Policy, AI, and High-Cost Therapies Shape AMCP Nexus 2026 Discussions

Shifting drug pricing legislation, the growing role of artificial intelligence (AI), and how to pay for high-cost cell and gene therapies were among the top themes at the Academy of Managed Care Pharmacy (AMCP) Nexus 2026 meeting, held October 26-29 in San Diego, California.

Throughout the conference, The American Journal of Managed Care^® asked experts to share their key takeaways and how those insights may shape the managed care field in 2027. The video features the following attendees:

• Adam Colborn, JD, vice president of congressional affairs at AMCP
• Lisa Cashman, PharmD, vice president of payer strategy at Lumanity
• Crescent Moore, PharmD, PhD, senior vice president of clinical strategy & product at LucyRx
• Jonathan Toft, PharmD, MBA, vice president of market access strategy at Lumanity
• Pamala A. Pawloski, PharmD, principal research scientist at the AMCP Research Institute

Colborn said public policy remains essential to watch because it affects how people do their jobs, but cell and gene therapies also drew considerable discussion. He emphasized that the traditional models of drug coverage and health care in the US do not really work with expensive therapies.

“That’s not to say those products aren’t providing good value for the price, but our system was not set up to accommodate products at that cost,” Colborn said.

Figuring out how to address treatments “that would have been considered the realm of science fiction 40 years ago” is one of the field's most pressing questions, he added. Colborn also said stakeholders may be starting to better understand glucagon-like peptide-1 receptor agonists, whereas AI is changing too quickly to predict its impact. Still, he said, the field cannot afford to ignore it.

For Cashman, the biggest theme was the number of legislative changes reshaping drug pricing. Because one piece of legislation does not always tie in with another, she said it is unclear which will prevail: Maximum Fair Price, Most Favored Nation, or direct-to-consumer pricing. That has created confusion over what a drug's price actually is, Cashman noted, with people trying to learn as much as possible so they can adapt.

Building on Colborn’s earlier point, Moore said AI, which stirs mixed feelings, kept coming up throughout the meeting.

“Regardless of how we feel about it, it's here, and we have to figure it out,” she said.

Sessions showed her innovative ways AI is being used to care for patients. Moore said that led her to consider how technology could help her within her own work. Overall, she said she left energized after a week of connecting with fellow professionals.

Toft, a 20-year industry veteran, said change has compounded exponentially in recent years, from legislation and increased pricing pressure to inflation and AI. Payers are integrating AI into their decision and review processes, and manufacturers are building it into their workstreams. As a result, learning to work smartly with AI will be a major takeaway, he noted.

Lastly, Pawloski echoed speakers who called the AMCP community “one big family.”

“I think that collegiality is a big takeaway in terms of moving forward and how we can make managed care better in 2027,” she concluded.