Ep. 79 – In the Know News: What Ohio’s PBM Ruling Means and NASP Updates

Suzette Dimascio - Specialty Pharmacy Podcast

In this timely episode, CSI Specialty Group President and CEO Suzette DiMascio, CHE, CMCE, CPC, shares recent news, updates and notes to help keep you in the know and make you the smartest specialty pharmacy professional in the room. Plus, Suzette chats about a few can’t miss events coming up at the National Association of Specialty Pharmacy (NASP) Annual Meeting in Washington, D.C., September 24-26, 2018.

Tune in to Discover:

  • How the Ohio ruling on PBMs may impact the future of the specialty marketplace
  • Creative solutions to enhance the patient journey at your SP
  • Upcoming highlights and can’t-miss sessions at the NASP Annual Meeting including:
    • First NHIA co-program launched
    • The popular Women in Specialty Pharmacy luncheon’s great speaker

Are You Going to Be at NASP? Don’t Miss the Women in Specialty Pharmacy Luncheon

Don’t miss the Women in Specialty Pharmacy Luncheon (WSPRX) taking place on Tuesday, September 25 from 11:30 a.m. – 1:00 p.m. Focusing on “Harnessing the Headwinds of Change,” keynote speaker, Air Force veteran Nicole Malachowski, shares the perfect message to inspire audiences to think differently about the headwinds of change they face – organizationally and personally.

Bonus Downloadable Content100 days of action

Download a free copy of the recently released Report on 100 Days of Action on the American Patient First Blueprint from the U.S. Department of Health and Human Services and author Dan Best, Senior Advisor to the Secretary for Drug Pricing Reform.

“The President’s blueprint for lower drug prices is working, drug prices are coming down, and American patients are going to see the savings in their pocketbook,” says Alex Azar, United States Secretary of Health and Human Services.

About CSI Specialty Group

CSI Specialty Group is a globally recognized leadership, strategy and talent consulting firm dedicated to helping clients drive sustainable, accelerated growth while continually elevating the specialty pharmacy industry. By providing inventive specialty pharmacy consulting, workforce planning and talent acquisition solutions, CSI uniquely tailors its service offerings to help clients drive sustainable, accelerated growth. As the provider of the industry’s first, dedicated podcast for specialty pharmacy, CSI is at the forefront of pioneering innovative concepts to meet the changing needs of specialty pharmacy, home infusion, mail order/PBM, health systems and pharma/biotech clients across the USA and throughout Europe.

Transcript Notes:

Hi, this is Suzette DiMascio with the CSI Specialty Group podcast. And today I wanted to change things up a little bit and talk a little bit about some of the conferences coming up for our industry as well as a couple of the most recent media news alerts of healthcare. It’s been a crazy year, hasn’t it?

One of the first things that I wanted to share with our listeners is we, again, are very excited to be bringing the women in Specialty Pharmacy luncheon back to the National Association, a Specialty Pharmacy annual meeting, that’s going to be held in Washington D.C. on September 24th through 26th. Now, the luncheon is going to be taking place on Tuesday, and I am just thrilled to death. I got a chance on Friday to speak with Nicole Malachowski who is going to be speaking for us.

If you aren’t familiar with Nicole or her story, you’re definitely going to want to consider attending this luncheon. She is a 21 year Air Force veteran, and, most importantly, was one of the first fighter squadron commanders, and also the first woman to fly in the Thunderbird. She just has an amazing personality, an amazing way of showing how she balances work with family life, and with challenges as you can understand, being in the military and raising a family. Just a wonderful, wonderful lady, and I’m looking forward to hear her myself.

So, she’s going to be tailoring her message just for us on that day. So, please be sure to attend. NASP is also going to have a couple of pre conferences this year. They will be bringing back their very popular legal day, which will be on Monday, September 24th as well as the very first joint meeting with the National Home Infusion Association. So, that will be taking place as well on Monday, September 24th. And you can go to the NASP website if you want to learn more information at NASPnet.org.

Now, the conference itself is looking to be quite an interesting program, a lot of great information. The annual event will be taking place, or starting, I should say, on Tuesday, September 25th. We’re going to start off with a year in review, kind of go through a lot of things as it relates to the patient journey, and then ending it up with a lot of information about accreditation and also, they’re also going to have in the exhibit hall from 5:30 to six o’clock, Newt Gingrich will be there signing his book. So, that’s pretty exciting.

The board of directors is also going to be having a get to know your board of directors reception that will also be taking place in the exhibitor, and as a board of director member, I would love to meet any and all of our listeners on here. Please be sure to come by and say hello, I would love to meet you.

The conference will continue on Wednesday, and it’s going to be a very interesting time. There is going to be a session that Charles Collins and David Cory will be doing on co-pay accumulators, which I’m sure will catch a lot of people there. Also, going to be having some information on some of the changes happening with the CSP credentialing and some of the things there as well as I’ll be the moderator for an overview on the patient, provider, and manufacturer, and the surveys that NASP is working on, so that should be good as well.

