The PCMA Business Forum was a two-day event offering invaluable networking and education for individuals involved in specialty drug benefit management and patient management including executives from the largest specialty pharmacies and PBMs, as well as from drug and biotech manufacturers, consulting companies, and other important stakeholders.

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PCMA Business Forum 2022 Agenda

Monday, February 28
7:00 am - 7:00 pm

Registration Open 

7:00 am - 6:30 pm

Private Meeting Rooms Open

7:30 am - 9:00 am

Networking Breakfast

9:00 am - 11:30 am

GENERAL SESSIONS

9:00 am – 9:15 am

Welcome and Opening Remarks

Brian McCarthy, Chief Strategy & Business Operations Officer, PCMA

 

9:15 am – 10:00 am

Managing Medical Benefit Drugs in the Commercial and Medicare Markets

Bethanie Stein, Senior Vice President, PBM Services, Humana Pharmacy Solutions

Matt Perlberg, President, Pharmacy Businesses, Evernorth

Moderator: Ian Spatz, Senior Advisor, Manatt Health, Manatt, Phelps & Phillips

 

10:00 am – 10:30 am

What’s Driving the Future of the PBMs?

Lisa Gill, Managing Director, Senior Analyst Equity Research Healthcare Services, JP Morgan

Moderator: Ian Spatz, Senior Advisor, Manatt Health, Manatt, Phelps & Phillips

 

10:30 am – 11:00 am

The Evolving Specialty Landscape: A Roadmap for the Future

Lucille Accetta, Senior Vice President PBM, Specialty Product Development, CVS Health

Jackie Mancini, Vice President Formulary Strategy & Operations, CVS Health

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UAN: 0841-0000-22-001-L04-P

A robust pipeline, expanding indications, and more specialty treatments for conditions previously treated by “traditional” medications means utilization is increasing. Specialty medications now make up 54% of pharmacy spend. The evolving marketplace and complexity of treatment also means managing care for patients, while effectively controlling spend for payers continues to be challenging. The presenters will share perspective on what is impacting overall spend, how to provide comprehensive patient care and support, and considerations for new management strategies to help drive to lowest net cost for all.

By attending this session, you should be able to:

  • Learn what is driving specialty spend and trend;
  • Understand how technology and digital tools can help provide a comprehensive, seamless patient experience for those managing complex conditions;
  • Hear about targeted approaches that can enhance management for specific therapeutic areas; and
  • Learn about considerations for new approaches to deliver lowest net cost for all in partnership with all stakeholders.

 

11:00 am – 11:30 am

Pharmaceutical Care Past, Present and Future 

Tim Wentworth, Former Chief Executive Officer, Evernorth

Moderator, JC Scott, President & Chief Executive Officer, PCMA

11:45 am - 1:15 pm

Networking Lunch &

Member Company Lunch Receptions: Ascent Health Services, OptumRx & Humana

Attendees flow in and out of the concurrent Member Company Receptions while the members serve as hosts. 

 

1:30 pm - 2:00 pm

Breakout Sessions (two concurrent)

PBM Clinical and Patient Care Programs: Aligning Pharmaceutical Care to Patients and Payers 

(Patient & Clinical Care Track)

Mark Bini, Chief Patient Experience Officer, Evernorth

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UAN: 0841-0000-22-002-L05-P

Don’t miss learning how to harmonize care for patients, plans, and healthcare partners.

By attending this session, you should be able to:

  • Describe the problem that healthcare fragmentation is causing for patients and plan sponsors;
  • Understand the importance of interoperability across the healthcare ecosystem;
  • Outline how Health Services Companies are putting into practice care coordination across pharmacy, medical and behavioral health; and
  • Review the benefit of digital health solutions to patients.

 

The Current State of the 340B Program

 (Specialty Track)

Jason Hardaway, Managing Director, CiiTA, Inc.

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UAN: 0841-0000-22-003-L03-P

The 340B program is experiencing unprecedented legal and legislative changes. This session will briefly discuss these changes and explore their impact on the audience.

 

By attending this session, you should be able to:

  • Describe the current regulatory and legal environment;
  • Describes the 340B contract pharmacy environment; and
  • Outline three elements affecting growth of the total 340B sales.

