Paying for Cures:

Self-Insured Employers Workshop

Learn innovative financing strategies to make cell and gene therapies accessible
and sustainable.

Paying for Cures:

Self-Insured Employers Workshop

Learn innovative financing strategies to make cell and gene therapies accessible
and sustainable.

Durable, potentially curative therapies for genetic disorders and cancer have arrived. Short—even single dose—treatment regimens yield lasting health benefits, but large single payments will challenge the current reimbursement system.

In this virtual workshop the FoCUS Project will help you explore the impact of cell and gene therapies on your health benefit plans, survey the risks, and learn about solutions.

June 17, 2021

11:00am – 3:00pm Eastern via Web conference

Registration is free

This intensive 1-day virtual workshop will help you:

Understand how these therapies are different
Explore new solutions and support resources
Discover actionable and affordable steps to ensure sustainable coverage and access

Ideal for:

Self-insured employer health benefits and finance professionals
Other advisors and partners such as self-insured employer brokers, consultants and stop-loss carriers

Hosted by MIT Center for Biomedical Innovation NEWDIGS Initiative

Workshop archive

Workshop recordings
Highlights from the workshop are shared here, and full workshop session recordings are included below in the agenda.

What to expect from consultants

Key takeaways

4 E's employers should think about

Self-Insured Employers Workshop Presentation

You can now download the archive of decks presented in the workshop.

Get the presentation archive

New White Paper: Emerging Market Solutions

Our research and analysis based on a survey of solution providers shows what's available, what's missing, and what might fit your needs.

Get the white paper

Precision Financing Strategies Toolkit

Learn more about the challenges, potential solutions, and with interactive calculators, how to assess your risk and plan for the future,

Visit the Toolkit

Agenda

Welcome and introductions

Framing the issues
Introduction to FoCUS, and to the unique challenges/risks cell & gene therapies present to self-insured employers.

Jane Barlow, Senior Advisor, NEWDIGS FoCUS Project

Framing the solutions
Precision financing solutions, including the free Paying for Cures online toolkit, to address risks of currently approved treatments and near-term pipeline of expected products.

Mark Trusheim, Strategic Director, NEWDIGS; FoCUS Project Lead; Visiting Scientist at MIT Sloan School of Management

Implications of cell & gene therapies on stop-loss coverage

Mehb Khoja, Chief Actuary at BCS Financial and President of Medical Risk Managers

New commercial solutions

Michelle Harika, Chief Clinical Officer for Equity Healthcare

Panel & Discussion

Actions self-insured employers can take today

Mark Trusheim, MIT NEWDIGS and moderator
Michelle Harika, Chief Clinical Officer for Equity Healthcare
Mehb Khoja, Chief Actuary at BCS Financial and President of Medical Risk Managers
Cynthia Pigg, Senior Vice President, AON
Luke Prettol, Lead Benefits Strategy Consultant at AT&T

Thanks and conclusion

Jane Barlow, Senior Advisor, NEWDIGS FoCUS Project

Agenda

Welcome and introductions

Mark Trusheim, Strategic Director, NEWDIGS; FoCUS Project Lead; Visiting Scientist at MIT Sloan School of Management
Gigi Hirsch, Executive Director, MIT Center for Biomedical Innovation (CBI); Director, NEWDIGS Initiative at MIT

Framing the Issues
Definition of Cell and Gene Therapies and their unique challenges/risks for self-insured employers including toolkit.

Mark Hansan, President and CEO, CareMetx

Drug development pipeline
Currently approved treatments and near-term pipeline of expected products

Colin Young, Director, Drug Development Pipeline Research, NEWDIGS FoCUS Project

Implications for stop-loss coverage

Jane Barlow, Senior Advisor, NEWDIGS FoCUS Project and Moderator

New commercial solutions

Jane Barlow, Senior Advisor, NEWDIGS FoCUS Project and Moderator

PANEL & DISCUSSION

Actions self-insured employers can take today

Jane Barlow, Senior Advisor, NEWDIGS FoCUS Project and Moderator

Recap and conclusion

Mark Trusheim, Strategic Director, NEWDIGS; FoCUS Project Lead; Visiting Scientist at MIT Sloan School of Management

Speakers

Jane F. Barlow, MD, MBA, MPH
CEO, Jane Barlow & Associates;
EVP and Chief Clinical Officer, Real Endpoints;
Senior Advisor, MIT Center for Biomedical Innovation, NEWDIGS

Dr. Jane Barlow is a clinical and strategic executive consultant with over 25 years of healthcare leadership experience. She is Chief Clinical Officer of Real Endpoints, a market access company and serves as Senior Advisor to the MIT Center for Biomedical Innovation project on Financing of Curative Therapies. Dr. Barlow focuses on evaluating the economic impact and value of pharmaceuticals and diagnostics to aid in defining access and coverage strategies with a focus on outcomes and innovative contracting.

