Pharmacy Benefit Managers 101

Presented by

Pharmacy Executive Forum

What health system leaders need to know

Pharmacy Benefit Managers 101

Regina Lohr

Senior Consultant

[email protected]

202-568-7895

© 2019 Advisory Board • All rights reserved • advisory.com

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Road mapRoadmap6

What is a PBM?1

2 How do PBMs make money?

3 What is the controversy surrounding PBMs?

4What unique opportunities do health systems

have to work with their PBM?

http://www.advisory.com/



7

Despite high-profile coverage, pharmacy benefit managers (PBMs) still cloaked in mystery

The Washington Post

“CVS’s $69 billion merger with Aetna is

approved in deal that could transform health-

care industry”

Forbes

“UnitedHealth And OptumRx To Pass Drug

Maker Rebates To More Clients”1

Rep. Earl L. Carter, PharmD (R-Geo.)

“The most immediate and significant impact

we can have on prescription-drug pricing is to

have transparency and expose the

middleman.”

Sen. Ron Wyden (D-Ore.)

“What PBMs do to earn all those profits is a

mystery.”

New York Times

“Express Scripts Offers Diabetes Patients a

$25 Cap for Monthly Insulin”

Director of Benefits

“It’s hard to know if you are maximizing the

value of your PBM contract. It’s very

conflicting and confusing.”

Source: Bluth, R., “Can Someone Tell Me What A PBM Does?” KNH, https://khn.org/news/senate-hearing-drug-pricing-lesson-on-pharmacy-benef it-managers/; Carter, E., “PBM Practices Drive

Up Costs for Rx Drugs,” WSJ, https://www.wsj.com/articles/pbm-practices-driv e-up-costs-for-rx-drugs-11551039255; Fung, B., “CVS’s $69 billion merger with Aetna is approved in deal that could

transform health-care industry,” The Washington Post, https://www.washingtonpost.com/technology /2018/10/10/justice-department-approv es-cvss-billion-merger-with-insurance-giant-aetna/;

Japsen, B., “UnitedHealth And OptumRx To Pass Drug Maker Rebates To More Clients,” Forbes, https://www.f orbes.com/sites/brucejapsen/2019/03/12/unitedhealth-and-optumrx-to-pass-drug-

maker-rebates-to-more-clients/; National Pharmaceutical Council, “Toward Better Value,” NPC, https://www.npcnow.org/system/files/research/download/npc-employer-pbm-survey-final.pdf;

Thomas, K., “Express Scripts Offers Diabetes Patients a $25 Cap for Monthly Insulin,” The New York Times, https://www.ny times.com/2019/04/03/health/drug-prices-insulin-express-scripts.html;

Pharmacy Executive Forum Interviews and Analyses

1. Advisory Board is a subsidiary of UnitedHealth Group,

the parent company of UnitedHealthcare, and Optum.

All Advisory Board research, expert perspectives, and

recommendations remain independent.




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Health plans hire PBMs to manage pharmacy benefits

Pharmacy

Manufacturers

Pharmacy

Benefit

Manager

Health Plan

Sponsor

• Negotiate discounts and rebates

• Determine formulary placement

• Manage prescription drug claims

• Maintain a list of drugs covered by the

plan (formulary) and any restrictions to

their use

• Set reimbursement rates

• Create networks of preferred

pharmacies

• Facilitate transactions at point of sale

PBMs work across industry stakeholders





9

PBMs’ core value proposition is lowering drug costs

DATA SPOTLIGHT

Annual drug

and related

medical cost

savings

reported by

PBMs

40-50%

Three strategies PBMs claim drive plan savings

Price

Negotiate manufacturer

rebates and pharmacy

reimbursement rates

Drug mix

Promote generics and

preferred brands through

substitutions, step

therapies, and co-pay tiers

Reduce inappropriate use

through prior authorization,

dispensing limits, and

clinical programs

Volume

21 3

Source: Visante, “The Return on Investment (ROI) on PBM Services,” pcmanet, https://www.pcmanet.org/wp-content/uploads/2016/11/ROI-on-PBM-Services-FINAL.pdf





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1. Market share figures for the largest companies also include some claims from smaller, regional

PBMs who contract with the larger entities as rebate aggregators or claims processors.