2:00 pm - 2:15 pm

Break

2:15 pm - 2:45 pm

Breakout Sessions (two concurrent)

CANCELLED: From Transaction to Connectedness – Leveraging the Value of an Integrated Model 

(Patient & Clinical Care Track)

Jackie Mancini, Vice President Formulary Strategy & Operations, CVS Health

 

 

Biosimilar Market Growth: Managing Cost Trends Rewarding Biopharmaceutical Innovation

 (Specialty Track)

Harold Carter, Vice President, Trade Relations, Express Scripts

Tom Moore, Vice President, US Market Access, Contracting & Trade, Amgen

Savitha Vivian, Senior Vice President, Clinical and Formulary Services, OptumRx

Moderator: Ian Spatz, Senior Advisor, Manatt Health, Manatt, Phelps & Phillips

2:45 pm - 3:00 pm

Break

3:00 pm - 3:30 pm

Breakout Sessions (two concurrent)

Behavioral Moments: A Conversation about Behavioral Health and Pharmacy Innovation

(Patient & Clinical Care Track)

Doug Nemecek, Chief Medical Officer, Behavioral Health, Evernorth
Melissa Reilly, Chief Growth Officer, Behavioral Health, Evernorth

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UAN: 0841-0000-22-004-L04-P

Behavioral health is more talked about then ever but barriers in true integration between behavioral and pharmacy and whole person health still remain. Meaningful progress can be made by looking for behavioral health moments, opportunities to take the pulse on mental health status, as companies look to leverage innovation and new care pathways.

By attending this session, you should be able to:

  • Be conversant about the value of behavioral health in the pharmacy space;
  • Understand recent market trends and innovations inclusive of digital therapeutics, specialty pharmacy and pharmacogenomics; and
  • Discuss how to find or create Behavioral health moments when individuals are seeking quality care.

 

Digital Therapeutic Care Management and Market Growth

 (Specialty Track)

Zachary Goodman, Director, Clinical Innovation, Evernorth

Eddie Martucci, Chief Executive Officer, Akili Interactive

Moderator: Ian Spatz, Senior Advisor, Manatt Health, Manatt, Phelps & Phillips

 

6:30 pm - 9:00 pm

Cocktail and Dinner Reception with Live Music

Tuesday, March 1
7:00 am – 4:00 pm ET

Registration Open

7:00 am - 5:30 pm

Private Meeting Rooms Open

7:30 am - 9:00 am

Networking Breakfast & 

Member Company Breakfast Receptions: MagellanRx Management & MedImpact

Attendees flow in and out of the concurrent Member Company Receptions while the members serve as hosts. 

9:00 am - 12:00 pm

GENERAL SESSIONS

9:00 am – 9:30 am

PCMA Chairman of the Board Keynote Address

William Fleming, President, Pharmacy Solutions, and Chief Corporate Affairs Officer, Humana Pharmacy Solutions

 

9:30 am – 10:15 am

Unlocking the Value of PBM and Small Manufacturer Relationships

Jeremy Fredell, Vice President Pharma Contracting & Strategy, Ascent Health Services

Jesper Lange, Chief Executive Officer, MC2 Therapeutics

Phung Osborn, Vice President, Market Access, Vifor

Moderator: Tom Knox, President, Fathom Healthcare Solutions Inc.

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During this panel discussion we will focus our attention on how emerging and small manufacturers can effectively communicate the value of their respective new treatments with PBM’s. We will explore what PBM’s find valuable working with emerging and small manufacturers and the areas of opportunity emerging and small manufacturers have to work with PBM’s.

 

10:15 am– 10:45 am

Health Equity and Pharmaceutical Care

A PCMA Diversity, Inclusion and Women’s Leadership Initiative Session

Sumit Dutta, Chief Medical Officer, OptumRx

Lilian Ndehi-Rice, Associate Vice President, Pharmacy Clinical and Specialty Strategies, Humana

Moderator: Ian Spatz, Senior Advisor, Manatt Health, Manatt, Phelps & Phillips

 

10:45 am – 11:30 am

Healthcare Integration Enables an Innovative Migraine VBC: Tying Net Price to Value

Lisa Carman, Vice President HEOR and VBC, Optum Life

Adam Greenan, Executive Director and General Manager, National Accounts, Amgen

Alex Hindman, Vice President, PDL Strategy and Analytics, United Healthcare

Joanne Sellner, Associate Vice President, National Accounts, Lilly USA, LLC

Moderator: Jen Forristal, Senior Vice President, Industry Relations, Optum Rx

 

11:30 am – 12:00 pm

Current and Future Trends in Specialty Pharmaceuticals CPE

Doug Long, Vice President, Industry Relations, IQVIA

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UAN: 0841-0000-22-005-L04-P

The COVID-19 pandemic has been a significant disruptor to patient care across the health care system.  Patient visits with physicians declined, prescription drug prescribing and utilization were significantly impacted, and a new “normal” has emerged.  Doug Long will break down the data to highlight the pandemic’s impact on Specialty pharmaceutical care and discuss what the new normal may look like.

