Pharmacy Partnership Forum - Reimagining Pharmacy Finance

June 2023

Authors:

Joan C. Barrett, FSA, MAAA
Consulting Actuary
Axene Health Partners, LLC

Tony Pistilli, FSA, CERA, MAAA, CPC
Consulting Actuary
Axene Health Partners, LLC

Gregory Warren, FSA, FCA, MAAA
Partner and Consulting Actuary
Axene Health Partners, LLC

Description

Pharmacy prices are top of mind for many consumers, policymakers, and payers. While there have been many efforts to reduce pharmacy costs over the years, many believe these efforts only helped us cope with the symptoms of the problem without providing a comprehensive cure for the underlying causes of this problem. The Society of Actuaries Health Section sponsored this Pharmacy Partnership Forum to gather multi-disciplinary experts in the pharmacy ecosystem. This report shares the insights and learnings that emerged from this group of health economics outcomes researchers, clinical pharmacists, medical doctors, health actuaries, benefits consultants and brokers, and their collective thoughts on advancing this exploration for society’s benefit.

Materials

Pharmacy Partnership Forum - Reimagining Pharmacy Finance

Thank You

The authors thank the following individuals for their support of this project.

Forum participants:
Erik D. Axene, MD, FACEP, Chief Medical Officer, Axene Health Partners, LLC
Joan Barrett, FSA, MAAA, Consulting Actuary, Axene Health Partners, LLC
Ladelia Berger, Community Engagement Manager, Society of Actuaries
Susan A. Cantrell, RPh, MHL, Chief Executive Officer, AMCP
Gary Claxton, Senior Vice President, KFF
Kristin Coyle, Principal, Mercer Government
Jeffrey D. Dunn, PharmD, MBA, Chief Clinical Officer, Cooperative Benefits Group / RealRx
Kevin Francis, FSA, MAAA, Chief Actuary, Triple Aim Partners
Beth Hamilton, MBA, Vice President, Global Oncology Market Access, Pricing and Value Evidence, AstraZeneca
Tom Hughes, BSPharm, PhD, Director, HEOR, Argenx
Cessily Johnson, MBA, Vice President of Data and Informatics, KlearTrust
Scott Kornhauser, Executive Vice President, KlearTrust
Jackie Lee, FSA, MAAA, Vice President & Principal, Lewis & Ellis, Inc
Jim Leonard, PharmD, Deputy Director, Pharmacy Office, Colorado Department of Health Care Policy & Financing
Martin D. Marciniak, RPh, MPP, PhD, Country Medical Director, Vice President, US Medical Affairs, Chiesi USA
Newell E. McElwee, PharmD, MSPH, Retired Vice President, HEOR, Boehringer Ingelheim
Achilles Natsis, FSA, MAAA, FLMI, Health Research Actuary, SOA Research Institute
Karen Nixon, Partner & CEO, Nixon Benefits
John Michael O’Brien, PharmD, MPH, President & CEO, National Pharmaceutical Council
Tony Pistilli, FSA, CERA, MAAA, Consulting Actuary, Axene Health Partners, LLC
Bruce Pyenson, FSA, MAAA, Principal and Consulting Actuary, Milliman
Jason M. M. Spangler, MD, MPH, FACPM, Chief Executive Officer, The Value Initiative
Gregory Warren, FSA, FCA, MAAA, Partner and Consulting Actuary, Axene Health Partners, LLC
Denise Wolff, PharmD, Executive Director, Pear Therapeutics, Inc.
Joe Wurzburger, FSA, MAAA, CAE, Managing Director, Strategy & Innovation, Society of Actuaries

The Health Section Council:
Kevin Francis, Chair
Derek Ray, Vice-Chair
Lydia Tolman, Secretary-Treasurer
Lina Chan
Greg Fann
Mandy Geyer
Gabrielle Guzman
Shuaiqing Liu
Karan Rustagi
Shereen Sayre
Alisa Swann
Julie Wang

Society of Actuaries Staff:
Achilles Natsis
Ladelia Berger

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