The last time the AMCP Nexus meeting was held at the Gaylord National Resort in National Harbor, Maryland, was in 2019. Donald Trump was president and the beginning of the COVID-19 pandemic was months away. And, as Susan Cantrell, the CEO of the Academy of Managed Care Pharmacy, reminded those attending a breakfast last week for first-time attendees and members, the Nationals, the Washington, D.C., major league baseball team, were on their way to winning the World Series.

What a difference three years can make. The Nationals finished last in their division this year, 32 games out of first place. The White House has quite a different sort of occupant, both in temperament and political party. But with the respect to COVID-19, the 2022 edition of AMCP Nexus last week was, in some respects, a return to 2019 and the times before pandemic.

About 2,600 people registered to attend the four-day meeting, which according to Academy of Managed Care Pharmacy (AMCP) officials was the attendance before the pandemic.

Attendees had to provide proof of vaccination. But only a handful of people were wearing masks.

The keynote speaker, Leana Wen, M.D., remarked on relative lack of masking in her talk Wednesday morning.

“With vaccination being widespread, we (public health officials) also changed our recommendations for how we can lead our lives,” noted Wen, a George Washington University professor and former Baltimore city health commissioner.” “The fact that we are all here, in person — I hear that there are more than 2,000 attendees at this conference — and most of us are not masking and associating freely with each other, we are able to do that now because of the vaccines that protect so well against severe disease.”

Wen’s more moderate stance on COVID-19 public health measures has angered some people in public health circles and a petition has been posted asking the American Public Health Association to rescind its invitation to have her speak at the association’s annual meeting in Boston next month. There was no evidence of controversy about her talk at AMCP Nexus 2022.

Some of the topics discussed at the 2022 meeting were new to AMCP Nexus. On Thursday, Tam C. Phan, Pharm.D., an assistant professor of clinical pharmacy at the University of Southern California School of Pharmacy, gave a talk about impact of managed care pharmacists on transgender care. Thursday morning also featured a panel discussion on racial disparities and breast cancer.

But the meeting also included sessions on prior authorization, formulary placement and other mainstream topics at the intersection of managed care and pharmacy.

As she has for many years, Evernorth’s Aimee Tharaldson gave an information-packed talk about the specialty drugs that have been newly approved or are in late-stage development. Tharaldson noted that gene therapies are coming on strong, with the one-time gene replacement therapies priced at more in the millions of dollars. Citing research from the National Bureau of Economic Research, Tharaldson said the cumulative annual cost of gene therapies could reach $25 billion by 2034.

Related: Gene Therapy Has Arrived. But So Will the $$$$$ Bills. | AMCP Nexus 2022

On Friday, Kaelyn C. Boss, a clinical consultant pharmacist at the University of Massachusetts Medical School,and Bhavesh Shah, chief pharmacy officer, specialty and hematology/ oncology pharmacy at Boston Medical Center, gave a similar talk but just on the oncology pipeline. Among the many topics they touched upon are possible competition for Keytruda (pembrolizumab), nivolumab (Opdivo) and the other PD-1/PDL-1 inhibitors and the steps that the makers of those drugs are taking that might fend it off.