Understanding Drug Pricing and Reimbursement in the US

8:45 AM–4:30 PM Jun 2, 2019

115A, Level 100


Understanding Drug Pricing and Reimbursement is a one-day course that examines the complexity of the US healthcare market. The relationships between drug manufacturers, government policy, insurers and patients are explained in detail giving participants a better understanding of drug use in America. Numerous topics are covered including pharmacoeconomics, the various methodologies of drug pricing and reimbursement strategies.

Five takeaways:
1. Understanding drug formularies, how they differ from one another, and what considerations are accounted for when deciding which drugs to accept onto a formulary
2. Familiarity with the types of information used to inform drug policy
3. Ability to apply different types of analysis used in determining drug prices
4. Appreciation of the role of the drug product lifestyle in drug pricing, marketing and reimbursement
5. Overview of the relationship between drug manufacturers, policy-makers, pharmacies, employers and patients.

Course Agenda

Setting the Stage 9:00-10:00
Preclinical development overview
Clinical development overview
Drug development statistics FDA adverse events reporting system

Break 10:00-10:15

Drug Placement Into Formularies 10:15-12:00
Types of formulary systems Considerations and issues for placement
Value proposition and drug price
Medicare, Medicaid, private insurers
Single payer markets
Role of pharmacy benefits manager
Manufacturer rebates
Tiering systems
Prior authorization
Step therapy
Patient adherence considerations

Lunch 12:00-1:00

Pharmacoepidemiology and Drug Use Safety 1:00-2:15
Individual and population drug safety
Prospective drug utilization evaluation
Retrospective drug utilization review
Drug use research using commercial databases
Drug use research using federal databases Evidence-based medicine Development of drug use guidelines

Break 2:15-2:30

Pharmacoeconomics 2:30-3:30
Health economics Cost-of-illness analysis
Cost-minimization analysis
Cost-benefit analysis
Cost-effectiveness analysis
Cost-utility analysis
Quality of life evaluation
Quality-adjusted life years

Drug Pricing and Marketing 3:30-4:30
Pricing strategies Brand and generic/biosimilar drugs
Drug product life cycle
Pricing surveys; pricing companies
Economic complements and substitutes
Specific buyers’ contracts (VA, 340b program)
Price discrimination abilities
Marketing strategies
Patient assistance programs
Role of direct-to-consumer advertising

Activity: Start-Up CEO 4:30-5:15

Evaluations 5:15-5:30

BIO Member: $1,250
Non-Member: $1,600

Session ID: 548955