Part B Drug Payment Change: Understanding the Implications for Pharma

Life Sciences, Pharmaceutical, Drug Discovery & Development, Healthcare, Commercialization & HEOR, Healthcare Finance,
  • Monday, March 28, 2016

Over the last six months, the Centers for Medicare & Medicaid Services (CMS) have hinted at changes in drug pricing, driven by their assertion that physician-drugs administered under Medicare Part B were potentially incentivizing providers to use more expensive medications. It wasn’t until the proposed rule, known as the Part B Drug Payment Model, released on March 8th that the industry got a sense of just how big a change they were considering. Using a nationwide, mandatory payment model, CMS is upending the Part B payment system for drugs by proposing to test changes in the add-on payment as well as introducing value-based payment tools and strategies like indication-specific pricing and outcomes-based risk adjustment. Such a program represents the biggest proposed change in Medicare drug reimbursement in years.

Join our featured speakers, Amanda Forys and Jennifer Snow, for a complimentary webinar focusing on what’s known about the proposed Medicare Part B drug payment model and what the implications are for pharmaceutical manufacturers. Additionally, the speakers will share strategies on how manufacturers will have to evolve to demonstrate product value.

During this webinar, participants will:

  • Gain insights on the proposed Medicare Part B drug payment model
  • Understand how the lessons from the commercial market’s experience with value may influence the model
  • Learn what strategies pharmaceutical manufacturers should consider in demonstrating product value for the future

Speakers

Amanda Forys, MSPH, Director, Reimbursement Policy Insights, Xcenda

Amanda Forys, MSPH, is a Director within Xcenda’s Reimbursement Policy Insights consulting team, joining the firm in 2012. She has 16 years of healthcare research and consulting experience and her experience includes reimbursement policy analytics, with emphases on Medicare and commercial coverage and payment policy. Her work has covered a wide range of topics, including biosimilars, bundled and episodic based payment models, chronic disease management, oncology, End Stage Renal Disease, and strategy for specialty Pharmaceuticals.
Ms. Forys has focused on policy analysis through claims data and cost reports, as well as payment system replication, budget impact modeling, policy scoring, as well as cost of care and burden of disease studies. Prior to joining Xcenda, she worked at The Moran Company, The National Association for Home Care & Hospice, and The Lewin Group. Ms. Forys serves as a national speaker on healthcare, and has spoken or presented posters at conferences for the National Comprehensive Cancer Network and The Academy of Managed Care Pharmacy. Ms. Forys has been cited in Kiplinger Magazine, Formulary Journal,Healthcare Traveler, Modern Healthcare, and has also presented findings of research to members of the Centers for Medicare & Medicaid Services (CMS), the Medicare Payment Advisory Commission (MedPAC), the Congressional Budget Office (CBO), the Office of Budget and Management (OMB), and the Joint Committee on Taxation (JCT).

Ms. Forys received her Master of Science in Public Health from the University of North Carolina at Chapel Hill, with a concentration in health policy and administration. During this time, she completed an internship with the Government Accountability Office’s healthcare team. She received a Bachelor’s of Science Degree in Biopsychology and Cognitive Sciences and a Bachelor’s of Musical Arts in Voice Performance from the University of Michigan.

Jennifer Snow, MPH, Director of Health Policy, Xcenda

Jennifer Snow, MPH, is a Director of Health Policy and keeps clients and stakeholders informed on the latest legislative and regulatory updates and their commercial impact. Her team analyzes the healthcare environment and provides strategic guidance on how to best navigate challenges to coverage and access.
Ms. Snow is a subject matter expert on the Affordable Care Act, quality measures, medication adherence and federal health programs, particularly the Medicare Prescription Drug Benefit (Part D), and has presented nationally for health plan, payer, patient and Pharmaceutical audiences. She has experience with reimbursement and policy strategy launch plans for various therapeutic areas including cardiovascular, respiratory, mental health, diabetes, oncology and rheumatoid arthritis.

Before joining Xcenda, Ms. Snow was a Director of Policy and Executive Branch Advocacy at a large Pharmaceutical manufacturer. In this role she was closely aligned with Managed Markets and Medical Affairs. She developed corporate positions on critical issues and implemented policy strategies into effective operational goals and tactical plans, including engagement with the Centers for Medicare & Medicaid Services (CMS). She represented the organization on a variety of trade association committees at PhRMA, BIO and the National Pharmaceutical Council.

Message Presenter

Jennifer Snow, MPH, Director of Health Policy, Xcenda

Ms. Snow also has experience working directly on the federal health programs; she worked at the CMS in the Office of Exchanges. There she developed and formulated policies on essential health benefits, oversight, essential community providers and basic health plans. She also has expertise in coverage and access issues from her time with a healthcare consulting firm where she worked with a variety of the top 20 bioPharmaceutical companies as well as her experience at Stanford University as a Senior Benefits Analyst. During her tenure at Stanford, she implemented both a consumer-driven health plan and a pharmacy benefit manager program. Ms. Snow holds an M.P.H. from the University of North Carolina-Chapel Hill and a B.S. in Russian from Georgetown University

Message Presenter

Who Should Attend?

This event will have wide appeal to individuals working for pharmaceutical and biotech companies. This includes professionals in:

  • Commercialization
  • Brand Management
  • Channel Management
  • Organized Customer Group Marketing
  • Provider, Payer, Patient Marketing
  • Health Policy
  • Market Access
  • Managed Markets
  • Reimbursement Strategy

Xtalks Partner

Xcenda

Xcenda is a strategic consulting firm with more than 20 years of experience applying real-world expertise in health economics and outcomes research, reimbursement, health policy, market research, and market access strategy. We support global Pharmaceutical companies as well as emerging pre-commercialization phase firms with challenges such as developing an evidence package to optimize access in key global markets, predicting product performance, and identifying reimbursement strategies and programs to maximize patient access. From development through market maturity, Xcenda helps manufacturers identify, demonstrate, and deliver their brand’s value proposition to key healthcare stakeholders.

Xcenda is backed by an even wider breadth of healthcare knowledge and partnerships through AmerisourceBergen Corporation (NYSE: ABC), one of the world’s largest Pharmaceutical services companies. Xcenda’s strategic consulting services support the design of patient support services and specialty distribution programs to improve product access and adherence at every stage of its life cycle.

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