Check out the recording, presentation materials and recap of October 27 briefing here.
On December 4th, please join us as NEHI convenes leading payers, biopharmaceutical manufacturers, and patient advocates on Capitol Hill to consider “The Next Generation of Value-Based Arrangements: What Are the Stakes for Patients?”
Value-based arrangements are an emerging payment model under which payers or pharmaceutical benefit managers and biopharmaceutical manufacturers agree to specific terms that tie payment to results, based on a drug’s actual impact on patients in real world medical practice.
While perspectives differ on the benefits and challenges to expanding value-based agreements, many analysts believe a new generation of value-based arrangements will play an essential role in any national strategy on coverage and payment of drugs. As health care leaders and policy makers explore the next generation of value-based arrangements, it is critical to examine what is at stake for patients and bring the patient perspective to these discussions. Join us as we explore key questions:
Jim Clement is currently a Partner of Coeus Consulting Group and a Co-Founder of Coeus Healthcare. Coeus Consulting Group is a boutique life science strategy consulting firm supporting life sciences companies, payors and health delivery systems in the U.S. Coeus Healthcare, the first value-based data aggregator and financial services company, offers pharmaceutical, biotech and gene therapy manufacturers the ability to offer unified value-based care and financial reimbursement models to health plans and providers while offering patient mobility between insurers. Clement draws on his over 25 years’ experience working in pharmacy benefits, biotechnology and health plans and specializes in value-based and innovative contracting, medical pharmacy management, and supply chain optimization. Prior to joining Coeus, Clement served as the Executive Director, Value Based Care and Supply Chain Strategy at Aetna where he focused largely on proving the value of pharmaceutical therapies. In that role, he was responsible for transforming the financing of the pharmacy benefit and leading Aetna’s enterprise relationships with pharmaceutical manufacturers. Mr. Clement maintained administrative oversight for pharmacy benefit strategy, actuarial services, network administration, client pricing, analytics, and vendor management in addition to innovative contracting models that help drive value-based care. He also served as a board member for sPCMA, collaborated with the Bipartisan Policy Center on innovative and value-based market access approaches for gene therapies, and served as an advisor to the Network for Excellence in Health Innovation (NEHI) on the publication of “Value-Based Contracting for Oncology Drugs.”
As Senior Principal, Health Economics and Outcomes Research at IQVIA, Mitchell DeKoven leads teams in a variety of health economics and outcomes research projects, including value development plans, retrospective database studies, and observational surveys. Mr. DeKoven was an associate director of reimbursement and market access at ValueMedics Research LLC, which IQVIA acquired in March 2007. Prior to joining ValueMedics, he was manager of reimbursement services at United BioSource Corporation’s Center for Pricing & Reimbursement. Before that, was a consultant with CHPS Consulting, now Navigant Consulting. Previous to his experience at CHPS, Mr. DeKoven was the program manager of the Center for Cancer and Blood Disorders at Children’s National Medical Center in Washington, DC, a position he held after completing a two-year administrative fellowship with the Johns Hopkins Health System. Mr. DeKoven is past president of the board of directors of the Lupus Foundation of America’s Greater Washington Chapter, sits on the editorial advisory boards of several leading peer-reviewed journals, and has published 25 peer-reviewed manuscripts across numerous therapeutic areas. Mr. DeKoven earned his M.H.S.A. from the University of Michigan School of Public Health and his B.A. in Spanish from Washington University in St. Louis.
Molly Guthrie is responsible for leading Susan G. Komen’s public policy and advocacy efforts. As such, Molly oversees Komen’s work to advance key legislative and regulatory objectives at the federal, state and local levels. In this role, she focuses on policy campaigns to increase funding for medical research and screening programs, and ensuring access to affordable, high-quality breast health and cancer care services. In addition to working on policy campaigns, her team works on increasing capacity for public policy and advocacy work with Komen Affiliates and grassroots volunteers. Molly joined the Washington, D.C. office of Susan G. Komen in 2009, relocating to the Dallas headquarters in late 2012. However, her Komen journey started as a child when the Race for the Cure was brought to Wichita, Kansas in 1990. The Wichita Race was the first Komen co-ed Race and the 4th in Komen’s history. She has been a loyal volunteer ever since. Prior to joining Komen, Molly attended the University of Kansas where she received her Bachelor of General Studies with an emphasis on political science and communication studies. She worked in the Offices of Governor Kathleen Sebelius and Congressman Dennis Moore during college. Molly resides in Dallas with her husband and two dogs.
