ICYMI: Highlights From AMCP Nexus 2025

These key takeaways and critical discussions presented at The Academy of Managed Care Pharmacy AMCP Nexus 2025 highlight major themes across health care policy, pharmaceutical innovation, treatment optimization, and regulatory challenges. Core focuses of the conference were the necessity of implementing thoughtful policies and technological innovation to establish a more effective and sustainable US health care system, the accelerating oncology pipeline, and steering cancer care toward more targeted and value-driven approaches.

The application of claims data also underscored the value of improved treatment adherence, as research showed that the HIV regimen bictegravis/emtricitabine/TAF (B/F/TAF) led to significantly higher 1-year treatment persistence. Finally, the regulatory environment surrounding pharmacy benefit managers represents a significant policy and market theme. While efforts aim to reduce conflicts of interest, experts noted that these varied state laws create administrative complexity.

Here is the top content from our coverage of AMCP Nexus 2025.

5. Real-World Data Key to Optimizing CAR T-Cell Therapy Delivery, Outcomes

For payers and providers alike, knowing that these highly individualized cancer treatments face significant implementation hurdles is just half the battle. High costs, limited insurance coverage, and geographic and socioeconomic disparities may be known to put up roadblocks to the use of chimeric antigen receptor (CAR) T-cell therapy, but the limited capacity of accredited centers to deliver the treatments, a lack of refined utilization criteria, and unclear decision processes also pose threats. To truly succeed at helping payers and health plans overcome these barriers, solutions must be sustainable and incorporate real-world data to improve decisions and outcomes, streamline care, and identify gaps in CAR T-cell therapy access.

4. Biktarvy Improves ART Persistence for People With HIV and Mental Health Disorders

Compared with dolutegravir/lamivudine (DTG/3TC), DTG/abacavir/3TC, and multitablet regimens of DTG plus emtricitabine/tenofovir alafenamide (DTG+F/TAF) or DTG plus F/tenofovir disoproxil fumarate (DTG+F/TDF), lower rates of treatment switching were seen with bictegravir/emtricitabine/TAF (B/F/TAF) according to posters presented at the conference. A lower risk of making a switch was also seen with the triplet combination, with unadjusted analyses showing the lowest rates of switching among those with mental health or substance use disorders. Using medical and pharmacy claims data, investigators also showed that 1-year treatment persistence with B/F/TAF was significantly higher compared with DTG/abacavir/3TC, DTG+F/TAF, and DTG+F/TDF (80.3% vs 68.9% vs 62.4% vs 36.7%, respectively).

3. Oncology Landscape Continues to Evolve With Expanded Indications, First-in-Class Therapies

In the meeting’s final keynote session, “Oncology Pipeline 2025: Emerging Breakthroughs and Trends,” experts emphasized that the oncology pipeline is accelerating, driven by novel agents and new indications within existing drug classes, leading toward more targeted and value-driven cancer care. Recent FDA approvals also have focused on expanding existing drug classes like antibody-drug conjugates in solid tumors and bispecific antibodies for relapsed/refractory multiple myeloma and pancreatic adenocarcinoma with an NRG1 gene fusion, while introducing first-in-class therapies, such as menin inhibitors and novel posttransplant cellular therapies. The oncology pipeline shows no signs of slowing down, with roughly thousands of treatments and vaccines currently in development. Ultimately, collaboration among clinicians, payers, and manufacturers is necessary to manage spending and ensure timely patient access to these transformative therapies.

2. New PBM Laws Seek to Protect Independent Pharmacies but Could Raise Costs, Limit Patient Access

State legislation targeting pharmacy benefit managers (PBMs) is rising rapidly across the US, with experts noting that although these laws aim to increase transparency and support local pharmacies, they may also increase costs and limit patient access. A significant example is Arkansas House Bill 1150, which prohibits the state Board of Pharmacy from issuing permits to any pharmacy owned by or affiliated with a PBM, a measure intended to protect independent pharmacies and reduce conflicts of interest. Although the bill passed, its implementation is currently delayed because of concerns that it conflicts with several federal laws and could limit patient access to essential services. Across the nation, most states have some form of PBM legislation, including reimbursement requirements, transparency laws, and oversight fees, all of which contribute to administrative complexity. The burdens these varied state laws create can ultimately stifle competition and result in higher administrative costs passed onto employers or clients.

1. Paul Ryan Champions Health Care Policy Reform, AI Amid Government Shutdown

Paul Ryan, former speaker of the House, addressed the necessity of implementing thoughtful policies and technological innovation to construct a more sustainable and effective US health care system amid the recent government shutdown. He argued that Congress must write clear, precise legislation to limit executive overreach, and he encouraged health care professionals to engage with policymakers to influence decisions. Ryan also highlighted the fiscal unsustainability of entitlement programs, advocating for reforms centered on patient choice and competition to modernize these systems. Stressing the global competition in technology, Ryan urged caution against overly restrictive artificial intelligence regulations so that the US can secure a first-mover advantage.