Source: Fein, AJ, The 2019 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers, Drug Channels

Institute, 2019. Roehrig, C., “The Impact of Prescription Drug Rebates on Health Plans and Consumers,” Altarum,

https://altarum.org/sites/default/files/Altarum-Prescription-Drug-Rebate-Report_April-2018.pdf

Consolidation gives PBMs strong negotiation position, leads to questions about transparency

Three largest PBMs manage majority

of U.S. prescriptions1

Share of pharmacy

claims processed

PBMs’ size leads to questions about

hidden profits

76%

Large market share allows

PBMs to extract large

rebates from manufacturers

Complex contracts

obscure actual charges

for their services


CVS Caremark30% market share

Express Scripts23% market share

Optum Rx23% market share

Vertical integration with insurers likely

to increase PBM market dominance




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Road mapRoadmap11

1

2

3

4

What is the controversy surrounding PBMs?

What unique opportunities do health systems


What is a PBM?

How do PBMs make money?




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Contract with plan sponsors dictates PBMs’ potential revenue sources

Manufacturers

Patients

Plan sponsors

Pharmacies

• Spread pricing

• Specialty pharmacy

• Prior authorizations

• Opt-in programs

• Administrative fee

• Rebates

• Administrative and

consulting fees

Copays and

co-insurance

Pharmacy fees and

concessions


PBMs commonly generate revenue from multiple stakeholders




13

Source: Langreth, R., et al., “Big Pharma’s Secret Drug Pricing Practices,” Bloomburg, https://www.bloomberg.com/graphics/2016-drug-prices/; The Pew Charitable Trusts, March 2019, https://www.pewtrusts.org/en/research-

and-analysis/reports/2019/03/08/the-prescription-drug-landscape-explored; . Pharmacy Benefit Management Institute, ”2018 Trends in Drug Benefit Design,” PBMI, www.pbmi.com/benefitdesignrpts

Hypothetical Rebate Example

Rebates provide price discounts, passed to plan sponsor

Manufacturer rebates

passed through to plan

sponsors in 2016

$89B

Plan sponsors with 100%

rebate pass-through

49%

Revenue source: Manufacturers

DATA SPOTLIGHT


Plan sponsors with 0%

rebate pass-through

17%Net price after

rebates

Rebate passed

through to

health plan

Rebate retained

by PBM

List price before

rebates

$1,728

$361$36

$1,331

Negotiated rebate:

23% of list price

$397

Humira 40-ml injection




14

Source: Lopez, L, “The Feds just asked ahuge healthcare company who their real slients are and the answer is totally unsatisfying,” Business Insider, https://www.businessinsider.com/sec-looks-into-express-

scripts-rebates-from-pharmaceutical-firms-2017-12; Breimhorst, M, “What You Need to Know about The Drug Rebate Economy,” PSG Consultants, https://www.psgconsults.com/blog/the-drug-rebate-economy

Administrative and consulting fees typically retained by PBM

37%

DATA SPOTLIGHT

Percentage of

Express Scripts

gross revenue

in 2017 came

from pharma

receivables,

including

rebates

Revenue source: Manufacturers

PBM

Manufacturers pay fees to PBMs for a variety of services

PBMs demand compensation when drug

price inflation exceeds negotiated rates

Price protection

PBMs administer rebate transactions

Administrative services

PBMs provide data to manufacturers, such as

reported side-effects

Utilization data

PBMs are tying risk-sharing agreements to

value and outcomes for drugs with

supporting metrics

Guaranteed outcomes





15

PBM revenue from spread pricing hidden from plan sponsors

Revenue source: Plan sponsors

Per pill price

billed to

health plan

$0.57Per pill price

paid by

pharmacy

$0.26 $27.90Spread kept

as PBM profit

EXAMPLE2Spread pricing

on re-packaged

medications in

PBM-owned

pharmacies

Two common sources of spread pricing

Amount PBM

billed to

health plan

$26.87Amount PBM

paid retail

pharmacy

$5.19 $21.68Spread kept

as PBM profit

EXAMPLE1Different, proprietary

price lists for plan

sponsors and retail

pharmacies

90Pills

dispensed





16

Source: Business Wire, “UnitedHealth Group Reports 2018 Results Highlighted by Continued Strong and Diversified Growth,” businesswire,

https://www.businesswire.com/news/home/20190115005285/en/UnitedHealth-Group-Reports-2018-Results-Highlighted-Continued; Business Wire, “UnitedHealth

Group Reports 2015 Results Highlighted by Continued Strong and Diversified Growth,” businesswire,

https://www.businesswire.com/news/home/20160119005765/en/UnitedHealth-Group-Reports-2015-Results-Highlighted-Continued; CVS Health, “2018 Annual

