The Pharmacy Drug Cost Puzzle

Finding and Fitting the Missing Pieces Together                  puzzle3

Approximately 100 New Mexico business owners, employers and industry representatives spent May 2, 2017 at the New Mexico Coalition for Healthcare Value's “The Pharmacy Drug Cost Puzzle – Finding and Fitting the Missing Pieces Together” Summit, hearing what one described as “a prescription for alleviating the headache of rising drug costs.” 

Coalition organizers said the Summit’s intent was to give New Mexico employers an up-to-date look at the ever-growing costs of prescription medications, a major concern for patients, providers, insurers and employers, 

Organizers said the increasing cost of prescription medications take up an estimated 20 percent of overall personal health care service costs paid by employers and insurers. Last year alone, estimates show spending increased 13 percent, with the overall price tag for prescription drugs roughly at $225 billion.

 “Instead of lamenting the issue, the New Mexico Coalition for Healthcare Value hosted this summit to provide New Mexicans with an overview of pharmacy cost issues, what the pharmaceutical drug spending is in the U.S., and what the situation is in New Mexico,” Coalition Executive Director Patricia Montoya said.

She said prescription drug costs have become a source of growing concern for patients, prescribers, payers and policymakers.

Keynote Speaker Sumit Dutta, chief medial officer for Optum RX centered his presentation on the role of pharmacy benefit management organizations which use their collective buying power to obtain discounts from pharmacies and rebates from drugmakers.

“Our organization employs doctors, pharmacists and data analysts who are focused on researching and making recommendations on the safety and efficacy of medications to avoid health risks and reduce financial impacts for people,” Dutta said.

NM Coalition Members can access videos of Summit presenters and all of the presentations by clicking on the "Membership" tab on the website and following the instructions.

Review our updated agenda! (skip to agenda)


Date:  Tuesday, May 2, 2017

Images From the Event

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8:30 –8:40 a.m.      
Welcome and Introductions

  • Pat Montoya, MPA, BSN, Executive Director, New Mexico Coalition for Healthcare Value
  • Mark Saiz, CGBA, HR Benefits Director, City of Albuquerque & Chair of New Mexico Coalition for Healthcare Value

8:40 –10:10 a.m.     
National Pharmacy Costs and Trends (Keynoters)

  • Sumit Dutta MD, SVP & Chief Medical Officer, OptumRx
  • David Uldricks, JD, LLM, Vice President, PBM Contracting and Strategy, Employers Health

10:10 – 10:30 a.m

10:30 –11:40 a.m. 
Overview on Pharmacy Costs from a New Mexico Perspective

  • Jenny Felmley, PhD, Program Evaluator,  New Mexico Legislative Finance Committee
  • Nancy Smith-Leslie, Director, Medical Assistance Division, New Mexico Human Services Department
  • Gary Petersen, FCA, ASA, MAAA, Vice President & Consulting Actuary, Segal
  • Kipp Snider, JD, Vice President, State Advocacy, PhRMA

11:40 –12:20 p.m.  
What is a PBM?

  • Vyas  Kautook, PharmD, RPh, Senior Pharmacy Consultant, National   Pharmacy Benefits Practice, Segal

What is the role of the Retail Pharmacist in the Community?

  • Pat Harvey, RPh, Senior Strategic Account Manager, Walgreens

12:20 –12:40 p.m.    
Lunch Break (pick up box lunches)

12:40 –1:40 p.m.     
Pharmacist Panel: Health Insurers (What are local health plans doing to contain pharmacy costs?)

  • Louanne Cunico, PharmD, RPh, Vice President of Pharmacy, Presbyterian Health Plan
  • Frank Koronkiewicz, RPh, MHA, Director of Pharmacy, Molina Healthcare New Mexico
  • Shawn Quinn, PharmD, RPh, Director of Pharmacy, Blue Cross Blue Shield New Mexico
  • Frieda Siminski, PharmD, RPh, Director of Pharmacy, New Mexico Health Connections

1:40 –2:20 p.m.       
Strategies for drug management cost: Prior Authorization

  • Mike McGinnity, Vice President of Sales and Marketing, Health Information Designs, LLC

Group Purchasing

  • Sam Shalala , MBA, Director of Business Development, Employers Health

2:20-2:30 p.m.       
Wrap up and next steps

  • Pat Montoya, MPA, BSN, Executive Director, New Mexico Coalition for Healthcare Value

Society for Human Resource Management (SHRM) credits are available to participants who would like or need these for their certification.