Understanding Drug Pricing and Reimbursement in the US

8:45 AM - 4:30 PM, Sunday, June 2, 2019 ・ 115A, Level 100
Understanding Drug Pricing and Reimbursement is a one-day course that examines the complexity of the US healthcare market. The relationships between drug manufacturers, government policy, insurers and patients are explained in detail giving participants a better understanding of drug use in America. Numerous topics are covered including pharmacoeconomics, the various methodologies of drug pricing and reimbursement strategies. Five takeaways: 1. Understanding drug formularies, how they differ from one another, and what considerations are accounted for when deciding which drugs to accept onto a formulary 2. Familiarity with the types of information used to inform drug policy 3. Ability to apply different types of analysis used in determining drug prices 4. Appreciation of the role of the drug product lifestyle in drug pricing, marketing and reimbursement 5. Overview of the relationship between drug manufacturers, policy-makers, pharmacies, employers and patients. Course Agenda Setting the Stage 9:00-10:00 Preclinical development overview Clinical development overview Drug development statistics FDA adverse events reporting system Break 10:00-10:15 Drug Placement Into Formularies 10:15-12:00 Types of formulary systems Considerations and issues for placement Value proposition and drug price Medicare, Medicaid, private insurers Single payer markets Role of pharmacy benefits manager Manufacturer rebates Tiering systems Prior authorization Step therapy Patient adherence considerations Lunch 12:00-1:00 Pharmacoepidemiology and Drug Use Safety 1:00-2:15 Pharmacoepidemiology Individual and population drug safety Prospective drug utilization evaluation Retrospective drug utilization review Drug use research using commercial databases Drug use research using federal databases Evidence-based medicine Development of drug use guidelines Break 2:15-2:30 Pharmacoeconomics 2:30-3:30 Health economics Cost-of-illness analysis Cost-minimization analysis Cost-benefit analysis Cost-effectiveness analysis Cost-utility analysis Quality of life evaluation Quality-adjusted life years Drug Pricing and Marketing 3:30-4:30 Pricing strategies Brand and generic/biosimilar drugs Drug product life cycle Pricing surveys; pricing companies Economic complements and substitutes Specific buyers’ contracts (VA, 340b program) Price discrimination abilities Marketing strategies Patient assistance programs Role of direct-to-consumer advertising Activity: Start-Up CEO 4:30-5:15 Evaluations 5:15-5:30 Pricing: BIO Member: $1,250 Non-Member: $1,600