There’s going to be kind of an open afternoon for a little bit while there’s a lunch break, and then a little bit about 340B, a little bit about what’s happening in the pipeline, and then the conference will be over. For any of you that are interested in taking, or becoming a certified specialty pharmacy pharmacist, you have the last time for this year to be able to take the exam. So, the exam and the applications are due by September 15th and there’s an overview, or a program, that’s going to be happening there that you can take to learn a little bit more about that.

So, we’re pretty excited about everything that’s happening. I think that everything from a market perspective with all the legal challenges that are happening, I think that it’s very important if you have anything to do with specialty pharmacy, you need to try to be there, and if you can’t be there, make sure someone from your organization can, because it’s very important for you to keep up with all the legislative changes, and NASP is a great resource for that.

The other thing that I would also encourage you to read about was this week, the Ohio government really came down hard on PBMs. I was pretty impressed, once the information came out a few months ago on how much they were paying for PBM services for their Medicaid population, they basically came out and said “enough is enough” that they are opposed to spread pricing, and they will only enter into new contracts who can provide a service on a pass through model.

So, they don’t want anymore spread pricing. They want to go through a pass through transparent model, and if a PBM cannot do that, they will no longer do business with them. So, we really want to take a watch on this, because this could have a ripple affect throughout the marketplace. I am very impressed with Ohio taking this stance.

Now, of course, there’s always two sides to every story. And there’s, on the PBM’s perspective, they feel that there’s been a lot of unnecessary finger pointing at them, but the numbers speak for themselves, so it will be very interesting to see what will, in fact, happen there.

On other news, we have seen more co-pay accumulator issues pop up. I was actually speaking to a client last week talking a little bit more in detail about what we see as a challenge for patients on all these life sustaining medications, and the creativity that needs to come out in order to help patients still is just … It’s been very interesting to watch. There’s been some neat programs that we’ve seen develop that if health plans are getting a little savvy in not allowing co-pay programs, if there’s a will, there’s a way. Just watch this one again. This is one of those ones where, gosh, every day something is changing and turning.

We were actually at a conference last week, the CBI summit in Philadelphia, and there was a lot of talk, or the whole conference, excuse me, was focused on how IDNs and pharmaceutical companies can partner together to enhance the patient journey. And one of the things that you keep hearing over and over again is the importance of data interoperability, and of course, that kind of goes hand in hand with the interoperability aspect of it, and I think that pharma is trying to do the best that I can to also look at ways to enhance the patient journey. But we aren’t where we need to be with big data yet.

My bet’s on companies that haven’t even been launched yet in the next five years to really show us different ways that we can harness this data and provide a better experience for the patient. One of the things that I chatted about early on in my telemedicine days when I was at Health Hero, the product that we had developed has a wonderful way to stratify patient care, and when the nurse case managers would come in every morning, they could review the information from the patient’s self reported information the day before and very quickly ascertain from a stratification methodology that they put in place on which patients they needed to be in contact with first.

And you know, this proactivity happens on a lot of different levels throughout managed care and different case management programs, but I think it’s something that is starting to resonate with a lot of the chronic and rare disease manufacturers on the importance of stratifying patients so that you’re able to give the more acute patient quicker service than someone that may not be as acute. One size doesn’t fit all, so again, I love the customization of health care. I love the fact that everyone’s eye is one the patient journey right now, and as long as that continues to happen, I think everything will continue to do great things for patients, especially in the world of Specialty Pharmacy.

Now, I’d love to hear from all of you listeners. If there is an innovative product out there, or a service, or data, or data aggregator, excuse me, or some data program that makes you run your business more effectively, helps you with patient care more effectively, I’d love to know about it and we can chat with individuals on our podcast. We’re always looking for a few good men and a few good women to be part of our podcast and also want to say good luck to the class of 2019 at West Point. My son is starting his senior year, and will be graduating, and I’m real excited about seeing these young men and women take on the world and serve their country.

So, just wish my boy, Collin, and all of his classmates a great year before they’re off to all parts of the world serving our great country. That’s it for now, have a great week, and always remember to take great care of your patients. Bye bye.

Have you heard the news? The 2018 State of Specialty Pharmacy Report is now available to download for free at CSIGroup.net/survey. For the report, we surveyed Specialty Pharmacy professionals of all level across all the main channels to uncover trends, opinions, and future predictions about the Specialty Pharmacy industry.

Please feel free to download the report today and find out what manufacturers, health systems, and independent specialty pharmacy professionals across the nation say the biggest opportunities as well as the biggest challenges are as we all work toward improving the patient journey. Get your free download today at CSIGroup.net/survey.

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About The Specialty Pharmacy Podcast

Join host Suzette DiMascio, CHE, CMCE, CPC, President and CEO of CSI Specialty Group, as she answers questions, addresses concerns and discusses the news you need to stay on top of the ever evolving world of specialty pharmacy. Tune in every episode to hear real world examples of the good, the bad and the outrageous from the experts at CSI Specialty Group, and to learn about the limitless growth opportunities available in the specialty pharmacy industry.

2018-09-27T16:23:15+00:00