Specialty Medication Seminar

Loading Map....

Date/Time
Date(s) - 05/27/2015
11:30 am - 1:00 pm

TSHCC Office
636 Hampshire, Suite 206
Quincy Illinois

Presenter:

John Ottavi, CPCU, GBA

Vice President

Cottingham & Butler

 

 

The program will broadly hit on pharmacy cost containment with a focus on Specialty.    Employers have not implemented many fundamental cost containment strategies including:

 

  1. Step Therapy
  2. Mandatory Generic
  3. Mandatory Maintenance Mail Order
  4. Prior Authorization
  5. Excluding Compounds – Prior Authorization on Compound medications
  6. Excluding manufacturers coupons – this is tough one for the PBM’s
  7. Medical necessity on Specialty RX –
  8. There are six defensive walls employers should build around Specialty to protect plans.  Any specialty prescription that wants to be paid from plan resources should pass through six checkpoints:#1:  Should the drug even be covered?

    #2:  Is the drug appropriate for the member?

    #3:  Has the member been incentivized to use available alternatives?

    #4:  Has the supply of the drug been minimized?

    #5:  Has the cost of the drug been minimized?

    #6:  Have you ensured the member is actually paying their cost sharing?

 

 

Add to Google Calendar
Add to iCal