Pharmacy benefit managers are at the forefront of implementing innovative contracting techniques that better align the cost of medications with their value. By offering additional tools to manage specialty drugs, including the use of specialty pharmacies, PBMs and payers are improving the quality and continuity of care patients receive, while ensuring they derive the greatest value from their medications. Over the next 10 years, PBMs and specialty pharmacies will save an estimated total of $654 billion on drug costs for health plan sponsors.

The PCMA PBM Policy Forum is designed for policy makers and staff from Capitol Hill and the Administration, as well as healthcare and drug industry advocates from think tanks, patient advocacy groups, and industry trade associations. The PCMA Policy Forum 2016 hosted almost 200 people from more than 100 companies, organizations, and government offices.

Highlights from last year’s PBM Policy Forum

PBMs’ Role in Clinical Patient Care

William Fleming, Segment PresidentHealthcare Services, Humana Inc.

Surya Singh, Corporate Vice President & Chief Medical Officer, CVS/Specialty, CVS Health

PCMA Leadership Addresses PBM Industry Solutions for High Price Drugs

Mark Merritt, President & Chief Executive Officer, PCMA

PCMA Leadership Discuss Policy Solutions for High Price Drugs

William Fleming, Segment PresidentHealthcare Services, Humana Inc.

Mark Merritt, President & Chief Executive Officer, PCMA

The FDA’s Role in Promoting Competition

Alex Brill, Chief Executive Officer, Matrix Global Advisors & Research Fellow, American Enterprise Institute

Conference Program Book

PBM Policy Forum 2018 Agenda

Thursday, April 19
11:30 am - 12:15 pm

Lunch Reception

12:15 pm - 4:45 pm


12:15 pm - 12:30 pm

Welcome and Introductions

Policy Forum Moderator: Ian Spatz, Senior Advisor, Manatt Health

12:30 pm - 1:00 pm

Perspectives on Prescription Drug Issues from Capitol Hill

Alyssa Palisi, Professional Staff Member, House Committee on Ways and Means

Rachel Pryor, Senior Health Policy Advisor, House Committee on Energy and Commerce

Brett Baker, Senior Health Policy Advisor, Senate Committee on Finance (invited)

1:00 pm - 1:30 pm

Point of Sale Rebates: Opportunities in Commercial Benefits

Lida Etemad, Vice President, Pharmacy Management Strategies, Employer & Individual and Community & State, UnitedHealthcare

1:30 pm - 2:00 pm

Perspectives from HHS

John O’Brien, Advisor to the Secretary & Deputy Assistant Secretary for Health Policy, U.S. Department of Health and Human Services

2:00 pm - 2:30 pm

Outside the Beltway: State Perspectives on Prescription Drug Benefits

Representative MaryLynn Magar, Florida House – District 82 (R)

Representative Kevin Roberts, Texas House – District 126 (R)

J.P. Wieske, Deputy Commissioner of Insurance, State of Wisconsin

2:30 pm - 3:00 pm

The Value of Specialty Pharmacy: Patient Engagement, REMS and Biosimilars

Brian Seiz, Senior Vice President, Specialty, Express Scripts & President, Accredo Specialty Pharmacy

3:00 pm - 3:30 pm

How PBMs are Driving Value Based Contracting

Kim Gwiazdzinski, Senior Director, Trade Relations, Value and Outcomes Contracting, Prime Therapeutics

3:30 pm - 4:00 pm

Perspectives from FDA

Scott Gottlieb, Commissioner of Food and Drugs, U.S. Food & Drug Administration

4:00 pm - 4:30 pm

Employers’ Perspectives on Drug Benefit Management

Kevin Host, President & Chief Operating Officer, PSG Consulting

4:30 pm - 4:45 pm

PCMA Perspectives and Wrap Up