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May 21, 2018 Issue

CEOCFO MAGAZINE

 

Artia Solutions LLC, a Consulting Firm Assisting Pharmaceutical Companies in Launching New Drugs and Promoting Access to Their Medications within the Medicaid Marketplace

 

 

George Kitchens, RPh

President

 

Artia Solutions LLC

www.artiasolutions.com

 

Interview conducted by:

Lynn Fosse, Senior Editor, CEOCFO Magazine, Published – May 21, 2018

 

CEOCFO: Mr. Kitchens, would you tell us about Artia Solutions?

Mr. Kitchens: Artia Solutions is a consulting firm based in Tallahassee, Florida, that specializes in assisting pharmaceutical companies in managing their U.S. Medicaid, VA/DoD, and Puerto Rico Medicaid business. We assist our clients in new drug launches by determining if they should be providing rebates for their drugs, and we also assist with any issue resolution that may impact access. We also provide guidance and operational help in both protecting and promoting access of their medications within the Medicaid marketplace.

 

CEOCFO: What are some of the lesser known challenges in the Medicaid market?

Mr. Kitchens: The complexity of Medicaid is what challenges every pharmaceutical company. All 50 states are different. There is a saying that goes: “If you have seen one state, you have seen one state.” Companies can either quickly expend too many resources when managing their Medicaid business, or they can underestimate the impact of working with Medicaid (i.e., how their drug status within Medicaid influences overall physician prescribing).

We have seen people on both sides—pharmaceutical companies and payers—not understanding their opportunity in Medicaid. Some underestimate the complexity by expending time and resources in certain states or areas when it was not necessary. Medicaid is a low-profit opportunity for pharmaceutical companies, but it is a necessary business to engage. Companies have to engage it wisely and be efficient in their processes if they want to participate in Medicaid. From cost perspective to the federal and state government’s influence and all of its nuances, it’s all crucial to understand so that Medicaid patients have access to medications.

It can also be challenging for the payers to have a comprehensive understanding of the value of the medication. The recent introduction of several expensive medications has many people focusing on pharmaceutical cost, while overlooking cost savings related to supportive help, provider costs, and even societal costs. Drugs that are now curing conditions add a new perspective to the value equation: durability. The status quo for coverage, reimbursement, and the determination of the overall value statement are now being challenged. There are no more quick fixes. Solutions will require multi-disciplinary teams that represent all major stakeholders. There is a bit of a conflict happening now where some still want to operate in the old system, and they may think they can take quick shortcuts in problem-solving. But that must change. At Artia Solutions, we help both pharmaceutical companies and payers understand the true value of the medication.

 

CEOCFO: How do you decide when the overall assessment is borderline?

Mr. Kitchens: When we have a “borderline” assessment, we do not know exactly how every drug is going to work in every patient. You and I are physiologically different. What may be beneficial or borderline beneficial for some patients (in a clinical study) may be different in the real world. We still need to allow physicians who know each patient and know the complexity of what they are dealing with, such as co-morbidities, etc., to say, “I think this drug has potential to be beneficial.” Therefore, a borderline could be beneficial to some patients. We have to be sensitive to that side of the equation, too.

 

CEOCFO: Are there many companies that specialize in this arena?

Mr. Kitchens: No—not to the level that we do. Not only do we provide strategic consulting and forecasting of access to their medications, but we are also operational. We are proactive, we talk with the states and the PBMs (Pharmacy Benefit Managers), and we help pharmaceutical companies position their drug so that the various state Medicaid can understand the value and financial information. Many of our clients appreciate that we live and breathe this work every day. We are working alongside them, and that provides a high level of confidence for us to say, “Here is what is going to happen,” or “here is what we predict your forecast will be.” We are confident in our consulting because we are working within it day-in and day-out.

 

CEOCFO: Do you have companies that routinely come to Artia Solutions when working on a new drug?

Mr. Kitchens: Yes. We have been in this industry for almost two decades, and we have gained the trust and confidence of the pharmaceutical industry. We are well-known because of the work we have done in the past and the results we continue to produce. There is a difference between someone telling a client: “Here is what Medicaid will do or will not do,” versus “This is how Medicaid works because we were just in a similar situation.” We provide the latter. We work alongside our clients as they begin to implement a new drug strategy. We are right there with our clients as long as they want us to be. Remember—there is not a lot of profit in Medicaid. Companies have to be extremely cost-effective, and they cannot dedicate a large staff to manage their Medicaid business. We help them to be targeted and effective. We do this every day—we complement our clients’ staff, fill in any gaps, and do the work that’s needed as they are trying to control their costs.

 

CEOCFO: How do you stay on top of not only the regulations in a given state but of the sentiment that might be leading to a change?

