CE CREDIT PENDING

Learning Objectives: 

Context, Rx as a Component of US Healthcare System

§  Complexity of US healthcare model vs. other countries

§  Coordination of care: a curse and an opportunity

§  Outcomes vs. financial machinations – it’s not healthcare that’s broken, it’s how we pay for it

§  Pricing: lack of transparency and wide variances from payor to payor

§  Implications for prescription drugs (20-25% of the overall medical spend and rising way, way faster than non-drug spend)

Cost Basis

§  Defining the nine commonly used ways to determine the cost of a prescription, nine!!

§  Differences in how it works for generic vs brand vs specialty

§  Implications for per prescription profitability

The Impact of Rebates and Spread Pricing

§  “I’m just a pill, yes I’m only a pill and I’m waiting for a prescription to fill…” (School House Rock 😊)

§  Representative journey of a typical prescription in the US and where the associated dollars get allocated--who all collects a “rebate” (a.k.a., bribe) or some other kind of “kicker” via spread pricing or what have you?

Why Transparency is Important

§  In any exchange of goods and services, there should be a clear connection between the party receiving the goods and services and the party providing the goods and services…in the world of prescriptions, that’s not the case, but it should and can be and here’s how…

Speaker: Jim Lodge, Senior Vice President of Sales & Chief Transparency Officer