The PCMA Annual Meeting is the industry’s premier executive conference. The event provides an un-matched and ideal venue for senior executives from PBMs, specialty pharmacy, payer organizations, and pharmaceutical manufacturers to network, conduct business and learn about the most current issues impacting the industry.

The decision makers in attendance, educational insights and business connections made while on-site, are ultimately what make the Annual Meeting so successful. The high level interactions that take place at this event help to promote continued industry collaboration and dialogue.

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Annual Meeting 2015 Agenda

Monday, September 21
9:30 am – 10:00 am

Partnership in Medical Innovation: Delivering Value for Patients, Health Care Systems and the Economy

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Bob Hugin, Chairman & Chief Executive Officer, Celgene

Moderator: Susan Dentzer, Senior Policy Advisor, Robert Wood Johnson Foundation

A strong health care system requires a collaborative ecosystem including health plans, pharmacy benefit managers, government agencies, academic institutions, healthcare providers, biopharmaceutical and medical innovators, and patient advocates. Successful partnership among all these sectors will produce value in medical innovation that helps patients live longer and better lives, reduces the burden on healthcare systems and grows our economy.

10:00 am – 10:45 am

Trade Relations Panel

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Ed Adamcik, Vice President, Pharma Strategy and Contracting, Express Scripts

Pete Clagett, Senior Vice President, Cost of Care and Specialty, Prime Therapeutics

Moderator: Kenton Stewart, Executive Vice President, Health Systems, Astellas Pharma US, Inc.

This session explores key issues that PBM pharma relations and pharma market access executives are facing in the age of specialty. The topics addressed during this discussion are meant to provide the audience with a glimpse into the current and emerging challenges and opportunities that PBMs and pharma are facing in their day to day business interactions.

Topics that will be addressed during the discussion include:

  • Innovation, affordability, and value;
  • PBM management strategies for the rising cost and affordability of drugs;
  • Considerations around risk;
  • Opportunities for minimizing fraud, waste and abuse; and
  • Manufacturer Collaboration with PBMs

10: 45 am – 11:15 pm

Analysis of the 340B Drug Program Omnibus Guidance

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Kevin Host, President, PSG Consulting

Moderator: Susan Dentzer, Senior Policy Advisor, Robert Wood Johnson Foundation 

340B Drug Pricing Program Omnibus Guidance was released in late August and proposes guidance for covered entities enrolled in the 340B Program and drug manufacturers that are required by section 340B of the PHSA to make their drugs available to covered entities under the 340B Program. After consideration of public comments, the final guidance will be intended to assist 340B covered entities and drug manufacturers in complying with the statute.

During this session, Kevin Host will provide the audience with an analysis is of the guidance.   He will discuss the genesis of the program and why it has been ambiguous, the difference in purchasing points between covered entities and non-covered entities, new compliance requirements, how the scope of the program impacts the big picture of US drug spend, and why manufacturers and PBMs are playing, or not playing, in the space.

11:15 am - 12:00 pm

A Wall Street Perspective on Market Evolution and Consolidation Trends

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Robert Willoughby, Managing Director & Senior Equity Research Analyst, Bank of America Merrill Lynch

Peter Costa, Managing Director& Senior Equity Research Analyst, Wells Fargo Securities, LLC

Moderator: Susan Dentzer, Senior Policy Advisor, Robert Wood Johnson Foundation

Wall Street analysts always offer a highly informed perspective of our industries. During this fireside chat-style session, Bob Willoughby and Peter Costa will provide their perspectives on various trends related to drug channel evolution including:

  • The ACA, channel consolidation, and scale;
  • Pharma innovation and reimbursement pressure;
  • The future role of drug retail;
  • Opportunity in managing specialty and predictions for PCSK9s;
  • Biosimilars; and
  • Tightening payer and PBM controls.

Tuesday, September 22
9:00 am – 9:45 am

Opening Remarks

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Mark Merritt, President & Chief Executive Officer, PCMA

Industry Leadership Panel Discussion

Sustainable Health Care: Promoting Innovation alongside Affordability

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Steve Miller, Senior Vice President & Chief Medical Officer, Express Scripts Jon Roberts, President, CVS/caremark & Executive Vice President, CVS Health

Dave Ricks, Senior Vice President & President, Lilly Bio-Medicines, Eli Lilly and Company

Jim Robinson, President, Astellas Pharma US, Inc.

