| CMSA's 19th Annual Conference & Expo |
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| 2308 |
| Title: |
Beyond Unit Cost: The Next Generation of Pharmacy Benefit Management |
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| Date / Time: |
Friday, June 11, 2010 at 02:15 PM - 03:45 PM |
| Type: |
CONCURRENT |
| Level: |
INTERMEDIATE |
| Sponsor(s): |
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| Speaker(s): |
Jim Andrews; Dave T. Smith |
Prescription drugs represent 19% of the workers’ compensation medical dollar, and are the largest contributor to workers’ compensation medical inflation.
Pharmacy programs, which only focus on managing unit cost, help to curb drug costs; yet, total pharmaceutical expenditures continue to rise. A next generation, holistic approach for managing rising pharmaceutical expenditures goes beyond unit cost by focusing on clinical and utilization controls supported by data analytics.
The audience will learn from industry experts the factors behind rising pharmaceutical expenditures; and how a large, self-insured employer has applied this unique, comprehensive approach to its book of business to reduce total pharmacy expenditures, including a significant decrease in the use of high-cost narcotics.
Discussion points include how pharmacy data can be used as a leading indicator of where a claim may be headed from a medical and indemnity point of view; and how utilizing data analytics to identify irregular utilization and prescribing patterns can be used to trigger strategies to improve clinical and return-to-work outcomes, and the overall management of claims.
Objectives:
- Analyze the current macro pharmacy trends in workers’ compensation and healthcare cost increases in general.
- Identify a holistic and comprehensive approach for managing rising pharmaceutical expenditures. Focus on the high cost and abuse of Opioids and Class II Narcotics.
- Discuss the early-warning program and its effect on a pharmacy management program.
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