Report,” Annual Reports, http://www.annualreports.com/HostedData/AnnualReports/PDF/NYSE_CVS_2018.pdf; CVS Health “2015 Annual Report,” Annual

Reports, http://www.annualreports.com/HostedData/AnnualReportArchive/c/NYSE_CVS_2015.pdf; Fein, AJ, “Pharmacy Revenues and Market Share from

Specialty Pharmaceuticals, by Company, 2015,” Drug Channels, https://www.drugchannels.net/2016/03/the-top-10-specialty-pharmacies-of-2015.html; Fein, AJ,

“Specialty Pharmacies and PBMs Hop On the 340B Money Train,” Drug Channels, https://www.drugchannels.net/2019/08/specialty-pharmacies-and-pbms-hop-

on.html; Fein, AJ. “The Top 15 Specialty Pharmacies of 2018: PBMs Keep Winning,” Drug Channels, https://www.drugchannels.net/2019/04/the-top-15-specialty-

pharmacies-of-2018.html; MacroTrends, “ESRX/revenue,” macrotrends, https://www.macrotrends.net/stocks/charts/ESRX//revenue

1. 2018 annual revenue based on average from Q1-Q3.

2. Previously Briova Specialty Pharmacy

PBM-owned specialty pharmacies a growing profit engine


17% 17%

30%

24%

Percent revenue from specialty pharmacy in

2015 vs. 2018

Optum Rx:

Optum Specialty

Pharmacy2

Express Scripts:

Accredo1

$37BCVS Caremark revenue from

CVS Specialty pharmacy in

2018

340B contract pharmacy revenue

contributes to growing profits

DATA SPOTLIGHT

2015 2018 2015 2018

43%Increase in CVS Specialty’s

340B contracts between

2018 and 2019





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PBMs charge fees for utilization management services

$500KAnnual fees from

PA for a health

system with 51,000

covered lives

DATA SPOTLIGHT

Physician prescribed Drug A

and submitted PA: Rejected,

incomplete information

PA resubmitted for Drug A:

Rejected, step therapy

requires Drug B

PA submitted for Drug B:

Approved


Prior authorization (PA) charges

accumulate on one prescription

Total PA charges

accumulated

$30-50Average PA fee

$150

$50

$50

$50





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Fee-based programs support plan value and outcomes

$11KSavings documented by a

PBM-led MTM program,

for which the system paid

$160K annually.


$500KOne-year savings from an in-house

MTM program started when the health

system repurposed the funds they had

been paying for the PBM program.

Mountain Maple Health System saw improved ROI by bringing

medication therapy management (MTM) program in house

…But health systems should evaluate the ROI against internal capabilitiesPBM-led programs

can improve patient

outcomes…

480,000Diabetic patients for

whom heart failure was

prevented annually by

PBM clinical programs

that improved care

management and

medication adherence

Source: “The Return on Investment (ROI) on PBM Services,” Visante, https://www.pcmanet.org/wp-content/uploads/2016/11/ROI-on-PBM-Services-FINAL.pdf


Common fee-based PBM programs

• Copay accumulators

• Adherence support

• Protection from fraud or cost increases

• Taking on outcomes risk for high-cost drugs




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Administrative fees often touted as “transparent” revenue

Pharmacy Executive Forum interviews and analysis.]

Claims processing

Prior authorizations

Rebate aggregation

Formulary management

Clinical programs

Data access


Even when a PBM says it’s

transparent, a strong contract

and audit rights are essential in

ensuring the PBM isn’t

retaining hidden rebates or

capturing any spread.”

Susan Hayes, Principal

PHARMACY INVESTIGATORS AND

CONSULTANTS

OTHER FEATURES

100% rebate pass-through

Single pricing list/pass-through pricing

(no spread)

No PBM-owned specialty pharmacy

For some PBMs, administrative fees are the only

source of revenue

INCLUDED SERVICESVerification is still essential.

