Topic: "What Plan Sponsors Need for Proper Pharmacy Oversight"

• A well negotiated contract minimizes a PBMs ability to change financial performance after a contract is signed.
• Oversight over the entire industry eliminates wasteful medications, pricing games, lowers trend, and will drive the best outcomes for patients.

Key Takeaways:

• To properly manage the pharmacy benefit, internal plan experts or trusted external advisors are critical.
• Individuals with expertise can hold the PBM accountable and navigate the entire pharmacy benefit landscape to drive higher value for patients and the plan.

Topic: "Understanding Rebates, GPOs, and Claims-Level Data Access"

• Explanation of Zinc, Ascent, and Emisar, and how GPOs have reshaped the rebating landscape since 2019.
• Importance of formulary design in driving the lowest net cost.
• Claims-level data access and how employers use it to fulfill their fiduciary duties.

Key Takeaways:

• Understand how GPOs impact rebate structures.
• Formulary design strategies for lowest net cost.
• The role of claims-level data in managing fiduciary responsibilities.

Topic: "Deep Dive into PBM Contracts: Avoiding Pitfalls and Asking the Right Questions"

• De-identified PBM contract review highlighting common pitfalls and red flags.
• Key questions to ask consultants and PBMs for accurate comparisons in RFPs.
• Evaluating proposals with a focus on hidden fees, transparency, and rebate pass-throughs.
• How to ensure the comparison of PBMs is fair and accurate, especially around fees, rebates, and formularies.

Key Takeaways:

• Identify red flags in PBM contracts.
• Ensure transparent and accurate comparisons of PBMs.
• Essential questions to ask for protecting your plan’s financial health.

Topic: "Understanding the Consolidated Appropriations Act (CAA) and Minimizing Risk in Benefit Design"

• Overview of the CAA and its implications for benefit buyers.
• How to ensure compliance and mitigate risks in PBM contracts.
• Aligning PBM contracts with CAA regulations to avoid penalties.

Key Takeaways:

• Grasp compliance requirements of the CAA.
• Minimize risks in PBM contracts.
• Best practices for ongoing compliance and fiduciary management.

Topic: "Biosimilars, PBMs, and the Future of Formulary Design"

• How major PBMs are becoming manufacturers and preferring their own products.
• Case studies on how biosimilars reduce specialty drug costs.
• How to push PBMs for biosimilar adoption in formulary design.

Key Takeaways:

• Understand the role of PBMs as manufacturers and its impact on formularies.
• Strategies for promoting biosimilar adoption.
• Identifying and avoiding conflicts of interest in PBM-managed formularies.

• Recap of key insights from the sessions
• Actionable next steps for benefit buyers
• Additional resources and support available from the National Alliance

Open to PBM Hub attendees, faculty, and invited guests only