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The Managed Care Executive

(E3) Navigating Uncertainty: Best Practices in Balancing Actuarial Pricing and Formulary Management

Tuesday, October 15, 2024
3:30 PM – 4:45 PM PT
Location: 123
CPE
ACPE UAN:0233-0000-24-049-L04-P | Contact Hours: 1.25 | Activity Type: Knowledge-based
With a robust pipeline of new drugs continuing to be developed, with the increasing complexity and costs of those drugs, and the current legislative and regulatory environment, managed care pharmacy leaders are tasked with balancing healthcare costs with patient affordability and access. Managed care pharmacy leaders must continue to partner with their actuarial teams to utilize information to effectively prepare and budget for the development and release of new drugs as they enter the marketplace.

In this session, participants will delve into the actuarial challenges managed care pharmacy leaders face in the dynamic landscape of pipeline drugs and new regulations that will have potential unpredicted impacts. The session will use historical and case scenarios to showcase how actuarial forecasting can effectively manage future pricing, formulary management, and risk assessment projections. Additionally, this session will showcase how managed care leaders can establish a strong partnership with their actuarial team.

Learning Objectives:

At the completion of this activity, participants should be able to:
  1. Summarize the current landscape of pipeline drugs and their impact on pharmacy actuarial approaches.
  2. Discuss strategies to effectively manage actuarial challenges pipeline drugs pose to optimize financial stability.
  3. Explain how managed care pharmacy leaders can use actuarial data to impact future pricing, formulary management, and risk management projections.
  4. Discuss best practices for managed care pharmacy leaders to partner with their actuarial teams