ACI Rx Drug Pricing & Rebate Fundamentals
Blank Rome partner Merle M. DeLancey, Jr. will serve as a presenter for two sessions of Rx Drug Pricing & Rebate Fundamentals, an American Conference Institute (“ACI”) Virtual Proficiency Series program being held October 30 through November 29, 2023.
Compendium of State Drug Transparency Laws
Wednesday, November 1
3:15–4:20 p.m. EDT
This session will explore the rise of state transparency laws across the country and how they are working in conjunction with government payor programs.
- Identifying states with current and pending drug pricing transparency laws
- Manufacturer notifications and justifications requirements from the manufacturer
- Enforcement and actions taken under existing laws
- Addressing challenges with and finding solutions for reporting under non-uniform and sometimes conflicting state laws
- Can a state request supplemental rebates within these models?
- If the rebate is denied, can the state exclude the drug from Medicaid coverage?
- Developing a system to keep track of these laws as well as a compliance program to address them
- Impact of transparency laws on Medicaid pricing
- Recap and Q&A
Advanced VA and DOD Pricing and Contracting
Wednesday, November 8
2:30–4:15 p.m. EST
- Specialized arrangements for personalized medicines
- Reviewing criteria for a drug to be eligible for consideration under the FSS
- Standardization versus therapeutic interchange contracts
- Analyzing how target drugs are chosen by VA/DoD/IHS/BOP for joint national contract targets
- What are the general requirements for issuing a drug contract?
- Package size considerations
- Bottle caps
- Safety seals
- 30-percent up-front requirement for VA mail order
- Understanding the factors for creating the requirements in the estimated volume of purchase
- Formulary status changes
- Automatic substitution by Pharmaceutical Prime Vendor
- Changes with pricing for other drugs in the class
- Examining the contracting process
- Post-Solicitation discussions
- What is the process for having the contract for a drug renewed?
- Identifying the factors considered by the agencies when a drug is up for renewal
- Supply considerations and challenges
- Comparative pricing
- Understanding the differences in the processes used by the VA National Acquisition Center and Defense Logistics Agency
- Recap and Q&A
ABOUT THE PROGRAM
ACI’s Rx Drug Pricing & Rebate Fundamentals is an intensive training program that will give novices and experienced practitioners alike a thorough understanding of core pricing competencies and applicable changes in the reimbursement structures of key payor programs.
The program is designed to make attendees proficient in essential pricing and rebate concepts under Medicaid, Medicare, and other related government payor programs, including those under the auspices of PHS 340B, the VA, and DoD. The course agenda has been refreshed to include in-depth sessions on changes to the pricing and rebate system under the Inflation Reduction Act as well as proposed changes to the Medicaid Drug Rebate Program under CMS’s newly Proposed Rule: Medicaid Program; Misclassification of Drugs, Program Administration and Program Integrity Updates Under the Medicaid Drug Rebate Program.
Sessions will be held Monday and Wednesday afternoons over the course of four weeks and examine:
- Drug Pricing and Rebate Essentials and Introduction to Medicaid
- PHS 340 B, VA and DoD Rx Pricing and Rebates
- Medicare Pricing and Rebate Essentials and Advanced CMS Pricing and Rebate Topics
- Pricing and Reimbursement for New Products and Therapies
For more information and to register, please visit the event webpage.