Available Until 12/31/2024

AMCP Talks: Incorporating Value Framework Assessments in Coverage and Reimbursement Decisions

Please Note: This session is not accredited for continuing pharmacy education.

Course Description:

Value frameworks and assessments are increasingly used as a resource for evaluating the value of pharmaceuticals and other health technologies in coverage and negotiation processes. These frameworks are designed to help health care decision-makers determine the comparative effectiveness and value of a medication or intervention. These frameworks continue to evolve and are designed for different decision-making applications and target audiences.

According to a recent survey of payers, the most important factors when selecting a framework to inform decision-making are the metrics and outcomes, comparative clinical effectiveness information, methodologic rigor, and transparency. Although payers agree on these important factors, their decision-making processes and incorporation of value assessment information in these decisions can differ vastly. This session aims to explore:
• payer decision-making processes and structures,
• current sources and use of value assessments in these decisions,
• future value assessment information needs, and
• the potential impact of the Inflation Reduction Act.

Join us to hear, from various payer perspectives, real-world strategies for incorporating and assessing value in their coverage and reimbursement decision-making. You won’t want to miss this session!

Learning Objectives:

At the completion of this activity, participants should be able to:
  1. Explain how value framework assessments are utilized in managed care practice.
  2. Describe at least two strategies payers use to incorporate value frameworks into decision-making.
  3. Identify opportunities for bolstering the relevance and usefulness of value framework assessments for payer decision-making.


Pat Gleason, PharmD

Assistant Vice President

Prime Therapeutics

Eagan, MN

Jessica Hatton, PharmD, BCACP 

Associate Vice President, Pharmacy


Dayton, OH

John M. O'Brien, PharmD, MPH

President & CEO

National Pharmaceutical Council

Washington, DC

Brenden O'Hara, RPh, BCACP

Team Leader, Provider Engagement Pharmacy Initiatives

Blue Cross NC

Cary, NC


Kimberly Westrich, MA

Director, Value & Access Strategy


Carrollton, TX

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