Mark Thierer, Chief Executive Officer, OptumRx

Moderator: Susan Dentzer, Senior Policy Advisor, Robert Wood Johnson Foundation

Discussions around a sustainable health care model are becoming more and more prevalent amongst industry insiders, economists, policy makers, and consumers alike. This panel brings together leaders from the pharmaceutical manufacturer and PBM industries to discuss their shared interests in brining innovative products to market that address unmet medical needs in the most effective and affordable way for the system.

During this session, the panel will discuss industry strategies, market trends, and collaboration opportunities. Discussion topics will include:

  • The importance of data and its role in defining value;
  • Biosimilars and their role in an open and competitive marketplace;
  • International pricing models, international drug approvals, and international patient data; and
  • 21st Century Cures and other industry regulatory challenges and opportunities.

9:45 am – 10:20 am

An Economist’s Observations of the US Health Care System

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Amitabh Chandra, Malcolm Weiner Professor of Public Policy & Director of Health Policy Research, Harvard Kennedy School of Government

Moderator: Susan Dentzer, Senior Policy Advisor, Robert Wood Johnson Foundation

Public policy plays an ever-increasing role in our health care market. The US government’s role as both health care payer and regulator complicates the market.  With health care cost and coverage challenges increasing at the same time that pharmaceutical innovation is at its greatest point in years, we need to understand how public policy impacts marketplace dynamics and progress.

During this session, Profession Chandra will share some of his observations around:

  • Predictions for further, post-ACA policy, regulatory, and marketplace changes;
  • Challenges federal and state governments face when budgeting for health care spend;
  • Payer coverage decisions and pricing strategies – predictions about bundled payments, reference pricing, licensing, etc.;
  • ACOs and their future role in this complicated system;
  • The long term role of exchanges and their market share;
  • Biosimilars impact on drug pricing;
  • Consumer choice – people with different income levels being willing to spend different amounts of money for different coverage quality; and
  • How the audience might think about their organizations’ role in the debate.

10:20 am – 11:00 pm

Beyond Competitive Unit Cost: Advancing Outcomes Incentive Alignment

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Chris Bradbury, Senior Vice President, Integrated Clinical Solutions and Specialty Pharmacy, Cigna Pharmacy Management

Thomas Stambaugh, Vice President, Cigna Specialty Pharmacy

Moderator: Kent Rogers, Principal Consultant, Blue Fin Group

Industry players and plan sponsors continue to focus heavily on improving drug therapy “unit cost” and utilization management as primary drivers of affordability. With new drug entrants, more therapeutic alternatives and rising drug prices, the need and opportunity to expand outcomes incentive alignment with manufacturers and healthcare providers are growingly rapidly. This session highlights the progression of outcomes incentive alignment, criteria for consideration, and plan sponsor expectations.

11:00 am – 11:35 pm

Biosimilars Market Analysis: Hurdles and Opportunities

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Ronny Gal, Senior Analyst, Global Specialty Pharmaceuticals, Sanford Bernstein

Moderator: Susan Dentzer, Senior Policy Advisor, Robert Wood Johnson Foundation

Biosimilars are here. Sandoz’s first biosimilar in the US launched the first week in September, finally making biosimilars a reality to US market. During this session Ronny Gal will discuss how these products will start to penetrate the US market. He will address the evolution of biosimilars and the pipeline of products, lessons we can learn from Europe, the current legal and IP landscape, approval and regulatory issues, financial models around revenues, profitability and margins, and strategies payers are considering for these new products.

11:35 am – 12:10 pm

Bending the Trend through Personalized Pharmacy Interventions

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Andrea Marks, Vice President & Chief Analytics Officer, OptumRx

Moderator: Susan Dentzer, Senior Policy Advisor, Robert Wood Johnson Foundation

CMS has been pushing payers for reviews of cost savings opportunities and improvements in adherence in the Medicare population.  During this session, Andrea Marks will present outcomes from a first- of- its- kind randomized control trial of a medication therapy management (MTM) and retrospective drug utilization review (RDUR) intervention in a large commercial patient population.  Data from this trial demonstrates that savings are directly attributable to drug adherence programs with wrap around counseling and MTM programs.  This was shown to be particularly true in this trial for diabetes and COPD/asthma patients, showing the value of pharmaceutical care and the opportunity it provides for savings.