“Episode 83: Is It Possible To Collaborate With A PBM Outside Of Drug Contracting? with Lisa Erwin of Aventria Health Group”
by Stacey Richter

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Lisa Erwin

Lisa R. Erwin specializes in Medicare Part D clinical program strategic and operational expertise with a strong focus on Quality and Star Ratings.  Among other positions, she serves as VP of Clinical Strategies for Aventria/Pinnacle Health Communications, a managed market agency. A common theme of Ms. Erwin’s 30-year pharmacy career encompassing long-term care, managed-care and hospital pharmacy has been a focus on improving the quality of medication utilization in the senior population. Most recently, Lisa held the position of Senior Director, Medicare Clinical Quality for Catamaran, a pharmacy benefit manager based in Schaumburg, Illinois. In her role at Catamaran, Lisa directed the company STAR ratings strategy and developed analytic and clinical intervention programs with an emphasis on close health plan client collaboration. She also has served as Pharmacy Director for Medicare Business at Blue Cross Blue Shield of Michigan, a provider of PDP and MAPD offerings. As Vice President, Clinical Operations for Omnicare, Inc., the largest institutional pharmacy provider in the United States, she oversaw the implementation of clinical and health management initiatives which were which were uniquely designed to serve 1.2 million residents of skilled facilities, assisted living and other institutions in 48 states.

Erwin is a graduate of the University of Michigan College of Pharmacy and has been credentialed as a Certified Geriatric Pharmacist by the Commission for Certification in Geriatric Pharmacy. She has served as a member of the ASCP Task Force on Medication Therapy Management and the Editorial Advisory Board for The Consultant Pharmacist journal.  Lisa held the position of co-chair of Stakeholder Advisory Panel (SAP-B) for the Pharmacy Quality Alliance (PQA) in 2015 and currently is an appointed member of the Measure Update Panel (MUP) for PQA.

00:00 Lisa Erwin explains what PBM stands for, and what Pharmacy Benefit Managers do.
02:00 Stacey and Lisa “follow the dollar”.
02:45 Achieving access in pharma.
03:15 How rebates work in pharma.
07:45 “Total cost of care matters.”
12:30 How PBMs acquire medical claims information.
16:00 How PBM star ratings work.
21:00 How PBMs assist plans with adherence.
23:15 What PBMs need from stakeholders.
25:50 How PBM incentives are aligned with pharmaceutical companies, despite a distinct separation of the two.
29:00 The lack of conversations around digital resources for PBMs.
30:00 Lisa offers her advice on the trend of relying on retail pharmacists.
33:00 “Retail pharmacy needs to rise to the challenge.”
33:40 A new vertical in pharma.
34:30 “PBMs are viewing themselves more and more as having an impact on the health of a member.”

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