Dr. Barlow previously held senior leadership positions at CVS Health, Medco Health Solutions and IBM. Her diverse background also includes positions with the U.S. military, federal government, industry and private practice.

Dr. Barlow attended medical school at Creighton University and completed her residency training in occupational medicine at Johns Hopkins University. She holds masters’ degrees in business administration and public health and is a Certified Physician Executive with a certificate in Health Information Technology from the American College of Physician Executives. Dr. Barlow is board-certified in occupational medicine and is a fellow of both the American College of Occupational and Environmental Medicine and the American College of Preventive Medicine.

Michelle Harika, PharmD
Chief Clinical Officer for Equity Healthcare

Michelle Harika, PharmD, is Chief Clinical Officer for Equity Healthcare, where she is responsible for oversight and performance of a customized clinical care model operated by multiple vendors. Dr. Harika also leads improvement initiatives designed to improve employee health, generate savings and increase value to Equity Healthcare’s member companies. Prior to coming to Equity Healthcare, Dr. Harika practiced pharmacy with a specialty in diabetes management followed by 10 years with Anthem where she was responsible for clinical program performance and improvement strategies. Outside of work, Dr. Harika serves on the board for the Richmond Pharmacists Association and is an active volunteer for the Virginia Medical Corps, but her favorite activity is spending time with her family.

Mehb Khoja
Chief Actuary at BCS Financial and President of Medical Risk Managers

Mehb Khoja is the President of Medical Risk Managers and Chief Actuary of BCS Financial. Mehb is a Fellow of the Society of Actuaries and joined MRM in 2018. Since that time, Mehb has managed MRM’s largest relationships and cultivated new opportunities with some of the country’s largest insurance carriers. Prior to joining MRM, Mehb had various consulting roles within the employer stop loss industry consulting to both employers and to employer stop loss carriers. Mehb spent 14 years at Mercer as an employee benefit consultant. In that role, he lead Mercer’s Stop Loss Center of Excellence (Central Market) – a team tasked with placing/procuring stop loss coverage for all of Mercer’s stop loss clients in the Central and Southern markets (nearly $500M of annual premiums out of Mercer’s $1.2B in annual placements at the time).

After a successful career at Mercer, Mehb went to actuarial consulting firm Milliman in Chicago. There, he focused on consulting to employer stop loss carriers (both third party and health plans). Mehb created the inaugural version of the Milliman Employer Stop Loss Survey - the largest industry survey ever.

MRM was acquired by BCS Financial in October 2020 and with the acqusition Mehb has duel roles as President of MRM and Chief Actuary of BCS Financial.

Mehb’s background as an actuary and employee benefit consultant makes him well suited to lead the team at MRM as well as the actuarial and underwriting teams at BCS. He is a frequent speaker at industry events, a volunteer with the Society of Actuaries and has published several pieces on the employer stop loss market.

Cynthia J. Pigg, BSMT, BSPharm, MHA, FAMCP
Senior Vice President, Commercial Market Leader, Pharmacy, AON

Cynthia serves as a senior vice president at Aon, where she leads the Health Solution’s commercial pharmacy employer team. In this role, she is charged with bringing innovative pharmacy solutions to employers seeking a direct, non-coalition solution, including strategy, vendor selection and management, financial negotiations, and ongoing client management. Cynthia is a pioneer in the pharmacy benefit management industry and has more than 30 years of experience as a pharmacist and as a healthcare executive leading actions to assist payers in maximizing their investment in pharmaceuticals across medical and pharmacy benefits.

Throughout her career, Cynthia has held executive level strategic and operational roles in a variety of healthcare settings including CIGNA Healthcare where she led Trade Relations, Magellan Health and Gateway Health where she served as the SVP of Pharmacy and the Chief Pharmacy Officer, the Academy of Managed Care Pharmacy Foundation where she served as CEO and Cardinal Health where she led the Managed Care department. She is a past president and chairman of the board of the Academy of Managed Care Pharmacy as well as a past president and chairman of the board of the Academy’s foundation. Cynthia is a nationally acclaimed speaker regarding a broad range of pharmacy topics including specialty pharmacy, pharmaceutical pricing, public policy and quality improvement. She also serves as a Director on the Board of the Pharmacy Quality Alliance (PQA).

