Managed Care Pharmacy Practice by Robert Navarro

Managed Care Pharmacy Practice

Second Edition
by
    Robert Navarro  

                    Managed Care Pharmacy Practice offers information critical to the development and operation of a managed care pharmacy program. The text also covers the changes that have taken place within the delivery of pharmacy services, now that a higher percent of the population is enrolled in some type of "managed" health care organization. The Second Edition reflects contemporary health care management and policy issues, details how the value of pharmaceuticals is assessed by health plans and PBMs, and discusses how value-based formularies are developed and managed. Health care policy issues are addressed from a societal perspective to illustrate how managed care organizations respond to, or lead, public policy decisions. The Second Edition has been thoroughly updated to reflect the significant changes in development and execution of managed care pharmacy benefit management.

The Second Edition includes a glossary, as well as new chapters and extended topics in:

• Drug Dossier Development and Applications
• Self-funded pharmacy benefit management Contracting with pharmaceutical manufacturers
• The impact of HIPAA on pharmacy benefit management
• Healthcare Benefits from the Employer
• Plan Sponsor Perspective Value of Pharmaceuticals
• Medicare Part D Public Policy and Managed Care Pharmacy
• AMCP Format for Formulary Submissions
• Pharmaceutical contracting with MCOs and PBMs
• Medication Therapy Management Programs (MTMPs)
• Pharmacy & Therapeutics Committees in Managed Care Operations
• Drug Formularies
• The role of employer groups in pharmacy benefit development and management
• "Specialty pharmacy:" the new pharmacy benefit management developed to cover injection-based biologicals created by pharmaceutical manufacturers
• The complex pharmacy benefit design options available today
• Implementing MTMPs as a basis for developing the next generation of clinical pharmacy programs to support disease management