Erin Huntingtonleads Pricing, Reimbursement, and Access strategy and marketing for Lilly USA’s Managed Health Services. In this role, Erin is charged with setting Lilly USA’s overall strategy for engaging with payers, pharmacy benefit managers (PBMs) and wholesaler partners in order to ensure that patients can access Lilly medicines. Erin began her career with Lilly in 1997, gaining critical experience through various corporate affairs, government relations and market access roles. From 2010 to 2017, she served in several payer leadership roles, including vice president of international corporate affairs and global pricing, reimbursement and access. Prior to that, Erin completed a five-year assignment in Europe where she was senior director responsible for Lilly’s corporate affairs strategy in Europe, Australia and Canada, as well as the corporate affairs director of Lilly UK. Before joining Lilly, Erin served on the staff of Senator Richard G. Lugar as legislative assistant with a focus on education and foreign policy issues. Erin holds a bachelor’s degree in political science and Spanish from Indiana University, and a master’s degree in international affairs from George Washington University.
Focused on improving health outcomes for people living with rare diseases by advancing the development of treatment and diagnostic opportunities for rare disease patients through science-driven public policy, Annie’s work includes building strong partnerships with policy makers, federal agencies, Industry, and alliances. Current areas of emphasis include leading the national Burden of Rare Disease Study, 21st Century Cures Act and PDUFA VII engagement, national newborn screening program engagement and state RUSP alignment legislation, and innovating around therapy valuation and access issues. Annie has served within the community for nearly three decades through her roles with Parent Project Muscular Dystrophy (PPMD) and the Muscular Dystrophy Association (MDA). In that time she helped lead legislative efforts around passage and implementation of the MD-CARE Act (2001, 2008, 2014), the Patient Focused Impact Assessment Act (PFIA) which became the Patient Experience Data provision within the 21st Century Cures Act (sec 3001), engagement with the FDA and Industry around regulatory policy and therapeutic pipelines, led access efforts as the first therapies were approved in Duchenne, and engaged with ICER around the development of the modified framework for the valuation of ultra-rare diseases. Annie’s community roles include service on the Board of Directors of Cure SMA, the PFDD Works coalition, the Steering Committee of the Patient Driven Values in Healthcare Evaluation, Cures for Life, the FasterCures Patient Exchange Working Group, the National Health Council’s PCORI Valuation Group, National Health Council’s Medical Innovation Action Team, and recently served as a Design Team member of the NCATS/ORDR Tool Kit Project.
Rebecca Kirch is EVP of Healthcare Quality and Value for the National Patient Advocate Foundation (NPAF), providing strategic focus and leadership in bringing patient and caregiver voices and values to the forefront of health reform efforts. As a leading health policy expert and advocate in her field, Rebecca is dedicated to advancing person-centered policies and practices that put people at the heart of healthcare. Prior to joining NPAF in 2016, she served for 15 years with the American Cancer Society and its advocacy affiliate, the American Cancer Society Cancer Action Network, directing development and execution of coordinated quality of life and survivorship research, policy and advocacy activities. A frequently invited speaker on the patient and family experience and person-centered care priorities and practices, Rebecca has authored numerous articles and book chapters, including publications in the New England Journal of Medicine, Archives of Internal Medicine, JAMA Oncology, Health Affairs, Circulation and other professional journals. She is the recipient of numerous national awards, has been featured in multiple media outlets and also serves in leadership roles on several stakeholder advisory committees and advocacy coalitions. Rebecca is currently serving as a member of the National Academy of Science, Engineering and Medicine’s Quality Care for People with Serious Illness Roundtable, as Quality of Life and Person-Centered Care task force co-chair for the American Congress of Rehabilitation Medicine, and a board member for children’s oncology Care Camps.
Dr. Klein is currently Senior Director, Oncology in the Global Patient Outcomes and Real-World Evidence Department at Eli Lilly and Company. In this role Eric leads the Outcomes Research team supporting the Oncology Business Unit and is responsible for the health economic, outcomes research, and real world evidence capabilities supporting Lilly’s early and late phase drug development oncology portfolio as well as the marketed oncology portfolio in the US. Eric has spent the last 20 years is leadership roles responsible for various aspects of the Outcomes Research and Real World Evidence organization at Lilly. Eric joined the Outcomes Research organization of Lilly USA in January of 1998 where he spent 6 years focused on building the organizations Outcomes Liaison capabilities. In September 2004 Eric transitioned to Lilly’s Global Health Outcomes organization where Eric held leadership roles associated with development across product and program phase research as well as the development of business management and operations capabilities including quality, capacity planning, capability management and development, strategic planning, and project management. In January of 2010, Eric returned to Lilly USA to assume responsibilities for strategic transformation efforts within the Outcomes Research organization and then in 2011, Eric took on responsibility for the Regional Outcomes Research teams globally. Eric assumed his current responsibilities in Oncology drug development in 2014.
