ProFusion LLC

The Inflation Reduction Act (IRA) is already transforming the pharmaceutical landscape in significant ways! Just one example: Starting in 2025, Medicare Part D will include an OOP cap of $2,000 and allow beneficiaries to spread their costs throughout the year under the new Medicare Prescription Payment Plan (MPPP). Understanding these changes is critical for every pharmaceutical team. ProFusion offers a suite of off-the-shelf modules to provide your teams with up-to-date information on relevant aspects of Medicare and the IRA. Pull through learning from the modules with customized training, facilitated by ProFusion, to focus on the aspects of the law that specifically impact your team and their customers. #PharmaceuticalIndustry #Medicare #InflationReductionAct #HealthcareReform #TrainingAndDevelopment

We are thrilled to introduce our latest additions to the ProFusion team: John Patteson, Cheryl Reid, BSN, and Nicholas Blackburn ? John brings over 20 years of experience in the healthcare industry. His remarkable track record includes successfully launching 6 new products while managing National IDN?Accounts. He most recently excelled as a Health System Access Manager at Otsuka Pharmaceuticals. ? Cheryl's background includes a rich history in the pharmaceutical industry, with expertise in account development, new product launch, brand marketing, and contract negotiations in the Managed Care/PBM sector. Her most recent role as Executive Director on the National Accounts Team at Otsuka Pharmaceuticals truly sets her apart. ? Nick plays a pivotal role in our operations, overseeing the production and distribution of over 30 off-the-shelf market access modules to our pharmaceutical clients. His adeptness in managing multiple studies at Duke Human Vaccine Institute and ensuring seamless operations will prove valuable to our team.? ? Their combined skills will drive the development of top-tier training solutions for our pharmaceutical customers. Welcome, John, Cheryl, and Nick - we are excited to have you on board!

Thank you to everyone who came by our booth at #LTEN this week. Don Benson and Nicole Sword heard from many pharma trainers about how much they value market access training, and are grateful for the opportunity to provide that service! They also had a great session with Chuck Petrozzini and Denise Lusnia on the importance of training field teams on the relative value each script brings to the manufacturer. There was great discussion amongst market access trainers, and we hope everyone walked out with some fresh ideas to bring back to their teams!

Attending LTEN? Be sure to catch this session on how to utilize market access training to pull through brand strategies. Don Benson will go into detail on valuable training topics needed to support this initiative. Be sure to add it to your schedule -> https://lnkd.in/ep3Ysq9b

The correct answer to our poll is "No". If someone asks "what is an ACO", the most common answer may be something like "a group of doctors and hospitals delivering value-based care". If that was the definition, then signing an ACO contract with one payer like Medicare would make that hospital an ACO for all its payer partners. But that is not the case. An ACO is defined by the contract signed between a provider and the payer. If a hospital doesn't sign an ACO contract with one of its payers, then it is not an ACO for patients covered by that payer. This is important because the value-based care environment changes treatment decisions. If that wasn't the case, ACOs would offer no value. In our example, the Mayo Clinic's providers may make different treatment decisions for patients covered by different payers. This discussion means it is important to recognize when providers are functioning like an ACO, and when they are not. Being able to define an ACO is the first step in that process!

Since the Affordable Care Act (ACA) was passed in 2010, healthcare has been shifting from a volume-based compensation model to a value-based one. With this, we have seen more Accountable Care Organizations (ACOs) emerge. We are curious, do you know what an ACO really is? Tell us what you think below!

Now that our poll is closed, we'll share a simplified calculation: The correct answer here is the $1,000 high-rebate drug, which reflects the broader problem with the U.S. drug pricing system. A Payer's net cost can be lower when typical rebates are applied to a more expensive branded drug. A contributing factor is the rise in a patient's coinsurance payment proportional to the drug's?list?price. In our example, a high patient cost share coupled with a high rebate can drive the net cost of the $1,000 drug lower than that of the $500 biosimilar alternative

Let's consider the payer's perspective for this next poll. Tell us your response and feel free to comment with an explanation! We'll circle back in a week with more on payer strategy.

UPDATE: we explain the correct answer in the comments. We’re having fun with these polls! Last week’s question stumped many pharma professionals. This week’s question looks into formulary exclusions, copay maximizers, and patient assistance programs. What do you think; is this statement true or false? Be sure to check back in a week to find out the correct answer.

It's nice that drug price negotiations work to the patient's benefit for a change. Look at the comment below for an explanation of why!