DATA SPOTLIGHT

$1 - $15Range of administrative fees,

typically charged per-member,

per-month




20

Source: Fein, AJ, CMS Considers Point-of-Sale Pharmacy DIR: Another Prelude to a World Without Rebates,”

Drug Channels, https://www.drugchannels.net/2018/12/cms-considers-point-of-sale-pharmacy.html

PBMs withhold money from pharmacies through retroactive price concessions

$0.2B2013

DATA SPOTLIGHT

Revenue source: Pharmacies

$4.0B2017

Reconciliation between negotiated rate and

price charged in the claim

Types of pharmacy fees and price concessions1

Fees to participate in a preferred

pharmacy network

Performance penalties, such as for

formulary compliance rates or patient

medication adherence rates

2,000%

Dramatic growth in estimated Medicare Part D

pharmacy price concessions

Increase in estimated

pharmacy price concessions

over a 4-year period

1. Often referred to as DIR fees


Claims transmission fees (per claim

processed)




21

Amoxicillin

Penicillin antibiotic used to treat infections and stomach ulcers

1. PBM clawback refers to the PBM taking back money that has already been paid to the

pharmacy. In the case of copay clawbacks, the PBM demands that the pharmacy pay

them any copay amount in excess of their negotiated reimbursement rate.

Source: Van Nuys, K., et al., “Overpaying for Prescription Drugs: The Copay Clawback Phenomenon,” USC Schaeffer,

https://healthpolicy.usc.edu/wp-content/uploads/2018/03/2018.03_Overpaying20for20Prescription20Drugs_White20Paper_v.1-2.pdf

PBMs profit when copay exceeds prescription cost

$7.69Average copay

overpayment

DATA SPOTLIGHT

23%Of the time a copay

is higher than the

cost of the drug

Revenue source: Patients

Typical copay

for Tier 1 drug

$10.00Cash price for

30-day supply

of 500mg

Amoxicillin

$3.98 $6.02Overpayment that

is typically

“clawed back” by

the PBM as profit

University of Southern California found 35.7% of claims for amoxicillin

involve copay overpayment and PBM clawback.1

CASE EXAMPLE





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Road mapRoadmap22

What is a PBM?1

2 How do PBMs make money?

3 What is the controversy surrounding PBMs?

4 What unique opportunities do health systems





23

PBMs can’t be singled out in drug-spend blame game

Prescribers

Prescribers don’t factor cost

into prescribing decisions

25%increase in U.S. per-

capita spend for retail

prescription drugs

from 2010-2019

Many parties criticized for contributing to rising drug spend

Drug manufacturers

Set high list prices for

new drugs, raise prices

for established drugs

Patients

Use copay coupons, don’t

seek lower-cost alternatives

PBMs and plan sponsors

Pursue higher rebates and

hidden profits


Source: Bluth, R., “Can Someone Tell Me What A PBM Does?”, KNH, https://khn.org/news/senate-hearing-drug-pricing-lesson-on-pharmacy-benefit-managers/




24

1. Net prices represent an estimate of the average manufacturer realized price, reflecting any reductions in net revenues due to off-invoice discounts, rebates,

copay assistance or other price concessions, Data exclude new brands marketed less than 24 months in each year as price growth cannot be calculated.

PBMs have a complicated relationship with drug spend


PBMs likely help limit drug price growth However, some PBM practices generate public and

political concern

4.3%

2.4%3.2%

1.9%1.5%

2014 2015 2016 2017 2018

decrease in drug spending in

2018 for Express Scripts’ U.S.

commercial plan customers

0.4%

1Rebates: Opaque rebate

system may inflate drug prices

2Spread pricing: Hidden spread

means health plans don’t know if

they are getting a good deal

3PBM-led prior authorization (PA):

PBMs may be motivated to approve

PAs for specialty drugs rather than

actively managing utilization

U.S. net drug price growth, 2014-20181




25

Source: IQVIA, “Medicine Use and Spending in the U.S.,” IQVIA, https://www.iqvia.com/insights/the-iqvia-institute/reports/medicine-use-and-spending-in-the-us-a-review-of-2018-and-outlook-to-2023; United States Government Accountability Office, “Medicare Part D: Use of

Pharmacy Benefit Managers and Efforts to Manage Drug Expenditures and Utilization,” GAO, https://www.gao.gov/assets/710/700259.pdf

Push for higher rebates may inflate drug spending


This may incentivize PBMs to negotiate with

manufacturers for higher rebates rather than lower costs

Health plans typically evaluate PBMs based on

rebate guarantees, rather than net drug spend

$252

$344

$38

$135

2009 2018

Net spend ($B)

Invoice-to-netdifference ($B)

