Avalere Health
An Inovalon Company

Prepare for Changes in Patient Access to Biopharmaceuticals

Caroline F. Pearson , Kelly Brantley

September 19, 2013
1:00 PM - 2:00 PM EST

Co-sponsored by Avalere Health and the California Healthcare Institute

Join Avalere Health and CHI for a complimentary webinar exploring the varied approaches states are taking to implement exchanges and what it means for the life sciences and provider audience. Each state has had an opportunity to define the benefits and services that will be considered the "essential health benefits" package for plans in that state. These benefits and services required in each state will have an enormous influence over access to particular products—from pharmacy and medical benefit drugs to devices

As essential health benefits have taken shape, one category of benefits has been most clearly defined. Coverage of prescription drugs has more specific known requirements than other categories of covered benefits. Through a process counting unique chemical entities, issuers must meet the same class-by-class counts of the state-selected benchmark plan. Further, standardized plans in some states and recent rate filings in others are offering insight into expected cost-sharing parameters for exchange plans. Even so, after the 2014 plan year, benefit design in exchange plans will continue to evolve.

During this webinar, you will:

  • Learn the varied approaches states are taking to implement exchanges

  • Understand how the essential health benefit requirements apply to drug coverage
  • Gain insight into expected cost-sharing structures for exchange plans
  • Peek into predictions for future approaches to formulary coverage in exchange plans in later years


Avalere’s webinar series delivers insight and analysis on how healthcare developments will impact your bottom line.

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