Managed Care - March 2008 - (Page B44) CONTINUING MEDICAL EDUCATION ASSESSMENT/EVALUATION/CERTIFICATE REQUEST Biologic Therapy Management: The Need for Value-Based Health Benefits Models CE Credit for Physicians/Pharmacists I certify that I have completed this educational activity and post-test and claim (please check one): I Physician credit hours I Pharmacist contact hours Signature: PLEASE PRINT CLEARLY EXAMINATION: Place an X through the box of the letter that represents the best answer to each question on page 45. There is only ONE correct answer per question. Place all answers on this form. A. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. Was this publication fair, balanced, and free of commercial bias? I Yes I No If no, please explain: Please use the following scale to answer the next four questions: Strongly Agree 5 Agree 4 Neutral 3 Disagree 2 Strongly Disagree 1 Did this educational activity meet my needs, contribute to my personal effectiveness, and improve my ability to: Treat/manage patients? 5 4 3 2 1 N/A N/A N/A First name, MI Last name, degree Title Affiliation Mailing address City State ZIP Daytime telephone ( ) Fax ( ) E-mail Physician — This activity is designated for a maximum of 3.75 AMA PRA Category 1 Credit(s).™ Pharmacist — This activity is approved for 3.75 contact hours (0.375 CEU). ACPE Universal Program Number (UPN): 812-000-08-009-H01-P Release Date: March 15, 2008 Expiration Date: March 15, 2009 To receive credit, complete the assessment/evaluation form and mail or fax completed form to: The Chatham Institute 26 Main Street, 3rd Floor Chatham, NJ 07928 Fax: (973) 701-2515 Allow 6–8 weeks for processing. This activity is jointly sponsored by The Chatham Institute and BioCommunications LLC and is provided at no cost to the participant through an educational donation provided by Amgen and Wyeth Pharmaceuticals. T7N39-MG I I I I I I I I I I I I I I I I I I I I B. I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I C. I I I I I I I I I I I I I I I I I D. E. I I I Communicate with patients? 5 4 3 2 1 Manage my medical practice? 5 4 3 2 1 PROGRAM EVALUATION So that we may assess the value of this self-study program, we ask that you please fill out this evaluation form. Have the objectives for the activity been met? 1. Define the societal issues pertinent to patient access to appropriate health care treatment options. I Yes I No 2. Evaluate the role and value of biologics for chronically ill patients. I Yes I No 3. Advocate for policies surroundng access to, reimbursement for, and financing of biologics. I Yes I No Other 5 4 3 2 1 N/A Effectiveness of this method of presentation: Very Excellent good Good Fair Poor 5 4 3 2 1 What other topics would you like to see addressed? Comments: 44 BIOLOGIC THERAPY MANAGEMENT
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