ICYMI: Highlights From AMCP 2025

The Academy of Managed Care Pharmacy (AMCP) 2025 Annual Meeting brought together leaders across policy, industry, and clinical practice to examine the rapidly evolving forces shaping drug coverage and affordability. Sessions explored how federal legislation, state-level reform, and emerging market dynamics are influencing managed care decision-making, from the Inflation Reduction Act (IRA) to pharmacy benefit manager (PBM) transparency initiatives to the growing pipeline of generics, biosimilars, and specialty drugs.

Here are the top 5 articles and interviews from this year’s AMCP Annual Meeting. You can view more of our coverage and interviews from the meeting here.

5. The IRA’s Unintended Consequences for Drug Pricing and Coverage

Experts warned at the April 2025 meeting that the IRA could increase Medicare Part D formulary restrictiveness, raise patient cost burdens, and reduce pharmaceutical innovation. Panelists noted that negotiated drug prices, reduced rebate flexibility, and shifting plan liabilities could lead to narrower formularies, higher premiums, and greater use of coinsurance, with additional concerns about manufacturers raising launch prices and 340B entities facing administrative and financial strain. Panelists also emphasized the need for policy refinements that balance cost containment with patient access and continued drug development.

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4. How Recent Federal Policy Changes Are Shaping Managed Care Pharmacy

Experts outlined how shifting federal policies, including changing agency leadership and the early impacts of the IRA, are reshaping managed care pharmacy through funding uncertainty, PBM reform efforts, and evolving Medicaid and Medicare rules. Key proposals included banning PBM spread pricing, restructuring subsidies and eligibility in federal insurance programs, tightening 340B oversight, and implementing cost-containment measures that could shift financial responsibility to states. Stakeholders emphasized that proactive advocacy and close monitoring will be essential for navigating the rapidly changing policy landscape.

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3. Legislative Updates Shaping Managed Care Pharmacy: Adam Colborn, JD

Adam Colborn, JD, associate vice president for congressional affairs at AMCP, outlined more than 500 state-level bills affecting managed care pharmacy, with most activity centered on PBM reform, 340B oversight, and new AI-related regulations tied to utilization management. At the federal level, he noted that bipartisan PBM reform remained likely for late 2025, while 340B reforms were gaining attention but lacked consensus. Colborn also highlighted the Medicaid VBPs for Patients Act as a potentially significant federal change, as it would codify key drug-pricing definitions and expand access to high-cost therapies through clearer value-based purchasing rules.

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2. US Pharmaceutical Pipeline Expands With Innovation and Competition

The 2025 pharmaceutical pipeline was expected to expand significantly, with major generic and biosimilar competition emerging alongside new therapies for migraine, cardiovascular disease, chronic kidney disease, fibromyalgia, and rare disorders at the beginning of the year. Patent thickets, settlement agreements, and skinny labels continued to delay market entry, even as several high-revenue drugs began facing their first generics. Specialty development remained strong with gene therapies, metabolic and neuromuscular treatments, and multiple new treatment options for hypercholesterolemia and Duchenne muscular dystrophy in the pipeline. Experts also listed a number of vaccines in the pipeline, including a meningococcal vaccine to compete against Pfizer’s 5-valent vaccine, and a combination vaccine for COVID-19 and influenza.

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1. The Push for Fair Pricing and Reform in Pharmacy Benefit Management

PBMs are facing mounting scrutiny over opaque pricing practices, spread pricing, and rebate structures, prompting calls for greater transparency and legislative reform at both state and federal levels. Industry leaders highlighted efforts to modernize PBM practices—such as eliminating prior authorization for some drugs, refining reimbursement models, promoting biosimilars, and committing to pass through all rebates—to reduce patient costs and improve affordability. Speakers emphasized that meaningful reform will require collaboration among PBMs, manufacturers, policymakers, and employers to balance benefit design, ensure access, and keep patients at the center of decision-making.

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