APFM Section 1 Module 4: Regulatory and Legal Considerations
Module Description
Understanding regulatory and legal considerations is a large part of developing and maintaining a formulary. This module will explore the FDA approval process, patents, and how various regulatory bodies impact different lines of business. In addition, this module will review the regulatory landscape and legislative mandates and considerations for ensuring compliance and mitigating risks associated with formulary decisions.
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:
- Summarize how the FDA drug approval process and patents impact formulary decision-making.
- Discuss the role and impact of various regulatory bodies on different lines of business.
- Describe the regulatory landscape and legislative mandates related to drug pricing, reimbursement, and formulary management strategies.
Faculty/Authors:
Lisa LeGette, MBA, RPh
Senior Director, Government Affairs
Express Scripts
Danilo Trivic, PharmD
Director, Pharmacy Formulary Management
Centene Pharmacy Services
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
Blue Cross Blue Shield of Michigan
Financial Relationship Disclosures:
Faculty/Reviewer/Planner | Reported Relevant Financial Relationships |
Lisa LeGette Faculty | Evernorth Health Services, PBM |
Danilo Trivic, PharmD Faculty | Centene, Employer |
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:0233-0000-24-069-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