(Self-Paced Program)

Self-Study Courses

Pharmacy Benefit Institute of America (PBIA) self-study courses are ideal for anyone who wants to break into pharmacy benefits, gain more salary negotiation leverage, become more competitive in the job market or for those already in the industry who want to become a better consultant or plan administrator. PBIA courses are ideal for HR, benefit brokers, consultants, finance, procurement and pharmacists wanting keen insight into pharmacy benefits management beyond its functional role in healthcare. Continuous learning gets people promoted and gives them an advantage over competitors both external and internal. There are seven courses each available in GoToTraining, which provides 24/7 access to the course curriculum. Courses are online, self-paced and allow students up to one year to complete. The online courses consist of on- demand recordings, supporting documents, quizzes, practice exams, capstone project, and a final exam. Upon completing any one of the self-study courses, students receive a certificate of completion representing professional academic achievement recognized by clients and peers especially when added to social media profile like LinkedIn. Most of the courses offer continuing education credits to maintain state licenses, SHRM, and HRCI certification credits.
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Introduction to Pharmacy Benefit
Management (ONLINE)

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  • Outline pharmacy benefit
    management (PBM) business
    operations and objectives.
  • Identify the services that PBMs provide and discuss why they are needed.
  • Explain the PBM revenue model.
  • Provide brief history of PBMs and their evolution.
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Benefit Design for the Pharmacy
Benefit (ONLINE)

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  • Identify utilization management
    tools for designing a clinically
    appropriate and cost-effective plan.
  • Describe how plan sponsors typically structure and manage cost-sharing.
  • Discuss cost, access, and patient preference in mail and retail network pharmacy channels.
  • Describe effective and clinically appropriate formulary management practices.
  • Design a cost-effective plan which optimizes healthcare outcomes while eliminating waste.
cpbs_self

Introduction to Pharmacy Benefit
Management (ONLINE)

cpbs_self
  • Outline pharmacy benefit
    management (PBM) business
    operations and objectives.
  • Identify the services that PBMs provide and discuss why they are needed.
  • Explain the PBM revenue model.
  • Provide brief history of PBMs and their evolution.

Fundamentals of PBM Pricing
(ONLINE)

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  • Describe the key pricing terms
    and their applications.
  • Explain the pharmaceutical
    reimbursement and supply chain.
  • Discuss pharmacy benefit management trend components.
  • List PBM hidden cash flow streams.
  • Establish internal benchmarks.
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Benefit Design for the Pharmacy
Benefit (ONLINE)

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  • Identify utilization management
    tools for designing a clinically
    appropriate and cost-effective plan.
  • Describe how plan sponsors typically structure and manage cost-sharing.
  • Discuss cost, access, and patient preference in mail and retail network pharmacy channels.
  • Describe effective and clinically appropriate formulary management practices.
  • Design a cost-effective plan which optimizes healthcare outcomes while eliminating waste.
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Cost-Containment Strategies for
the Pharmacy Benefit (ONLINE)

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  • Define and explain why cost
    containment is important.
  • Identify the main components of PBM revenue and how they are used in reimbursement to the dispensing pharmacies.
  • List the features and describe the effects of various cost containment tools.
  • Discuss how health plan enrollees respond to cost containment strategies.
  • Formulate payer strategies to achieve lowest net cost for PBM services.
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PBM Contracts (ONLINE)

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  • Describe the elements of PBM
    contracts with pharmacies,
    manufacturers, and plan sponsors
  • Discuss key stakeholders and contractual arrangements between pharmacies, manufacturers, pharmacy benefit managers, plan sponsors, and members.
  • List important considerations of a pharmacy benefit management contract.
  • Discuss important contracting considerations for plan sponsors.
  • Design best practices for PBM contract pricing.
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Specialty Pharmacy Benefits
Management (ONLINE)

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  • Explain how specialty drugs are
    priced for contracting purposes.
  • Describe the different specialty drug disease states and how they may affect plan goals.
  • List pathways to specialty access.
  • Map how drug benefit design applies to specialty drugs
  • Discuss key differences in the administration of specialty drugs under the pharmacy and medical benefits.
  • Explain differences in utilization and cost by site of care and how plans influence use of various channels.
  • Discuss and put into play best practices for optimal specialty utilization.
  • Identify manufacturer strategies to increase patient utilization.
  • Examine specialty distribution channels and clinical management of specialty drugs.
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PBM Contracts (ONLINE)

cpbs_self
  • Describe the elements of PBM
    contracts with pharmacies,
    manufacturers, and plan sponsors
  • Discuss key stakeholders and contractual arrangements between pharmacies, manufacturers, pharmacy benefit managers, plan sponsors, and members.
  • List important considerations of a pharmacy benefit management contract.
  • Discuss important contracting considerations for plan sponsors.
  • Design best practices for PBM contract pricing.
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PBM Procurement (ONLINE)

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  • Identify savings opportunities by
    developing visibility into the direct
    and indirect drug spend.
  • Expand awareness of the importance
    of PBM procurement and its influence
    on the bottom line.
  • Facilitate sourcing performance, reduce maverick spend, increase compliance and generate savings.
  • Explain the features and benefits of Request for Proposals (RFPs) and Reverse Auctions.
  • Explain the pros and cons of the various pricing arrangements: spread, pass-through and fiduciary.
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Specialty Pharmacy Benefits
Management (ONLINE)

cpbs_self
  • Explain how specialty drugs are
    priced for contracting purposes.
  • Describe the different specialty drug disease states and how they may affect plan goals.
  • List pathways to specialty access.
  • Map how drug benefit design applies to specialty drugs
  • Discuss key differences in the administration of specialty drugs under the pharmacy and medical benefits.
  • Explain differences in utilization and cost by site of care and how plans influence use of various channels.
  • Discuss and put into play best practices for optimal specialty utilization.
  • Identify manufacturer strategies to increase patient utilization.
  • Examine specialty distribution channels and clinical management of specialty drugs.
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Specialty Pharmacy Benefits
Management (ONLINE)

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Courses can be taken one at a time and most work towards earning the Certified Pharmacy Benefits Specialist® (CPBS) designation. Upon completion of all seven courses, students if they desire, can register for the CPBS final exam. Students will have 30 days from registration to complete the final exam and Capstone project. The fee for the final exam is $200 (waived for PBIA members). Lastly, PBIA members receive a savings of up to 25% off of PBIA course tuition and a plethora of resources that pair with continued professional success. If you are not a member, join PBIA today.

Courses can be taken one at a time and most work towards earning the Certified Pharmacy Benefits Specialist® (CPBS) designation. Upon completion of all seven courses, students if they desire, can register for the CPBS final exam. Students will have 30 days from registration to complete the final exam and Capstone project. The fee for the final exam is $200 (waived for PBIA members). Lastly, PBIA members receive a savings of up to 25% off of PBIA course tuition and a plethora of resources that pair with continued professional success. If you are not a member, join PBIA today.

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