Managed Care Keeps Pace With Policy as AMCP Nexus Heads to San Diego

When managed care leaders convene in San Diego October 26-29 for the Academy of Managed Care Pharmacy (AMCP) Nexus 2026 meeting, they will follow an agenda shaped by this question: how do payers, providers, patient advocates, and manufacturers keep patients’ access to medications affordable amid ever-shifting federal policy? These leaders from across the managed care ecosystem will examine the legislative, regulatory, and operational changes affecting patient access and affordability.

For AMCP CEO Susan Cantrell, who is marking her 10th year leading the organization, there has been a dramatic shift over the past decade. “Some of the topics we’re talking about now were not even on our radar screens back in 2016 when I joined AMCP,” she said in an interview with The American Journal of Managed Care^® (AJMC^®) ahead of the meeting. She pointed to Medicare’s negotiation of Part D prices, now coming to Part B, as the most pivotal policy of that period.

“That is a major sea change,” she said.

Policy Takes the Lead

Attendees can expect updates on the federal policies and regulations influencing managed care pharmacy, along with perspectives on how policy changes affect formulary management, patient access, and benefit design. The week kicks off with the AMCP Pharmacy Policy Summit on October 26, during which panels will examine 340B, Medicare Advantage drug pricing policies, and financing for gene therapy. Charlie Cook, founder of the Cook Political Report, opens the day with a nonpartisan look at the midterm elections and the policy issues that may follow. Cantrell noted the stakes.

“The cost of pharmaceuticals is front and center, just as it was in the 2016 presidential election,” she said.

Policy continues through the main program. This is the first year that Medicare Part D maximum fair prices are in effect. “We’re seeing a lot of consequences of that, some intended, many unintended,” Cantrell said.

Sessions will also cover TrumpRx, Most Favored Nation pricing, and the recently launched GLP-1 Bridge Program (currently slated to run through the end of 2027), including the education session, “Beyond Price Negotiation: Has Maximum Fair Price (MFP) Reshaped Formulary Dynamics?” and a Tuesday update on federal legislation and regulation. The goal, Cantrell told AJMC, is to help members work out “how do we manage this in today’s environment, and also how do we keep up with it, because it is a rapidly changing environment?”

AI and Innovation

Eric Topol, MD, executive vice president of Scripps Research and founder and director of the Scripps Research Translational Institute, opens the Tuesday, October 27, general session for an in-depth discussion that will draw on his work at the intersection of artificial intelligence (AI), digital health, and care. Other sessions will address precision medicine, real-world evidence, biosimilars, cell and gene therapies, and the use of patient experience data in coverage decisions. The keynote on Thursday, October 29, “The AI Debate: Advancing Humanity or Undermining It?” will weigh the technology’s promises and risks.

“We’re going to have a debate about AI where we’re going to look at not only the benefits of AI, but some of the potential pitfalls and safety issues with AI, and how it might impact us in the future,” Cantrell said.

In addition, more than 300 posters and abstracts will be presented, with researchers on site, and moderated poster tours taking place during the week. Connection is built in as well, with chances to network with payers, providers, patient advocates, and industry leaders working to improve health care outcomes. Cantrell said meetings like AMCP Nexus are where people “make connections and build our networks that often facilitate our careers.”

Her closing message reflects the theme of the week. Of the event, she said, “Meetings and conferences like Nexus 2026 are where we all come together. We share best practices. We talk about issues and challenges. But more importantly, we come up with solutions.” She said the program overall is designed to deliver “actionable insights and strategies [attendees] can take back and implement in their organizations right away.