Q & A with:

Robert Taketomo, Pharm.D, MBA
President & CEO
Ventegra, LLC

Who is Ventegra®?
Ventegra, focused on the delivery of pharmaceutical services that make paramount both transparency and flexibility, is backed by a stellar management team of veteran professionals representing both the managed care and pharmaceutical industries. Ventegra is the first Contracting Service Organization (CSO), offering an innovative solution for cost-efficient pharmaceutical services that maximizes the benefits for payors, providers, patients, and industry.

What is unique about Ventegra?
Ventegra is the first managed care Contracting Service Organization (CSO) or infrastructure vendor. We are a fully transparent contracting organization offering new approaches to Pharmacy Benefit Administration (PBA) services to better control rising drug benefit costs.

Is Ventegra a national organization?
Yes, we serve clients in all states and are not limited by any geographic boundary.

How long has Ventegra been in business?
Ventegra incorporated in 2004 and formally launched in January 2005.

Will Ventegra be there “tomorrow”?
Our growing Ventegra team has more than 300 combined years of expertise. We continue to experience sustained growth on a business model that resonates with our clients. With over 70 clients who work with close to 5 million lives, we are on a profitable growth trend that ensures our viability. This has set the stage for our goal to build a legacy...a legacy of a new delivery channel of cost-effective, quality healthcare.

How is Ventegra different from a Pharmacy Benefit Management (PBM) company?
Unlike PBMs, which are focused on the business of claims and mail order management, Ventegra is dedicated to delivery systems, processes and infrastructure that optimizes appropriate medication use. Tactically, PBMs are generally "all-inclusive" entities, whereas Ventegra ofers an "a la carte" approach to Pharmacy Benefit Administration services. With Ventegra, clients take back control and are assured of true transparency. Clients choose the services that best fit their needs. In addition, our transparency is guaranteed in our contracts with clients, suppliers and other vendors. Others may speak about transparency, but Ventegra guarantees it. Finally, Ventegra contracts with selected suppliers in order to aggregate volume and reward our clients with the best price and performance.

How is Ventegra different from a Group Purchasing Organization (GPO)?
Ventegra offers many more services than a GPO, across a wider spectrum of health care. While our contracting service for pharmaceuticals is an important aspect of our service portfolio, we also offer specialized services that include the Ventegra Injectable Program (VIP), an innovative solution to the injectable dilemma, and the Robo-Rebate system: a web-based pharmaceutical rebate management application that allows for full transparency. Our formulary and clinical programs provide unique systems and tools to optimize contract performance. Ventegra’s business model also extends beyond the segments that are covered by traditional GPOs. Finally, the process by which Ventegra engages our clients in the process is unique in the industry.

How is Ventegra different from a specialty pharmacy?
First and foremost, Ventegra is not a pharmacy nor does it take title to product. Specialty pharmacy has historically been a distribution solution, whereas, the Ventegra Injectable Program (VIP) was designed from the start to be a total management solution. All injectables are evaluated as “another dosage form of a drug” and processes to address distribution, claims administration, utilization management, formulary and rebate administration are delivered in an integrated manner. Ultimately, we offer an efficient solution for injectables providing integration across method of administration (e.g. oral, self-injected, administered by provider, infused) and location (e.g., home, office, clinic, hospital). Our clients and our experience in the PBM, health plan and provider settings will guide us in the development of these solutions.

How does Ventegra get its revenue?
Ventegra earns its revenue through administrative services, membership and program fees. A unique feature of the Ventegra business model is full transparency for our clients around (usually hidden) program fees and administrative service fees from industry. Ventegra does NOT engage in any spreads or margin differences between what is paid to providers and what is billed to payors (the "bill/pay" spread). We are advocates for a transparent fee-for-service solution.

What is the pricing for Ventegra services?
Many services are included as part of our agreements at a nominal, or no additional charge to our client. Additional programs and services are available for a fully disclosed charge to our clients.

What is full transparency Acquisition Cost-Based Mail Service (ACMS)?
Ventegra offers mail service at true cost! No longer do payors need to calculate AWP - ?% or costs based upon some fictitious Maximum Allowable Cost (MAC) that generates a hidden margin for suppliers. With true transparency, the actual contracted costs of brand and generic drug purchases are always known to our payors. The recent "AWP rollback" had NO impact on Ventegra clients using ACMS. Other payors were subject to adjustments on AWP rollback that creates a fictitious pricing scheme around branded pharmaceutical agents. Ventegra asks the question: what action did the PBMs take on behalf of their clients when the AWPs were initially inflated in 2003?

