• Outline how access to health care will be expanded through health care reform
• Describe major mandates of health care reform on individuals, government and private insurers, and employers
• Review the timeline of changes outlined in the Patient Protection and Affordable Care Act and discuss how it may affect prescribing patterns
• Explain how, when, and through what funding expansions in health care coverage will be paid and its expected effect on the deficit
• Identify the key stakeholders who are affected through the implementation of the Patient Protection and Affordable Care Act
• Describe the impact to each key stakeholder affected by health care reform, and how each is expected to react to these changes
• Discuss the themes comprising the new pharmaceutical marketing and sales paradigm, and outline methods for substantiating value in a pharmaceutical product
• Summarize the roles of generic versus branded products under the new marketing and sales paradigm
• Identify health care reform imposed challenges to traditional sales and marketing efforts

• Describe the general history and eligibility requirements of Medicare and Medicaid
• Explain the four key components of Medicare: Parts A, B, C, and D
• Describe the Medicare Modernization Act of 2003 – or MMA – and its implications for key
  health care stakeholders
• Describe Medicare Prescription Drug Plans (PDPs) and Medicare Advantage Prescription
  Drug Plans (MA-PDs)
• Compare the standard Medicare Part D drug benefit design with plan designs marketed by
  drug plan sponsors
• Explain the implications of the MMA for key health care stakeholders

• List those aspects of organization and management that will help you determine the best sales approach and prioritize your time in each hospital
• Explain formulary types, approval processes, and best methods for gaining product acceptance for use in each of your target hospitals
• Discuss the restructuring that has occurred in the health care market and the effects of integrated delivery systems upon hospitals
• Describe the hierarchy in medical, surgical, nursing, and pharmaceutical staffs as well as positions held by other hospital personnel in specialty departments, and determine whether and how to sell to particular staff members
• Identify methodical planning by setting objectives for sales goals, analyzing hospital structures, maximizing your first visit, and locating and accessing key personnel
• Outline the sales techniques and practices that work best in hospitals, and determine how to apply the skills most likely to elicit the positive response required for success

• Summarize the various roles of the retail pharmacist
• Identify the activities that take place behind the pharmacy counter
• Describe the pharmacist’s role in drug selection
• Discuss drug adjudication procedures in today’s retail environment
• Demonstrate best practices for relationship-building with retail pharmacists

• Summarize the attributes and demographic trends in the U.S. senior care population
• Describe the settings in which senior care is provided
• Explain government and private sector coverage and reimbursement for senior care
• Summarize the important role of pharmaceuticals in senior care
• Identify key players in the senior care environment
• Describe the role of the pharmaceutical manufacturer in meeting the needs of senior care customers

• Assess your coaching skills in the context of today’s managed care environment
• Improve your district sales team’s selling skills in the managed care arena
• Observe and evaluate the skills of others when faced with managed care objections
• Differentiate judgmental observations from objective ones
• Provide effective one-on-one feedback
• Create strategies for handling the difficult managed care formulary situations
• Develop action plans that keep products near the physician’s top of mind in managed
  care settings
• Teach others to gain the willing commitment of physicians to change their managed
  care prescribing behaviors
• Enhance your coaching skills through “real world” role plays

• Describe the accountable care organization (ACO) model and how it developed
• Identify how the ACO model impacts health care delivery
• Demonstrate an understanding of the players within the ACO model
• Describe the relationship between health care reform and the ACO model
• Explain the reimbursement and payment methodologies within the ACO model
• Understand how the ACO model may impact your business

• Define patient-centered medical home (PCMH)
• Describe the principles of the PCMH
• Discuss the organizations supporting this model
• Demonstrate an understanding of the coordination of care concept
• Explain the reimbursement / payment mechanisms related to the PCMH
• Provide examples of private- and public-funded PCMHs
• Discuss the implications of the PCMH on the account managers

• Define specialty pharmaceuticals and profile the evolving specialty marketplace
• Explain the unique characteristics of the specialty market sector as they relate to market structure, key players, purchasing procedures, and distribution channels
• Describe reimbursement policies and practices for specialty pharmaceuticals, specifically as these policies relate to managed care pharmacy and medical benefits
• Summarize the provisions for specialty pharmaceuticals under Medicare
• Apply market-specific strategic and tactical selling issues in your day-to-day selling activities

• Describe the most common physician practice business models
• Discuss the data behind the trends
• Identify how the physician’s business model affects patient care and drug selection
• Define the relationship between the health plan and the practice
• Discuss hot-button issues like reimbursement schemes and quality measures
• Outline government’s impact on health care

• Outline the structure of the typical managed care health benefit design
• Track the flow of payer and consumer dollars through the health care system
• Describe the role of pharmacy benefit managers (PBMs) in the delivery of health care services
• Shape sales messages in ways that address managed care financial factors

• Define step edit
• Explain the rationale for the step edit process
• Outline the sequential phases that occur when a step edit is in effect
• Describe how prior authorization relates to the step edit process
• Effectively position any product that is subject to a step edit

The goal of this book is to serve as a resource for both the new and seasoned professional to put diagnosis, treatment, cost, and quality of patient care into context. This book focuses on the following:

• An overview of cancer, how it is diagnosed, and the major treatment modalities
• The health infrastructure that treats cancer (health care personnel, facilities, etc.)
  • Who diagnoses and treats cancer patients
  • Where cancer patients receive treatment
• The business of oncology
  • The types of practice structures in which cancer patients are treated
  • The types of inpatient treatment facilities available
  • The costs of treatment and payment structures available
• The push and pull of the hospital in treatment options
• The changes occurring in cancer treatment and care
  • The transformation of a cancer diagnosis from a terminal illness to a chronic disease and the impact this is having on the cost of patient care
• Overall familiarity with the business drivers and processes in oncology