AMCP Partnership Forum Develops Strategies to Address High-Investment Medications
Alexandria, Va., May 2, 2022 – Last week, nearly 40 experts representing payers, pharmacy benefit managers, integrated delivery system leaders, actuaries, providers, employer groups, pharmaceutical manufacturers, patient groups, and other key stakeholders in the managed care setting convened for AMCP’s Partnership Forum: High-Investment Medications. The purpose of the forum was to identify concerns for high-investment medications related to predictability, affordability, and accessibility. Participants also explored alternative payments, financial tools, and policy initiatives related to these medications.
Forum participants discussed the current state of high-investment medications, including that an “avalanche” of new cell and gene therapies that may provide important and life-saving treatment options will hit the market in the near future. Participants also discussed a recent survey that found nearly 50% of health plans and employers are considering new financial tools and payment models to address the often high upfront or one-time cost of these medications. Participants further elaborated that stakeholders value and define the predictability, affordability, and accessibility of medications and health care costs in different ways. Multiple financial and payment tools such as warranties, annuities, and value-based contracts are being developed and tested to balance stakeholder needs.
Additional outcomes from the discussions focused on the need for industry alignment on data collection, privacy, and governance to monitor treatment benefits as well as multi-disciplinary education on these new financial tools. Participants also identified possible policy levers and opportunities for testing and piloting innovative payment solutions.
“As novel therapies to address important medical needs are approved, the high costs for these medications, and especially cell and gene therapies, can raise sustainability and affordability concerns for employers, payers, and patients,” said AMCP CEO Susan Cantrell, RPh, CAE. “The participants at the Partnership Forum developed a foundation to address the challenges surrounding these treatments as we endeavor to get patients the medications they need at a cost they can afford.”
All findings and recommendations from the AMCP Partnership Forum: High-Investment Medications will be published in an upcoming issue of Journal of Managed Care + Specialty Pharmacy. In addition, AMCP will host a webinar in 2022 reporting the findings and recommendations. The event was sponsored by Bristol Myers Squibb, Janssen, Precision Value & Health, Sandoz, Seagen, and Takeda Pharmaceuticals.
AMCP is the professional association leading the way to help patients get the medications they need at a cost they can afford. AMCP’s diverse membership of pharmacists, physicians, nurses, biopharmaceutical professionals, and other stakeholders leverage their specialized expertise in clinical evidence and economics to optimize medication benefit design and population health management and help patients access cost-effective and safe medications and other drug therapies. AMCP members improve the lives of nearly 300 million Americans served by private and public health plans, pharmacy benefit management firms, and emerging care models. Visit www.amcp.org.