Who are Ventegra’s clients?
We are working with health plans, employers, employer coalitions, consumer-driven health programs, qualified medical service organizations and Health Saving Accounts, as well as other pharmacy benefit administrators or entities with downside risk. With healthcare reform, we believe the Ventegra model is especially conducive to supporting the development and growth of Accountable Care Organizations.

What is Ventegra’s pharmaceutical contract portfolio?
Ventegra has acquired a large number of key pharmaceutical contracts, encompassing injectable/specialty drugs and oral drugs (brand name and generics) and over-the-counter products. We manage a very robust portfolio of contracts for injectable drugs due to our injectable management capabilities and injectable formulary. We have also entered into durable medical equipment products with a special focus on testing supplies and systems for diabetes. Ventegra is continuing to grow our contract portfolio to provide our clients with very aggressive discounts and a robust spectrum of products to meet their business needs and the needs of their patients.

What is the pricing for drugs and what rebate incentives are available from Ventegra contracts?
This is dependent upon the degree of control, utilization management systems (e.g. formulary controls, benefit designs) and interest by the payor. We are capable of modeling “what if” scenarios for clients to extrapolate the impact to their drug costs if they choose to work with Ventegra.

How does Ventegra avoid “double-dipping” of dollar incentives?
Ventegra evaluates every client and addresses any potential scenarios of “double-dipping.” Our focus is on the ultimate payor, and we avoid situations where there are multiple levels of intermediate aggregators (not uncommon in the PBM industry). We ensure there is sufficient contractual language in our agreements to protect our suppliers from this practice. Finally, our transparency and granularity around clients ensures that the manufacturer is fully aware of the ultimate payor. With this information, manufacturers will be in position to validate the contract compliance of Ventegra clients.

How many formularies does Ventegra have?
Ventegra launched its Consumer Edition Formularies in January 2006. We currently offer three different commercial formularies – Preferred, Premium, and Premium Plus. We also have one Medicare Advantage preferred products list (not applicable to Part D Prescription Drug Programs) and have developed a specific formulary for the hospice and long-term care segments. Finally, we offer a single Injectable Formulary that overlays all of these formularies for traditional drugs.

How do Ventegra’s three commercial formularies differ?
The three formularies that make up the 2010-2011 Ventegra Drug Formulary – Consumer Edition consist of Preferred, Premium, and Premium Plus. The Preferred formulary consists of basic generic and brand drugs that cover all of the significant therapeutic categories and can be considered a "closed" formulary. The Premium formulary contains all drugs in the Preferred formulary plus additional selected cost-effective brand drugs ("managed formulary"). The Premium Plus formulary contains all drugs in the Premium formulary plus a larger number of branded products for a more robust formulary offering ("open formulary").

Are Ventegra’s formularies open or closed?
The Ventegra formularies cover a spectrum of control, ranging from the basic drugs covering all of the significant therapeutic categories to our robust Premium Plus formulary. For all of our drug formularies, our Clinical Advisory Committee (CAC) oversees the recommendations of adding, deleting, and the positioning of drugs. Most importantly, through its foluc on "appropriate medication use," Ventegra is continually adding new innovations in systems, processes, and infrastructure to educate payors, patients, and providers about the advantages and opportunities surrounding use of preferred formulary agents. This has allowed Ventegra to develop a documented history of performance on contract compliance and pull through that maximizes returns on available discounts for Ventegra clients.

Can clients pick and choose formulary products?
Ventegra clients are paneled to one of Ventegra's formularies, but the client retains the right to approve any changes. Because we engage our clients in the contracting and formulary development process, we have an extremely high rate of formulary compliance (almost 100%). With Ventegra's client-driven formulary process, we are continually customizing it to fit changing needs. We offer the services of our highly qualified clinical team to work with you.

How are drugs added or deleted from the Ventegra formulary?
Ventegra has formed our Clinical Advisory Committee (CAC) to advise on drug formularies, preferred drugs and clinical programs related to our formularies. The mission of the CAC is to promote quality, safe and cost-effective drug therapy that reflects community and national standards of practice.

What are Ventegra’s goals and vision for the future?
Now that we have reached a profitable state and have validated our business model over our first five years, we will now focus on further growth in clients and infrastructure. We are coming to the realizeation that, as Ventegra evolves, we are starting to look less like anything else on the market. Thus, our biggest challenge will be in explaining our capabilities and systems to potential customers whose mindset is based upon current paradigms. Over the next five years, Ventegra will expand its programs, products and services to address the issues and challenges faced by a broader segment of the healthcare industry. We look forward to the new opportunities created by efforts at healthcare reform. Over time, our customer base will broaden and new channels will be developed that are integrated, more efficient, less fragmented, and provides higher quality care at a reasonable cost.