AMCP Annual

Leaders at UC Davis Health created an emerging therapies committee to review and prepare for the wave of treatments that cost millions of dollars.

After the onboarding of cell and gene therapy bogged using normal pharmacy and therapeutics (P&T) committee procedures, UC Davis Health set up an emerging therapeutics committee to streamline and speed up the process of delivery expensive cell and gene therapies.

Spending on the GLP-1 class of therapeutics is expected to grow by 378% to $8.1 billion by 2027.

Up to 50 generics could be approved this year, including Victoza to treat patients with diabetes. If generics of Victoza become available, this would the first GLP-1 to face generic competition.

Andel, principal of CommonHealth Solutions LLC, weighed in on potential strategies and challenges for Part D plans in navigating medication formulary limitations during catastrophic coverage phases in this second part of a two-part video series.

One result of the Inflation Reduction Act shifting a greater proportion the cost of drugs during the catastrophic phase of coverage to the Part D plans result may be narrower formularies.

Innovative contracts are becoming more common for gene therapies. They aim to balance a therapy’s cost-effectiveness and affordability, as well as address the uncertainty of long-term benefit.

Adam Colborn outlined four trends in state-level action on pharmacy benefit managers (PBMs) and drugs in an interview prior to this presentation at the annual meeting of Academy of Managed Care Pharmacy (AMCP) today.

Panelists discussed reaching beyond large patient advocacy groups for input and how clinical trial endpoints may paint an incomplete picture of a drug's true value to patients.

Ross Margulies, J.D., M.P.H., a partner at the Foley Hoag law firm, discusses whether proposed transparency rules in the pharmacy benefit manager (PBM) legislation that Congress is considering might apply to the PBM-affiliated group purchasing organizations.

Ross Margulies, J.D., M.P.H., a partner at the Foley Hoag law firm, discusses proposals to “delink” what pharmacy benefit managers are paid from the price of drugs.

The pipeline for NASH treatments is robust, with six therapies in phase 3 development. Speakers at the annual AMCP meeting discuss Rezdiffra, the first drug approved specifically for NASH, and how to think about coverage issues.

According to the co-author of a poster presented at the annual AMCP meeting hosted in New Orleans this week, the interest in the study where the data was found stemmed from the prevalence of PPD in adults, especially women after giving birth.

Factors preventing biosimilar access include pharmacy benefit manager contracts and pharmacies not communicating with providers, a survey finds.

Ross Margulies, J.D., M.P.H., a partner at the Foley Hoag law firm, says there is broad agreement on transparency provisions and a ban on spread pricing in Medicaid.

The Access to Prescription Digital Therapeutics Act remains a top priority for the Academy of Managed Care Pharmacy (AMCP), according to Jennifer L. Mathieu, AMCP senior vice president of professional and government affairs.

Use of GLP-1 drugs and weight-loss care management programs need to focus on adherence and persistency for better health outcomes, suggests Prime Therapeutics/MagellanRx Management poster at AMCP 2024.

This week, the annual meeting of the Academy of Managed Care Pharmacy (AMCP) will bring 3,400 pharmacy, payers and industry leaders to New Orleans.

Managing Directors of L.E.K. Consulting, Joe Johnson, Todd Clark and Brendan Mitchell introduce the innovations happening in pharmacy, more specifically disruptive innovations, and how they affect managed care. The team explained some of the innovations to be on the lookout for in the future, also.

The Academy of Managed Care Pharmacy is throwing its support behind federal legislation that would create a Medicare benefit category for prescription digital therapeutics.

Yoona Kim, PharmD, PhD, co-founder, CEO of Arine Inc., talked about the relationship between racial health disparities and medication non-adherence, and how artificial intelligence can help improve adherence between groups most affected such as Black, Latino and Asian populations.

Specialty drugs are expected to comprise 80% of the FDA approvals this year. Among them are gene therapies for hemophilia A and Duchenne muscular dystrophy priced at between $2 million and $3 million.

Sharon Jhawar, Chief Pharmacy Officer at SCAN Health Plan, said the organization researched their health plans to figure out what inequities existed in their members. What stood out was that their quality was lower for Black members and they weren't meeting their needs. They also saw in medication adherence, a significantly lower percentage of their Hispanic and Black members who were non-adherent. With the help of AI and cultural matching patients with physicians, they have noticed the improvement of adherence from their patients.

Jane F. Barlow, MD, MPH, MBA, chief clinical officer of Real Endpoints led a presentation at the annual AMCP meeting that can help align payers and their manufactures for success in value-based contracting. In this interview Barlow gives some insight on where we are now with value-based contracting compared to a few years ago and if it's gained some traction or if there are challenges that remain. She also touched what therapies are prime candidates for value-based contracting.

Melissa Andel of CommonHealth Solutions spoke at the AMCP annual meeting today in San Antonio about the ins and outs of the Inflation Reduction Act. She shared her discussion highlights the Act's plans of cost shifting in healthcare and the Medicare part-D benefit re-design. In this interview with Managed Healthcare Executive, Andel addressed the Eli Lilly $35 Insulin cap and how plans of price negotiation will resonate with the public. She also expressed what we may expect through Congress when it comes to repealing any provisions through the IRA, and what could be coming through inflation penalty rebates.

Coverage decisions about prescription digital therapeutics may take payers out of their comfort zones and require new processes and subject matter experts, according to members of a panel at the AMCP annual meeting. But P&T committees are likely to still be central to the process.

They are the trendy way to lose weight and payers have been noticing an increase in GLP-1 claims. An analysis of the pharmacy and healthcare claims of a small commercial health plan in Texas documents the growth in the off-label usage of the GLP-1s, such as Ozempic, for weight loss.

Ben Urick, PharmD, PhD, Health Outcomes Research Principal at Prime Therapeutics, LLC, discussed how non-adherence to medication has lead to medical cost offsets and shared solutions to improve adherence from patients and providers. In particular, Urick shared best data-collecting practices that can in-turn improve both adherence and cost. Urick led a discussion on the challenges leading to non-adherence and shared the efforts underway to remove them at the annual AMCP meeting in San Antonio.

The IQVIA vice president sees trouble for generics manufacturers, but painted a bright picture for biosimilars during his keynote address at the annual meeting of the Academy of Managed Care Pharmacy (AMCP).

When asked for solutions in better managing expensive drug costs, Michelle Booth of Magellan suggests a "mortgage-like" payment that could help make these therapies, which are covered under medical benefits, more accessible and affordable. Because there aren't many gene therapies out there just yet in the market, there hasn't been much pressure in offering discounts through value-based contracts to patients. Though, more discussions on this initiative are happening, Andy Killpack also of Magellan, said in the second-part of a two part AMCP annual meeting video series.