“Big Four” Pharmaceutical Pricing Boot Camp

Pre-Conference Workshop AMonday, May 16, 2011

1:00 p.m. to 4:30 p.m. (Registration begins at 12:00 p.m.)

“Big Four” Pricing 101

Marci Anderson
Senior Auditor,
VA Office of Inspector General (Jacksonville, NC)

Michael Grivnovics
Director,
Federal Supply Schedule Division,
Office of Contract Review, VA Office of Inspector General (Washington, DC)

Jennifer L. Plitsch
Of Counsel,
Covington & Burling LLP (Washington, DC)

This workshop will provide an overview of pricing for the “Big Four” agencies and will prepare you for the more in-depth discussions that will take place throughout the conference.

• The Department of Veterans Affairs’ delegated authority for GSA FSS pharmaceutical contracts
• Veterans Health Care Act (VHCA) pharmaceutical programs
  • PHS 340B
  • Federal Ceiling Price
  • Pharmacy benefi ts management programs national formularies
  • VA National Formulary
  • DoD Uniform Formulary
• The “Big Four:” who are they and what do they do?
  • Veterans Affairs (VA)
  • Department of Defense (DoD)
  • Public Health Services (PHS) including the Indian Health Service
  • Coast Guard
• Omnibus Budget Reconciliation Act (OBRA)
  • relationship of OBRA to Medicaid rebate
  • relationship of Medicaid rebate to “Big Four” pharmaceutical procurement programs
• Veterans Health Care Act of 1992 (VHCA)
  • what is its scope and role in government pharmaceutical procurement?
  • introduction to Section 602 pricing for PHS covered entities
  • Section 603 – authorization for the VA to negotiate drug prices
• Comparing the different definitions given to key terms under each discount program
• Exploring the Federal Supply Schedule relative to pharmaceutical government contracting
• The mechanics of supply schedule contracts
  • multiple award schedule (MAS)
  • indefinite delivery-indefi nite quantity (IDIQ)
  • FAR Part 8 – rules for purchasing off the FSS
• Understanding VA’s authority over all pharmaceutical FSS contracts
• The Federal Acquisition Regulations a/k/a “The FAR” understanding the cornerstone of government procurement regulation and its relationship to “Big Four” contracting
• Adhering to mandatory reporting requirements
  • accurately completing the CSP sheets
  • disclosure obligations
• Treaties by which GSA/FSS contracts are bound
  • Trade Agreements Act
  • Buy America Act
• Identifying FSS eligible entities
• Complying with FSS clauses regarding socioeconomic programs
• Entering into the Master Agreement (MA) and a Pharmaceutical Pricing Agreement (PPA)
• Introduction to the non-FAMP and FCP calculations
• Interacting with the VA and understanding the agency’s structure
  • how is the Department of Veterans Affairs organized: identifying key offices in government pharmaceutical contracting and negotiating
  • Office of Acquisition and Logistics (OA&L)
  • Federal Supply Schedule Service
  • Pharmaceutical benefit management
  • Office of the Inspector General

Post-Conference Workshop BThursday, May 19, 2011

9:00 a.m. – 12:00 p.m. (Registration begins at 8:15 a.m.)

Advanced Training in DoD and TRICARE Contracting, Formulary, and Operational Issues

Lisa C. McNair
Senior Manager of TRICARE
Contracting Compliance Implementation Services (Media, PA)

This workshop will take a more in-depth look at manufacturer interactions with the DoD and the TRICARE program. This hands-on session will enable you to maximize business opportunities with the DoD and will allow you to manage DoD and TRICARE operations more effectively and efficiently.

• Mapping out an organizational chart of the DoD and TMA offices and key contacts within each office
• Defining the roles and responsibilities of the different offices
  • recognizing which departments handle different problems −or questions
• Navigating the DoD and TMA websites
• Contracting with the DoD
  • what is the difference between DoD DAPAs (Distribution −and Pricing Agreements) and the FSS schedule?
    • is a DAPA necessary to have the DoD cover your products?
• How does TRICARE know when there a new product is available?
  • what coordination efforts, if any, are there between the VA and the DoD?
• How are new products handled by the DoD and TRICARE?
• How are transfer products handled by the DoD and TRICARE?
  • how do you get a transferred product moved onto the right contract?
• Advanced formulary considerations
  • understanding the relationship between the TRICARE −formulary and MTF (Military Treatment Facilities) formularies
  • staying abreast of formulary product reviews
    • taking advantage of opportunities to meet with the P&T committee
• best practices for in-person presentations
• Managing TRICARE rebates
• identifying allowable exclusions
  • how does the DoD plan to handle these disputes?
• proactive reviews of TRICARE invoices to prevent unnecessary payments
• reconciling invoices with utilization data
• training on the MAR system​

- Actions -

- Share -