By attending this session, you should be able to:

  • recognize where the US Specialty Pharmaceutical market growth has been and near-term forecast for growth;
  • identify the fastest growing Specialty classes and products and the slowest growing;
  • understand new and future launches; and
  • identify which factors will affect future growth.

 

12:15 pm – 1:45 pm

Networking Lunch &

Member Company Lunch Receptions: Express Scripts, CVS Health & Prime Therapeutics 

Attendees flow in and out of the concurrent Member Company Receptions while the members serve as hosts. 

2:00 pm - 2:30 pm

Breakout Sessions (two concurrent)

Physician Engagement in the Integrated Care Model 

(Patient & Clinical Care Track)

Ann Nguyen, Vice President, Enterprise Pharmacy, OptumCare

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UAN: 0841-0000-22-007-L04-P

As health care continues to evolve, coupled with an unprecedented demand for services and transformative delivery models, physicians, pharmacists, and healthcare professionals are re(engineering) the care team approach and ecosystem. This session will explore the growing trend for integrated team-based care models to drive coordinated treatment planning, whole patient care management, and how this may reshape the interactions with pharmaceutical manufacturers.

By attending this session, you should be able to:

  • Recognize the different provider payment risk models and how this can change the “payor” landscape;
  • Explore an integrated care model ecosystem aimed at reshaping physician and pharmacist engagement to achieve better patient outcomes and value; and
  • Identify emerging trends that pharmaceutical companies, health plans, and PBMs can impact to reshape health care or prescription transactions.

 

The Emerging US Biosimilars Marketplace – Past, Present, and Future

 (Specialty Track)

Jon Martin, Associate Vice President, US Biosimilars, Organon

Emily Colaizy, Assistant Vice President, Trade Relations and Strategy, Prime Therapeutics

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UAN: 0841-0000-22-006-L04-P

The US biosimilars market has largely been focused on medical benefit therapies, but the pharmacy benefit biosimilar market will see rapid growth in the coming years .  Emily and Jon will discuss  past, present and future adoption, compare the US market evolution  with the EU experience, and discuss key considerations for the future.

By attending this session, you should be able to:

  • Recognize past and current US biosimilar adoption rates;
  • Describe the pipeline of future biosimilar introductions ; and
  • Understand the ways US payers may optimize biosimilar education and uptake.

 

2:30 pm - 2:45 p

Break

2:45 pm - 3:15 pm

Breakout Sessions (two concurrent)

Drug Development Pipeline: Innovation, Patient Care, and Cost Management 

(Patient & Clinical Care Track)

Linda Isham, Vice President, Clinical Strategies and Operations, Humana

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UAN: 0841-0000-22-009-L04-P

Over the past five years, there have been an increasing number of novel drugs that have been approved by the FDA with 59 new drugs being approved in 2021.  Linda Isham will discuss how PBMs are tracking the clinical pipeline and the information that is necessary to support P&T Committee decision making.

By attending this session, you should be able to:

  • Understand trends on novel drug approvals and disease states;
  • Discuss practices used by PBMs to monitor the drug development pipeline; and
  • Identify opportunities to enhance components of the drug development pipeline to support P&T decisions.

 

Introduction to Self-Funded Medical Plans: Why Employer Groups Could Be Financing High Cost Therapies

 (Specialty Track)

Matt Paul, Senior Vice President, Value and Access, COEUS Consulting

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UAN: 0841-0000-22-008-L04-P

A substantial portion of employee’s in the commercial market are on a self funded platform for their employer sponsored health plan. High cost Rx / therapies are compromising the integrity of the employee’s claim fund, forcing employer’s & carrier’s to shift liability. Matt Paul will highlight the basics of a self funded plan and the thought process around why this is occurring.

 

By attending this session, you should be able to:

  • Understand why groups choose to self fund their employee medical plan;
  • List what types of groups self fund;
  • Describe the size of the commercial market on a self funded platform;
  • Identify the reason for purchasing stop loss insurance;
  • List the reason for lasering; and
  • Identify why groups are carving Specialty Rx / infusion therapies out of the plan.

4:00 pm - 5:30 pm

PCMA Diversity, Inclusion and Women’s Leadership Initiative Networking Reception

8:00 pm - 10:00 pm

Cocktail and Dessert Reception

Join your peers for dessert, cocktails, and conversation with colleagues at this after-dinner reception.