Cynthia received the “Distinguished Service Award” from the Academy of Managed Care Pharmacy, recognizing her sustained contributions to the Academy. She has also been elected as a Fellow of the Academy of Managed Care Pharmacy, recognized for her sustained excellence in the pharmacy profession.

Cynthia earned Bachelor of Science degrees in Pharmacy and Medical Technology from Virginia Commonwealth University/Medical College of Virginia where she was elected to Phi Kappa Phi. She also received her master’s degree in healthcare administration from Virginia Commonwealth University.

Cynthia is a member of the Academy of Managed Care Pharmacy, the Business Group on Health, the Women’s Business League, the American College of Healthcare Executives and is a licensed pharmacist in the Commonwealth of Virginia.

Luke Prettol, CEBS HCS PHR
Lead Benefits Strategy Consultant at AT&T

Mark Trusheim, MS
Strategic Director, NEWDIGS;
Visiting Scientist, Sloan School of Management,
Massachusetts Institute of Technology

Mark Trusheim is a Visiting Scientist and Executive-In-Residence at the MIT Sloan School of Management. He has been a Special Government Employee for the FDA’s Office of the Commissioner and is the Founder and President of Co-Bio Consulting, LLC. He holds degrees in Chemistry from Stanford University and Management from MIT. His research focuses on the economics of stratified (personalized) medicines, particularly the integrated quantitative modeling of stratified medicine development and commercialization, to inform public policy, corporate strategy and individual product development programs. Together with the FDA and industry, he led a multi-disciplinary consortium to examine the economic challenges of co-development of companion diagnostics and therapeutics whose work was covered by the Nature Review Drug Discovery.

In addition, he has been a frequent invited speaker on stratified medicine at international conferences and conducts confidential workshops and analyses for biopharmaceutical and diagnostic firms. Prior to his work in stratified medicine, he was a Board Member and Interim President of the Massachusetts Biotechnology Council. As an entrepreneur, he founded and was the first President and CEO of Cantata Laboratories which developed and marketed biochemical profiling clinical diagnostics and pharmaceutical biomarker services.

Prior to Cantata, he worked at Monsanto/Pharmacia, culminating his career there as Co-President and Chief Operating Officer of Cereon Genomics, LLC-a 5 year, $500M collaboration with Millennium Pharmaceuticals, and held roles of Vice President in the Health & Wellness Sector, Marketing Director in Searle Pharmaceutical and Director in Agriculture Division Strategy. He spent the first half of his career in the high tech industry at both Wang Laboratories in computer hardware and the start-up Kenan Systems Corporation which focused on developing quantitative models and artificial intelligence based applications for large corporations and government agencies.

Agenda

Welcome and introductions

Framing the Issues
Definition of Cell and Gene Therapies and their unique challenges/risks for self-insured employers including toolkit.

Mark Hansan, President and CEO, CareMetx

Drug development pipeline
Currently approved treatments and near-term pipeline of expected products

Colin Young, Director, Drug Development Pipeline Research, NEWDIGS FoCUS Project

Implications for stop-loss coverage

Jane Barlow, Senior Advisor, NEWDIGS FoCUS Project and Moderator

New commercial solutions

Jane Barlow, Senior Advisor, NEWDIGS FoCUS Project and Moderator

PANEL & DISCUSSION

Actions self-insured employers can take today

Jane Barlow, Senior Advisor, NEWDIGS FoCUS Project and Moderator

Recap and conclusion

Mark Trusheim, Strategic Director, NEWDIGS; FoCUS Project Lead; Visiting Scientist at MIT Sloan School of Management

Registration

June 17, 11:00am – 3:00pm
Zoom Web conference
Registration is free

Paying for Cures:

Self-Insured Employers Workshop

Learn innovative financing strategies to make cell and gene therapies accessible and sustainable.

Paying for Cures:

Self-Insured Employers Workshop

Learn innovative financing strategies to make cell and gene therapies accessibleand sustainable.

June 17, 2021

Welcome and introductions

Panel & Discussion

PANEL & DISCUSSION

PANEL & DISCUSSION

Learn innovative financing strategies to make cell and gene therapies accessible
and sustainable.

Learn innovative financing strategies to make cell and gene therapies accessible
and sustainable.