The CAR-T Carve-Out: Reevaluating CAR-T Reimbursement and Long Term Outcomes - Nexus 2018

ACPE UAN #:  0233-0000-18-055-H04-P

Release DateOctober 24, 2018

Expiration Date:  October 24, 2021

Activity Type:    Knowledge-based

Contact Hours:  1.5

Activity Fee:  Member:  Free        Non-Member: $30

Target Audience: Pharmacists who practice in managed care settings.

Activity Description

The CAR-T treatment process is complex and involves a multidisciplinary team, with intense coordination between patients, treating providers, manufacturers, and payers. Clinicians are tasked with coordinating the treatment of oncology patients with autologous T cell immunotherapy. In an insurance landscape where patients often switch health care coverage, payers and stakeholders are tasked with assuring appropriate provider reimbursement of a one-time, inpatient-administered therapy across the medical and pharmacy benefit.

This session will take learners through the CAR-T treatment process and identify its impact on patient outcomes through a review of supporting clinical evidence. Learners will identify payment strategies of commercial, Medicare and Medicaid payers, as well as manufacturers. Finally, learners will review an example of how one Medicaid program carved out CAR-T immunotherapies from the medical benefit to ensure appropriate provider reimbursement,  and the lessons learned in the creation of a monitoring program.

Learning Objectives:  

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

  1. Describe the place in therapy of CAR-T immunotherapies currently on the market and the process of treating oncology patients with this treatment modality.
  2. Describe the coordination between multiple stakeholders in the management of patients receiving CAR-T therapy.
  3. Discuss the challenges and successes of a CAR-T Monitoring Program established by one Medicaid program.

Schedule of Educational Activity

This activity consists of an audio recording, pre-test assessment questions (not required to pass or continue), post-test questions (required to pass with a score of 70% or higher) and a specific activity evaluation. 

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

As an accredited provider, AMCP strictly adheres to the ACPE Standards for Commercial Support and other relevant guidelines and standards to ensure the independence of continuing pharmacy education (CPE) activities.  It is AMCP’s intent that all CPE activities be independent, objective, balanced, evidence-based and free of any commercial bias.

CPE Requirements:   

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 Nexus 2018.  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.


Gene Reeder, RPh, PhD | Professor and Director of Outcomes Research | University of South Carolina | College of Pharmacy | Columbia, South Carolina.

System Technical Requirements/Viewing Requirements: System Requirements 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.

Credit Information

Activity Number Credit Amount Accreditation Period
ACPE UAN #0233-0000-18-055-H04-P 1.5 Contact Hours October 24, 2018 - October 24, 2021