Coverage and Reimbursement for High-Cost Curative Therapeutics: Does a Solution Exist? - Nexus 2018

ACPE UAN #:  0233-0000-18-054-H04-P

Release DateOctober 23, 2018

Expiration Date:  October 23, 2021

Activity Type:    Knowledge-based

Contact Hours:  1.5

Activity Fee:  Member:  Free        Non-Member: $30

Target Audience: Pharmacists who practice in managed care settings.

Activity Description

More and more, managed care organizations are straddling the line between making new, innovative therapies available to their patients and ensuring they can cover the costs of these therapies. In many cases, the cost of these treatments may surpass any costs seen to date – and current methods of coverage determination and reimbursement may not be adequate.

Managed care organizations and the larger health care community will be challenged to work together to explore new economic models and break down barriers to ensure these innovative therapies are available to appropriate patients while addressing and offsetting the financial risk.  This timely session will provide an overview of potential new financing and reimbursement models and the role they could play fill for managed care organizations in the future.

Learning Objectives:  

At the completion of this activity, participants should be able to:

  1.   Identify at least two promising economic models for high-cost therapies.
  2.   Discuss the results of payer surveys regarding the need for – and key elements of – new financing tools for curative high-cost therapies.
  3.   Summarize perspectives from various payer segments on high-cost therapies and the benefits and challenges of various economic models.

Schedule of Educational Activity

This activity consists of an audio recording, pre-test assessment questions (not required to pass or continue), post-test questions (required to pass with a score of 70% or higher) and a specific activity evaluation. 


The Academy of Managed Care Pharmacy (AMCP) is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

As an accredited provider, AMCP strictly adheres to the ACPE Standards for Commercial Support and other relevant guidelines and standards to ensure the independence of continuing pharmacy education (CPE) activities.  It is AMCP’s intent that all CPE activities be independent, objective, balanced, evidence-based and free of any commercial bias.

CPE Requirements:   

Participants should claim continuing pharmacy education (CPE) credit for this home study activity only if they have not claimed credit for the live activity presented at AMCP Nexus 2018. 

CPE credit will be processed through the AMCP Learn portal and reported directly to CPE Monitor.  Please allow 72 hours for processing and posting in your NABP account.

To receive credit for an online activity you must:

  • Review the full content of the activity.
  • Successfully complete the post-test (required to pass with a score of 70% or higher, it may be taken a maximum of three times).
  • Complete a specific activity evaluation.


Jim Hopsicker, RPh, MBA | Vice President Pharmacy Programs | MVP Health Care | Schenectady, New York.

System Technical Requirements/Viewing Requirements: System Requirements Courses and learning activities are delivered via your Web browser and Acrobat PDF. For all activities, you should have a basic comfort level using a computer and navigating websites.  View the minimum technical and system requirements for continuing education online learning activities.

Credit Information

Activity Number Credit Amount Accreditation Period
ACPE UAN #0233-0000-18-054-H04-P 1.5 Contact Hours October 23, 2018 - October 23, 2021