Increased plan sponsor involvement in the critical functions of drug benefit design and administration leads to greater savings. Three hundred drug benefit executives—from employers, union groups, health plans, and third party administrators—convened at PBMI’s ninth annual Prescription Drug Utilization Management Conference in Scottsdale, Ariz., in April, to discuss these savings opportunities.

Plan sponsor and pharmacy benefit manager (PBM) attendees alike benefited from three days of dialog about ways plan sponsors and PBMs could work together more effectively to reduce drug benefit costs. It is clear, as illustrated in the table on page 2, that plan sponsors should step up their involvement in the development of cost and utilization management strategies to ensure plan designs, clinical programs, contracts, formularies, MAC lists, network contracts, and rebate agreements are all aligned with their benefit objectives. 

Conference faculty shared their real-world experiences and case study examples of how best to develop collaborative working relationships with PBMs to implement cost and utilization strategies. Because cost and utilization management occurs in a complex market environment, conference sessions also were devoted to legal issues, PBM consolidation, and updates on electronic prescribing and claims standards.

A complete list of conference topics is shown below. Read summaries of each conference session on line at www.pbmi.com/Conference.5.ASP. 

Benefit Management
• Automated Prior Authorization
• Drug Management Strategies
• Longitudinal Drug Analysis Case Study
• Structuring Mail-order Design 

Clinical Issues
• Analytic Models Identify Cost-effective Treatments 
• Clinical Predictive Modeling
• Impact of Rx to Over-the-Counter Switches
• Integrating Medical and Drug Benefits

Doing Business with PBMs 
• Evaluation of PBM Formularies
• PBM Business Model
• PBM Consolidation

Legal and Regulatory Issues
• Federal Issues
• Medicare Prescription Drug Act
• OIG Guidance
• State Regulation of PBMs

Marketplace Changes
• Consumer-driven Pharmacy Benefit
• ePrescribing Landscape
• Pharmacy Claim and Data Standards

PBMI’s 10th annual conference will be held from March 30 to April 1, 2005 in Scottsdale, Ariz. See article on page one about the 2005 Call for Speaker Presentations.

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