Mr. Kitchens: Several of the Artia Solutions staff are former Medicaid officials, but we don’t just rely on past experience. We are well-connected around the country with people whom I would consider to be thought leaders, and many are my former peers or people I have known for years. We converse with the states and the PBMs on a daily basis because gaining insight on their perspective is key. Not just insight on an individual drug—it could be their situation, or what they believe the states are wanting. Sometimes, their view is very different from what I see from my view, so it is helpful that we have these conversations. They don’t only understand the nitty-gritty detail on the state of the industry today, but they also are forecasting what the next two to five years may look like. Through these types of conversations, our daily work, listening to people in Washington and several lobbying firms that are knowledgeable and helpful, etc., we’ve created a network of people we trust. I’m thankful that I continue to learn something new every day.

 

CEOCFO: You offer a variety of services. Is it typically soup to nuts?

Mr. Kitchens: Our services are customized for each client, and many of our clients use our services from beginning to end because they find that it is an efficient way to measure a successful Medicaid business. Some of our clients have a small staff and need all of our services in order to manage their Medicaid or VA/DoD business. Some have a large staff and may only need a few services, but many of our clients expand their services over time. For example, a client may use our monitoring services daily but soon realize they need to add on our mobile app, the ARTIA app, for even more updates and information. When we begin our services with a new client, our first few conversations revolve around discovering what their needs are. We build a customizable and flexible plan for every client.

 

CEOCFO: Does a drug have to be available in all states when it becomes available?

Mr. Kitchens: Once a drug manufacturer has decided to participate in Medicaid and signed the CMS rebate agreement, the drug is technically covered in all states. However, the variances in access are impacted by utilization tools, such as Preferred Drug List status, new drug policy, and clinical prior authorizations.
 

CEOCFO: Are Medicaid requirements stricter than a Medicare program?

Mr. Kitchens: An outsider looking in may think Medicaid is more liberal, due to some of its more well-known policies and CMS rebates. However, the states are allowed to use different drug management tools to ensure that a particular drug is used properly and that there is not misuse and abuse or overuse—just like in a commercial plan or Medicare. It’s important to note that people typically only hear the gross cost—before rebates are paid—of drugs in Medicaid, and they’re alarmed. The rebates that are given to the states by the manufacturers are significant, and those rebates end up in the lower net cost, as compared to a commercial plan or Medicare D plan, and this dictates different decision-making. One may look at a Medicaid formulary (we call them “preferred drug business”) and think: “Wow. They have a lot of brands, and they’re not doing a good job of controlling their cost.” The reality is those brand drugs are much less costly than generics. The states are going a good job of controlling their drug cost. There is a huge disconnect in public perception. With rebates, Medicaid recipients typically have better access to brand drugs, compared to a commercial plan, because the net cost of brand drugs is less than generics.

 

CEOCFO: The tagline on your website is Consult, Guide, and Connect. Would you explain the Connect?

Mr. Kitchens: An important part of our business is the relationships we have with the drug manufacturers and the states. Many state pharmacy directors were my former peers, along with some of my staff members, so we assist in connecting the two. We set up meetings; we attend meetings with them in-person; we make phone calls. We are actively involved in making sure our clients are talking to or meeting with the right people at the right time. We take the lead and participate in this connection, if that is what our client requests.

 

CEOCFO: How is business?

Mr. Kitchens: Great! I have been in business for 13 years, and I have been blessed with a wonderful staff. When I just started out as a pharmacist who graduated from Samford University, I never would have thought that I could look back at my career and be amazed at where we are. I’m grateful for this business and the people I get to work with every day. I can say the same about working with the states and the PBMs—there are great people in this industry, and the job is very satisfying. It’s also amazing to see the groundbreaking work in the area of pharmaceuticals—gene therapy, biosimilars, etc. We’ve also recently announced our inaugural Medicaid conference, Crossroads, which will take place in Nashville, Tennessee, in November. We’re excited to bring together stakeholders from every side of the pharmaceutical industry to discuss patient access to medications. Crossroads will be the first event of its kind in this industry.

 

CEOCFO: Why is Artia Solutions an important company?

Mr. Kitchens: In today’s environment, you cannot afford a misstep in any particular business venture, especially in one as complex as Medicaid. Artia Solutions is there to assist, consult, guide and connect pharmaceutical companies and ensure they are maximizing their Medicaid business opportunity.

 


 

“In today’s environment, you cannot afford a misstep in any particular business venture, especially in one as complex as Medicaid. Artia Solutions is there to assist, consult, guide and connect pharmaceutical companies and ensure they are maximizing their Medicaid business opportunity.”
- George Kitchens, RPh


 

Artia Solutions LLC

www.artiasolutions.com

 

Contact:

Melody Kitchens

850-222-8456

mkitchens@artiasolutions.com



 


 

 



 

 

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