Ira Klein, MD, MBA, FACP, is the Senior Director of Health Care Quality Strategy in the Strategic Customer Group of J&J Health Care Services, advancing value-based solutions for market access. Previously, in his 10 years at Aetna, he was the National Medical Director for Clinical Thought Leadership, founded the Oncology Solutions team, and acted in a variety of other roles. Prior to Aetna, he led the quality, cost and care management area for the Bayshore Community Health System. Previous to that, he was CMO of Elderplan, serving the frail elderly in NYC. He began his career practicing Internal Medicine for 7 years at Robert Wood Johnson Medical School as Assistant Professor in the Division of General Internal Medicine. Ira holds a BS from Rutgers University College of Pharmacy, an MD from University of Medicine and Dentistry of New Jersey – Robert Wood Johnson Medical School, and an MBA from Rutgers University.
Lynn M. Neilson, PhD, is a Program Administrator at the UPMC Center for Value-Based Pharmacy Initiatives (VBPI) within the UPMC Insurance Services Division. VBPI strives to promote greater value in medication use through the development, implementation, and evaluation of innovative value-based payment and contracting models for pharmaceuticals. Leveraging its unique position within an integrated delivery and finance system, and in close collaboration with UPMC Pharmacy Services, VBPI engages with clinical subject matter experts to develop and evaluate medication-related clinical programs and inform evidence-based formulary design. In her current role, Lynn guides and collaborates on VBPI research and contracting initiatives across its portfolio, including epidemiological analyses of drug utilization trends, costs, and health outcomes, and the conduct of consensus-building Delphi studies to identify the most meaningful and measurable disease-specific outcomes among diverse stakeholders (including patients, providers, caregivers, payers, pharmaceutical company representatives, and pharmacy benefits managers) to be included in value-based agreements. Prior to joining VBPI, Lynn served for ten years as Assistant Director for Research Services at the UPMC Hillman Cancer Center, and is a graduate of Georgetown University’s doctoral program in Tumor Biology.
Kristen Santiago has substantial experience working in the healthcare industry in roles in the public, private, and not-for-profit sectors. As Senior Director of Public Policy Initiatives for the LUNGevity Foundation, Kristen is focused on breaking down barriers to patient access to high-quality care and treatment innovation. In her role, Kristen participates on a variety of committees and advisory boards to represent the interests and perspectives of lung cancer patients, presents at Capitol Hill briefings, submits letters to legislators, regulators, and independent organizations seeking patient input, and convenes multi-stakeholder meetings to resolve complex issues that hinder patient access to diagnostics and the most advanced therapeutics. In Kristen’s previous positions include: Senior Director, Policy & Advocacy for the Cancer Support Community; Director, Strategic Initiatives & Outreach for C-Change; as well as positions with TAP and Takeda Pharmaceuticals, The Commonwealth of Pennsylvania, and the American Speech-Language-Hearing Association. Kristen earned a Masters of Science in Health Promotion Management at American University and a Bachelor of Arts in Speech Language Pathology from The George Washington University and is driven by a strong personal desire to impact the health status and quality of life of individuals through strategic alliance development and advocacy.
Bethanie Stein is the Vice President of Strategic Contracting, Purchasing & Analytics at Humana Pharmacy Solutions. In this role, Bethanie leads the work relevant to the pharmaceutical supply chain, specifically Pharmacy Network Contracting, Trade Relations, Purchasing for Humana’s Mail, Specialty, and retail pharmacies, and Analytics that supports the Pharmacy and PBM business. Her leadership of these combined organizations comes at a time of increased convergence in our relationships with Pharmaceutical Manufacturers, Wholesalers, Pharmacies, and Payers, and analytics at the core of driving our strategy. Bethanie joined HPS 10 years ago, starting as a Pharmacy Resident, and has held a number of positions in the clinical and operational areas of the business. Previous to this role, she was Vice President of Trade Relations responsible for managing a multi-billion-dollar pharmacy and value-based rebate program. Bethanie has also led Formulary strategy, Medicare contracting strategy, and Humana’s pipeline and generic drug strategy in managing overall drug cost trends at Humana. Bethanie received her Doctor of Pharmacy degree at Duquesne University in Pittsburgh, PA. She went on to complete a 1-year managed care residency at Humana. Bethanie is a member of AMCP (Academy of Managed Care Pharmacy) and PCMA (Pharmaceutical Care Management Association).
For more information, contact Tom Hubbard at email@example.com.