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The Medicare & Medicaid Programs

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    Marketplace Blog

    Trends in the Marketplace

    The Increasing Exploitation of Patient Assistance Programs

    Copay accumulator programs have only one purpose; increase profits for payers. Patients don’t gain an advantage, nor do manufacturers. On top of that, providers face the difficulty of helping patients manage a process they don’t understand. And somehow, the whole concept has gotten worse. Patient Assistance Programs offered by manufacturers are intended to relieve the patient’s financial burden when filling their prescription. From the patient perspective, this is great. This blog takes a closer look behind the curtains to reveal

    Fractures in The 340B Program

    The 340B Program remains controversial. Hospitals and other Covered Entities (providers qualified to buy drugs at 340B prices) that benefit from the program describe it as a lifeline that keeps them in business. Pharma sees 340B as a program that has grown well beyond its original purpose, and at their expense. This controversy has created fracture lines that run in many different directions. The fractures are being created by lawsuits, government regulations, federal law, and other factors. We’ll describe the

    The Impact of Medicare Price Negotiations

    The Inflation Reduction Act (IRA) passed on August 16th, 2022 brings big changes for the pharmaceutical industry. On August 31st we had a live discussion on the law’s anticipated impact. Here is a summary of our discussion: Inflation Penalty The intent of the law is to impose penalties on manufacturers who raise drug prices faster than inflation. Penalties will begin very soon; however, recent Consumer Price Index (CPI) inflation rates allow increases of around 13.5% without any penalties assessed. Manufacturers

    Program Description

    The topics discussed during this program primarily focus on product access, and go into detail on:​

    • The various components of the Medicare Program​
    • The structure of the Medicaid Program​
    • Managed Medicare/Medicaid​
    • Benefit design, including Dual-eligibles​​
    • Patient cost-sharing​
    • Program design changes that impact product access​

    Program Structure

    Upon registration, you will be assigned a set of e-learning courses to complete prior to the live webinar. These courses will detail key topics impacting market access in the Medicare and Medicaid space:

    • The Medicare Program​
    • Medicare Part D​
    • Medicare Part D Low-Income Subsidy​​​
    • The Medicaid Program​

    Pull-through Live Discussion

    The webinar pulls through concepts learned and demonstrates real-world application. A comparison of the two programs will be shared, with a focus on product access. Come prepared to think constructively about your own business environment as it relates to the topics discussed.

    What to Expect​

    Once you purchase a MAP Program, you will receive 3 emails from ProFusion MAP:​

    • Welcome! Learning Awaits​
      • This email will provide you with account information for access to the MAP Program you registered for​
    • Register for…
      • This email will list all available live webinar sessions for the MAP Program you purchased​
      • Sessions are closed to registration after the 10-person max is reached. Sign up early!​
    • You’re enrolled in…​
      • This email will direct you to the MAP Program with all e-learning courses to complete before your live session​
      • These courses are only available for 90 days after your purchase date. You are encouraged to complete all courses prior to the live session​

    ​Tip: You can save the ProFusion MAP LMS to your bookmark for quick access!​

    If you have any questions, contact ProFusion MAP Support at +1 877-369-2580​

    Stay Updated on New MAP Programs and Dates

    As the market access environment changes, relevant topics will be covered through new programs. Subscribe below to be the first to know about new MAP Program topics and added dates for existing Programs.

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      Manufacturers Restricting 340B Sales to Contract Pharmacies

      • Abbvie
      • Amgen
      • AstraZeneca
      • Boehringer Ingelheim
      • Eli Lilly
      • Merck
      • Novartis
      • Novo Nordisk
      • Sanofi
      • UCB
      • United Therapeutics
      • and more…