Rebates and

other discounts

totaled 28% of

invoice drug

spend in 2018

U.S. net drug price growth, 2014-2018

Factors that health plans

use to select a PBM

• Brand and specialty

rebate guarantees

• Rebate pass-

through rate

• Generic discount

guarantees

• Guaranteed generic

fill rate

Missing from a typical

PBM evaluation

• Net drug spend

• Brand and specialty

drug lists




26

Source: 3 Axis Advisors, “Analysis of PBM Spread Pricing in Michigan Medicaid Managed Care,” Michigan Pharmacists, https://www.michiganpharmacists.org/Portals/0/resources/3AA%20MI%20Medicaid%20managed%20care%20analysis%20-

%20Final%2004.10.19.pdf; Anderson, M., “Michigan’s Medicaid program may fire it’s PBMs,” Becker’s Hospital Review, https://www.beckershospitalreview.com/pharmacy/michigan-s-medicaid-program-may-fire-its-pbms.html; Yost, D., “Ohio’s

Medicaid Managed Care Pharmacy Services Auditor of State Report,” Ohio Auditor, https://audits.ohioauditor.gov/Reports/AuditReports/2018/Medicaid_Pharmacy_Services_2018_Franklin.pdf

Audits find excessive spread in state Medicaid programs


$5.71

Average spread onMedicaid prescriptions

(4/1/17 - 3/31/18)

Market rate per-prescription fees

PBM spread in Ohio Medicaid

program found to be 3x the market

rate for equivalent fees

“Excessive”

spread per

prescription in

Ohio Medicaid

Spread on oral solid generic drugs, as a percent

of Michigan Medicaid managed care’s cost

2% 34%

PBM spread in Michigan’s Medicaid program

grew dramatically, leading to proposed

program changes

Q1 2018

Michigan’s Medicaid program may fire its PBMs.”

Becker’s Hospital ReviewOctober 8, 2019

$0.90-

$1.90

$3.81+Q1 2016




27

1. Includes PA requests submitted by Northwestern Medicine’s Dermatology

and Rheumatology clinics from 6/1/2015 to 6/12/2017.

PAs are an imperfect tool for utilization management


Source: Alendry S et. al., “What Is the Value of the Prior Authorization Process in Specialty Drug Therapy? [abstract]”. Arthritis Rheumatol. 2017;

69 (suppl 10). https://acrabstracts.org/abstract/what-is-the-value-of-the-prior-authorization-process-in-specialty-drug-therapy/.

93% Approval rate for all specialty pharmacy PAs from two clinics,

according to research conducted by Northwestern University1

Ideally, PAs ensure high-value,

appropriate medication use

Plan sponsors are concerned that

PBMs do not use the PA process to

suggest alternative therapies because of

potential PBM profits from manufacturer

rebates and PBM-owned pharmacies

Provide an opportunity to suggest lower-

cost or clinically superior alternatives

Protect against inappropriate or

unnecessarily costly therapies

Providers bear a substantial burden

from PA paperwork and dispute PAs’

necessity given high approval rates

Patients are frustrated about

delayed treatment starts and the

need to monitor PA processes

In reality,

stakeholder

concerns are

amplified by

high PBM-led

PA approval

rates



https://acrabstracts.org/abstract/what-is-the-value-of-the-prior-authorization-process-in-specialty-drug-therapy/


28

PBMs respond to concerns, but impact still uncertain

Guaranteed Net Cost

pricing model

• Pricing model provides plan

sponsor a guaranteed net cost

per claim

• Improves predictability to help

clients manage drug costs

• Promises 100% rebate pass

through

• Savings program brings

discounts to consumers at the

point of sale

• Early results showed that

consumers saved an average of

$130 per eligible prescription

• Required for all new employer-

sponsored plans beginning

in 2020

Point-of-Sale

Discount Program


OptumRx addresses pricing

visibility and drug cost for

consumers

CVS Caremark offers to

simplify financial arrangements

for plan sponsors

National Preferred

Flex Formulary

• Formulary prioritizes products

with lower list prices, such as

authorized generics

• Reduces brand product

utilization and reliance on

rebates

• Includes 3,800+ brand and

generic medications

Express Scripts offers to

increase coverage for lower

cost prescription drugs

Source: “CVS Health Introduces New Approach to Pricing of Pharmacy Benefit Management Services,” CVS Health, Dec 5, 2018, https://cvshealth.com/newsroom/press-releases/cvs-health-introduces-new-approach-pricing-pharmacy-

benefit-management; Miller S, “National Preferred Flex Formulary: Built for the Evolution of Drug Pricing,” Express Scripts, Nov 13, 2018, https://www.express-scripts.com/corporate/articles/national-preferred-flex-formulary-built-evolution-

drug-pricing; “Successful Prescription Drug Discount Program Expands to Benefit More Consumers at Point-of-Sale,” Optum, Mar 12, 2019, https://www.optum.com/about/news/successful-prescription-drug-discount-program.html.



