Where We Stand: AMCP believes that a health care delivery system that is based upon a competitive marketplace will provide greater value to patients and payers than a system that is one‐size‐fits‐all that relies on centralized governmental controls and regulatory mandates.
Medicare Part B pharmaceutical spending has increased rapidly, more than doubling in 2006-2017. Yet, it is unclear whether this increase was driven by increased utilization or increased cost per claim.
Legislative & Regulatory Position: AMCP recognizes that many patients today depend on high‐cost specialty medications that often do not have therapeutic alternatives. Medication cost-share offset programs provide out-of-pocket discounts or free product at the point of sale. AMCP is concerned that certain cost‐share offset programs may undermine formulary development and utilization management techniques and can also increase costs for health plans and, ultimately, patients themselves.
AMCP CEO Blog: A new article in Health Affairs (http://bit.ly/2BQlgo9) highlights the challenges that many health plans and payers face as spending on pharmaceuticals continues to rise. The report, which looked at total health care spending at Harvard Pilgrim Health Care (HPHC) from 2011 and 2016, found that spending on pharmaceuticals had increased to a full 25% of all dollars spent.
AMCP CEO Blog: By now, it’s virtually an article of faith that the costs of pharmaceuticals are too high (and, by-the-way, so are costs of hospitalizations, MRIs, ambulance rides and many other health care interventions).