AMCP Nexus: The Academy of Managed Care Pharmacy Nexus

As deductibles for Medicare Part D beneficiaries and enrollment continue to rise, new policies and reconciliation negotiations aimed at lowering costs may hold the key to stabilizing Part D plans, according to presenters at the Academy of Managed Care Pharmacy Nexus 2021 meeting.

Two posters presented at AMCP Nexus 2021 review the high burden of social determinants of health (SDOH) on patients with serious mental illness.

During her presentation at the Academy of Managed Care Pharmacy Nexus 2021 meeting, Aimee Tharaldson, PhD, highlighted the most anticipated specialty pharmacy drugs awaiting FDA approval, including several treatments for cancer and rare diseases.

Novel financial concepts will help to ensure sustainable access to gene and cell therapies, which may help reduce disparities, said Jane F. Barlow, MD, MPH, MBA, senior advisor, FoCUS Project, MIT Center for Biomedical Innovation, and executive vice president and chief clinical officer at Real Endpoints.

There are potential ways that precision medicine could exacerbate disparities, but it should be used to guide people to the right treatments, said Nick Page, chief clinical and strategy officer, and Patty Taddei-Allen, PharmD, MBA, BCACP, BCGP, vice president of clinical programs and services, WellDyne.

A panel discussion at AMCP Nexus 2021 explored the current biosimilar landscape and level of uptake, with survey results showing payers are accepting of biosimilars and that a majority support nonmedical switching.

A panel of experts highlighted a number of emerging product solutions that can help health plans overcome challenges associated with financing and reimbursing gene and cell therapies and offered insight into how these solutions can be expanded as more therapies enter the market.

Multiple trastuzumab biosimilars were approved and launched very quickly in the United States, which sets up an interesting scenario in the market to see the nuance of having multiple options available, said Cate Lockhart, PhD, PharmD, MS, program, director, Biologics and Biosimilars Collective Intelligence Consortium (BBCIC).

Large health system pharmacies need to first identify their own contributions to health care disparities before identifying areas of opportunity to address the issue, said Aimee Loucks, PharmD, manager, specialty clinical pharmacy programs and formulary, Kaiser Permanente.

A panel of experts at AMCP Nexus 2021 explored multiple ways that health plans and providers can begin to address disparities in health care and offered recommendations on how to implement these tactics effectively.

The fall meeting has multiple sessions on different aspects of health disparities and addressing drug costs, including 3 sessions on biosimilars.

Tackling disparities in diabetes management first requires collecting data and identifying affected groups before being able to take action, explained Brenden O'Hara, RPh, BCACP, from Blue Cross Blue Shield of North Carolina.

While sickle cell disease is not prevalent in the general population, the significant cost associated with the condition warrants action from payers and formulary decision makers to improve patient access and align cost with their budgetary goals.

In her presentation, Aimee Tharaldson, PhD, senior clinical pharmacist of emerging therapeutics at Express Scripts, discussed the upcoming pipeline of specialty drug approvals and their potential impact on the market.

In the current pipeline of specialty medications seeking approval, a majority of development lies within orphan drugs and cancer medications, said Aimee Tharaldson, PharmD, of Express Scripts.

The pressure on state budgets exerted by new approvals of costly therapeutics has led many states to implement legislation aimed at regulating drug prices, but the success of these efforts is not uniform across the nation.

Americans not covered by Medicaid should be aware of 2 key factors: the use of copay accumulators in commercial health plans and management of emerging high-cost specialty prescription drugs.

A collaborative effort between the health system and health plan pharmacists, as well as care managers and prescribers is key to improving clinical, quality outcomes in value-based payment models.

Pharmacists have an important role to play in the success of value-based payment models, according to panelists who discussed their health plan’s value initiatives at the Academy of Managed Care Pharmacy Nexus 2020 meeting.

For pharmacy practices to effectively manage specialty drugs, an extensive staff of pharmacists with clinical and managed care expertise is needed, as well as a collaborative effort between all those involved in the care team.

In a panel discussion at the Academy of Managed Care Pharmacy Nexus 2020 meeting, experts discussed driving factors of and barriers to the use of real-world evidence by payers in oncology decision-making.

In assessing a post–coronavirus disease 2019 (COVID-19) world, several aspects may impact managed care pharmacy practices long-term, including self-administration of therapies and issues in pharmacy reimbursement spotlighted by the pandemic.

A panel discussion examined the changes in the health care landscape occurring due to the coronavirus disease 2019 (COVID-19) pandemic, particularly around pharmacists’ scope of practice, and which changes are likely to persist after the pandemic.

Marty Makary, MD, MPH, kicked off the Academy of Managed Care Pharmacy Nexus 2020 meeting with a call to action around reducing overprescribing, increasing price transparency, and recapturing the public’s trust in the health care system.

Attendees at the Academy of Managed Care Pharmacy (AMCP) Nexus 2020 meeting will hear a keynote from a surgeon who has become more visible over the past year and a half discussing what he says are “structural problems” behind the cost of US health care.

With the virtual format of this year’s Academy of Managed Care Pharmacy (AMCP) Nexus 2020, there will be several sessions and novel features to look out for, including networking events, educational programming, and a keynote speech.

A preview of some of the topics that will appear at next week’s Academy of Managed Care Pharmacy (AMCP) Nexus 2020 meeting, which will be held virtually.

Collaboration between stakeholders and the federal government is critical to addressing underlying gaps in patient care, said Debbie Witchey, MHA, executive vice president of the Healthcare Leadership Council.

Discussions around healthcare spending have been ignored for decades, but Robert Dubois, MD, PhD, chief science officer and executive vice president at National Pharmaceutical Council, believes we have the ability to start those discussions now.

By using the available evidence, data, and facts surrounding healthcare spending, we can begin conversations on necessary innovations, said Ceci Connolly, BA, president and chief executive officer of Alliance of Community Health Plans.