicaid plan covering a digital therapeutic product. Presenters will provide an overview of the clinical outcomes demonstrated and the product’s impact on the patient’s overall cost of care and describe lessons learned around the inclusion of digital therapeutic products on a Medicaid formulary.
The session will include a discussion of best practices in coverage policies for digital therapeutics including consideration of creative contracting opportunities (such as value-based contracts).
Pharmacists who practice in managed care settings.
At the completion of this activity, participants should be able to:
- Explain a Medicaid program’s formulary review process for coverage of prescription digital therapeutics.
- Discuss a real-world case study, including review of clinical outcomes and overall cost of care impact of a prescription digital therapeutic product.
- Summarize lessons learned around coverage strategies for prescription digital therapeutics.
Neha Kashalikar, PharmD
Manager of Strategic Pharmacy Contracting, MassHealth
UMass Chan Medical School
Kimberley Lenz, PharmD, MBA, FAMCP
Chief Pharmacy Officer
University of Massachusetts Chan Medical School
Office of Clinical Affairs/MassHealth
Mahsa Salsabili, PharmD, PhD
UMass Chan Medical School
Tasmina Hydery, PharmD, MBA, BCGP
Associate Director, Digital Solutions
Financial Relationship Disclosures
- 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.
Activity Type: Knowledge-Based
Contact Hours: 1.25
Release Date: November 15, 2023 • Expiration Date: December 31, 2024
Activity Fee: Free for Members and $30 for 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 Nexus 2023. 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.
- 1.25 ACPEThe Academy of Managed Care Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
- 1.25 Certificate of Completion
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