Biotechnology Healthcare - June 2008 - (Page BFACCov2) Steven R. Peskin, MD, MBA Medical Director, The Chatham Institute EDITOR Michael D. Dalzell EDITOR IN CHIEF, EDITORIAL ADVISORY BOARD BFAC: A Valuable Resource for Third-Party Payers and Employer Purchasers David B. Nash, MD, MBA SENIOR EDITOR Katherine T. Adams SENIOR EDITOR, CUSTOM PUBLICATIONS T Amy Krajacic SENIOR CONTRIBUTING EDITORS Amanda Brower Bob Carlson, MHA John Carroll CONTRIBUTING EDITORS Lola Butcher Scott Kober WEB EDITOR Tony Berberabe, MPH DESIGN DIRECTOR Philip Denlinger PRESIDENT AND GROUP PUBLISHER Timothy P. Search, RPh DIRECTOR OF NEW PRODUCT DEVELOPMENT Timothy J. Stezzi EASTERN SALES MANAGER Scott MacDonald SENIOR ACCOUNT MANAGER Kenneth D. Watkins III DIRECTOR OF PRODUCTION SERVICES Waneta Peart CIRCULATION MANAGER Jacquelyn Ott BIOTECHNOLOGY HEALTHCARE (ISSN 1554-169x) is published bimonthly by BioCommunications LLC, 780 Township Line Road, Yardley, PA 19067. This is Supplement 1 to Vol. 5, No. 1. Standard postage paid at Morrisville, Pa., and at additional mailing offices. POSTMASTER: Send address changes to BIOTECHNOLOGY HEALTHCARE, 780 Township Line Road, Yardley, PA 19067. Price: $18 per copy, $95 per year in the United States; $120 per year elsewhere. E-mail: editors@biotechnologyhealthcare.com. Phone (267) 685-2788; Copyright 2008, BioCommunications LLC. www. biotechnologyhealthcare.com he emergence of biologic therapies is straining traditional models of health insurance and health care financing. During my decade of experience as a commercial and Medicare health plan medical director, I had to make difficult decisions every day. Biologic therapies and personalized medicine add yet another dimension of complexity to the challenges today’s managed care decision makers face. For patients, biologics offer benefits for improved quality of life, and are sometimes life saving. For payers and purchasers, the cost of biologics is provoking benefit design changes that include significant cost shifting to patients and attempts to control or limit the cost of these therapeutics to the plan or plan sponsor. These issues must be addressed if employers are to continue to afford to offer health benefits to workers and their dependents. In developing this white paper, the Biologic Finance and Access Council BFAC CO-CHAIRS STEVEN R. PESKIN, MD, MBA (BFAC) examines the “value” Christopher V. Goff, Esq. of biologic therapies from the perspectives of CEO & General Counsel various stakeholders, then applies those perEmployers Health Purchasing Corp. of Ohio spectives to issues they routinely face, such as Joel C. Hoffman, ASA, MAAA, FCA Managing Principal access, affordability, benefit design, and the adReden & Anders ministration of biologics. F. Randy Vogenberg, PhD, RPh Rheumatoid arthritis is used as an example Chief Strategic Officer to illustrate the concepts described in the first Employer-Based Pharmaceutical Strategies three chapters, primarily because of RA’s COUNCIL PANELISTS prevalence in the working-age population, and George Beach because its treatment involves myriad medical National Patient Advocate and financial considerations. The final chapter Arthritis Foundation applies issues discussed in the previous secJan Berger MD, MJ tions to theories about efficient administration Senior Vice President and Chief Clinical Officer and management of biologics — the complexCaremark ities of which resonate across numerous conWilliam B. Bunn III, MD, JD, MPH ditions that affect working-age populations. Vice President, BFAC comprises thought leaders from large Health, Safety, Security, and Productivity International Truck and Engine Corp. employers, national and regional health plans, Lon A. Castle, MD and pharmacy benefit managers, as well as naDirector of Medical Policy & Clinical Quality tionally regarded health economists, actuaries, Medco Health Solutions benefit consultants, clinicians, patient advoJoseph Flood, MD cates, and academicians. The council facilitates President Musculoskeletal Medical Specialists the exchange of ideas and rigorously analyzes Geoffrey Joyce, PhD research, empirical data, and other informaSenior Economist tion regarding access to, current and future Rand Corp. means of financing, and management of bioJoseph N. Romano, ASA, MAAA logics. BFAC assists purchasers, payers, and Senior Vice President and Chief Actuary Capital BlueCross policymakers in finding their own answers regarding the value and place for biologics. Joseph P. Romano, MD Health Affairs Vice President (Ret.) This white paper is a framework for BFAC’s AT&T fully integrated approach to resolving difficult Louis Rossiter, PhD health care financing and benefit design issues. Research Professor and Director, The council is primed with intellectual capital, Schroeder Center for Healthcare Policy College of William and Mary and we encourage you to take advantage of it. William N. Yang, MD, MPH I am happy to facilitate that discussion. Health Management Physician I hope you find this document thought proThe Coca-Cola Company voking and useful in your daily responsibilities. http://www.biotechnologyhealthcare.com
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