Applied Policy joined more than 4,000 attendees at the Academy of Managed Care Pharmacy (AMCP) Annual Meeting from April 15-18 in New Orleans, Louisiana, to connect with fellow industry stakeholders (and to try beignets from the famous Café Du Monde). A key event for managed care pharmacy professionals, AMCP’s Annual Meeting brings together pharmacists, payers, manufacturers, providers, and industry partners at the forefront of managed care pharmacy innovation. Attendees could choose from a number of tracks at the conference, including drugs, diseases, and managed care impact; legislative and regulatory trends; and making the way for innovation tracks.
The Inflation Reduction Act (IRA) remains at the forefront of discussion. As we move toward 2025, when significant changes under the Part D benefit redesign will go into effect, stakeholders continue to navigate the interplay between patient access, formularies, and manufacturer considerations. These changes impact the liability of beneficiaries, manufacturers, and plans, adding a new dynamic to the already-complex interaction between these groups. In the nearer term, pharmaceutical stakeholders are anticipating the Centers for Medicare and Medicaid Services’ (CMS) announcement of the maximum fair price (MFP) for drugs subject to negotiation under the IRA’s Drug Price Negotiation Program by September 1, 2024. The numerous changes under IRA underscore the importance of adaptability in navigating the health policy landscape, with AMCP offering a space for stakeholders across the industry to connect on how to address these changes. In the session, “An Update on IRA: What’s your Perspective?” panelists highlighted an IRA policy that has previously flown under the radar- the Medicare Prescription Payment Plan (or “M3P”), which begins in 2025 and requires Medicare Part D plans to give enrollees the option to pay their out-of-pocket prescription drug costs in capped monthly installments rather than paying the full cost at the pharmacy.
Although stakeholders are busy with IRA implementation, additional legislative changes could be on the horizon at the end of this year in areas like PBM transparency, drug shortages, and biosimilar adoption and uptake.
The approval of two new cell and gene therapies, Casegevy and Lyfgenia, for sickle cell disease has underscored the need to address specialty drugs within the context of value-based care, prompting stakeholders to consider new reimbursement strategies and patient access pathways. Value-based contracting was a focus on the conference, as payers consider new ways to pay for high-cost therapies, such as outcomes-based agreements, that can have significant impacts on patient health.
Alongside value-based contracting considerations, incorporating the patient experience into discussions on value continues to be a key issue. Pharmacy stakeholders are continuing to recognize the importance of including the patient voice when evaluating outcomes and making coverage decisions, particularly as resources and best practices for engaging with patients continue to be developed. Across multiple sessions on patient engagement, the International Consortium for Health Outcomes Measurement (ICHOM) was reiterated as a resource for better understanding the outcomes that are most important to patients and how they can be used by healthcare decisionmakers. As Kimberly Westrich of the National Pharmaceutical Council noted in her panel “Innovative Approaches to Integrating the patient Experience”, full integration of the patient experience involves interaction with patients at all stages of decision-making.
In a keynote session “2023-2024 Health Care and Pharmaceutical Marketplace Trends”, Douglas Long of IQVIA highlighted a number of developments and trends in the pharmaceutical market, including the return of health services utilization to pre-COVID-19 levels; overall growth across the total pharmaceutical market; and expected increases in biosimilars uptake, as biosimilar sales begin to slowly rise. The growing use of novel anti-obesity GLP-1 drugs such as Ozempic and Mounjaro continues to be a hot topic, as adoption of and spending on these drugs continue to grow, and drug development continues to accelerate in this space. Long also highlighted how drug shortages may continue to persist and impact the pharmaceutical supply chain, with more shortages continuing to be reported rather than resolved. Applied Policy appreciated the opportunity to connect with colleagues on emerging industry trends. Keeping abreast of the latest developments in the complex landscape of managed care strengthens our expertise and positions us to best represent our clients’ interests.
Up next for AMCP, the 2024 AMCP Nexus meeting will be held in Las Vegas, Nevada from October 14-17, and the 2025 AMCP Annual meeting will be held in Houston, Texas from March 31- April 3.
Pictured above: Senior Health Policy Associate Emma Hammer and Health Policy Director Alison Falb