https://cvshealth.com/newsroom/press-releases/cvs-health-introduces-new-approach-pricing-pharmacy-benefit-management

https://www.express-scripts.com/corporate/articles/national-preferred-flex-formulary-built-evolution-drug-pricing

https://www.optum.com/about/news/successful-prescription-drug-discount-program.html


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Road mapRoadmap29

1

2

3

4

What is a PBM?


What unique opportunities do health

systems have to work with their PBM?





30

Pharmacy expertise helps health systems lower benefit costs

System-owned Pharmacies

Pharmacy Executive Forum interviews and analysis.

• Lower drug prices by leveraging

participation in a group purchasing

organization (GPO) or the 340B

program

• Eliminate “spread” when the right

billing model is in place

• Reduce waste by working with

patients to appropriately time refills

• Improve adherence and eliminate

unnecessary prescriptions

through medication therapy

management

• Reduce high-cost prescriptions

by educating physicians about

lower-cost alternatives

Clinical Pharmacists

• Optimize PBM services and

contract by collaborating with

benefits leaders

• Identify contract discrepancies

through claims and invoice reviews

• Improve formulary value by

removing high-cost drugs and

aligning formularies across settings

Pharmacy leaders




‹#›

Road mapRoadmap31

1

2

3

4

What is a PBM?


What unique opportunities do health

systems have to work with their PBM?





32

Additional resources on managing the employee drug benefit

Pharmacy Executive Forum interviews and analysis.]

Forthcoming: Cheat sheets

• Two-pagers explaining why and how to

deploy pharmacy expertise in lowering

employee pharmacy costs

• Brief case studies to illustrate opportunity

• Topics include:

– Supporting benefits conversations with

brokers and PBMs

– Reviewing pharmacy claims data

– Encouraging use of in-house pharmacy

– Establishing cost-plus reimbursement for

employee prescriptions

Available now on advisory.com

Research Report

How pharmacy leaders can help reduce

employee health benefit costs

Benchmarking Data

Results from the 2019 Pharmacy

Benefits Management Quick Poll

Case Study | UNC Health Care System

Establishing a Health System-Owned

PBM: From Idea to Impact



https://www.advisory.com/research/pharmacy-executive-forum/research-reports/2018/how-pharmacy-leaders-can-help-reduce-employee-health-benefit-costs

https://www.advisory.com/research/pharmacy-executive-forum/resources/2019/pharmacy-benefits-management-quick-poll

https://www.advisory.com/-/media/Advisory-com/Research/PEF/Expert-Insights/2019/050919/UNC-Health-Care-System-May-Meeting-Write-Up.pdf


Credits

34

Advisors to our workSusan HayesPharmacy Investigators

& Consultants

Lake Zurich, IL

LG HanzelRxResults

Little Rock, AR

Chuck Gamsu R.Ph., MBA SkySail Rx

Pepper Pike, OH

LeAnn BoydSouthern Scripts

Natchitoches, LA

Pramod JohnVivio Health

San Leandro, CA

Binita PatelMemorial Hermann

Health System

Houston, TX

Brad MyersMU Health Care

Columbus, MO

Kelley CurtisSt. Luke’s Health System

Boise, ID

Robert SchenkHackensack Meridian Health

Edison, NJ

Robert SchmidtUnited Health Services

Binghamton, NY

Laurie WhalinNew Hanover Regional

Medical Center

Wilmington, NC

Matt WolfAmerisourceBergen

Chesterbrook, PA

Carl SchuesslerMitigate Partners

Atlanta, GA

Colleen MahoneyIndependent pharmacist

Springfield, VA

Michael MedelPharmaceutical Strategies

Group

Plano, TX

David ContornoE Powered Benefits

Mooresville, NC

Michael HurleyUPMC

Pittsburg, PA

Charlene RossbackCatholic Health Services

of Long Island

Rockville Center, NY




Credits

35

Lindsay Conway

Rebecca Tyrrell

Program Leadership

Elle Choi

Contributing Consultants

202-568-7895

[email protected]

Regina Lohr, MPP

Project Director

Pharmacy Executive Forum



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Pharmacy Benefit Managers 101