Cell & Gene Therapies (CGT) offer potentially curative treatment to patients with chronic and hereditary conditions but carry high price tags. One proposal to overcome such financing challenges is to create a national risk pool.
Letters, Statements & Analysis
AMCP communicates the importance of managed care pharmacy by collaborating with members to provide comments, analysis, and testimony to Congress and federal and state agencies on the impact of proposed regulations and laws on managed care pharmacy and patients.
The Academy of Managed Care Pharmacy (AMCP) thanks the Department of Health and Human Services (HHS) for the opportunity to provide comments in response to the Request for Information: Categories Used in Federal Vaccine Recommendations and the Role of Shared Clinical Decision-Making (RFI).
The Academy of Managed Care Pharmacy (AMCP) thanks the Centers for Medicare & Medicaid Services (CMS) for the opportunity to provide comments in response to Medicare Drug Price Negotiation Program: Draft Guidance, Manufacturer Effectuation of the Maximum Fair Price in 2028 (Draft Guidance). CMS issued this draft guidance to describe the processes and requirements for manufacturer effectuation of the maximum fair price (MFP) in 2028 for selected drugs payable under Medicare Part B and/or covered under Medicare Part D.
The following chart compares provisions of existing 340B reform proposals in the 119th Congress.
On Sept. 15, the House E&C Health Subcommittee held a hearing on H.R. 3164.
AMCP’s comments focus on provisions in the Proposed Rule that affect prescription drug payment and access to clinically appropriate therapies. AMCP has an interest in ensuring that Medicare payment and coverage policies promote transparency, control prices, preserve beneficiary access, and avoid fragmented incentives across care settings and benefit designs. AMCP encourages CMS to provide clear methodological explanations and monitor effects on beneficiary access and provider behavior.
On Aug. 28, AMCP responded to Senate HELP Chairman Bill Cassidy's 340B reform proposal.
AMCP supports efforts to make prescription medications more affordable for Medicare beneficiaries. At the same time, implementation of the Medicare Drug Price Negotiation Program (Negotiation Program) should preserve the evidence-based formulary management, utilization management, market competition, and clinical decision-making processes fundamental to managed care pharmacy.
The No Surprises Act Enforcement Act would increase insurer penalties up to $10,000 per surprise billing violation.
On June 16, Senate Finance Committee Democrats released an RFI on proposals to lower the cost of prescription drugs. On Aug. 17, AMCP submitted comments in response.
On June 5, the New York State Assembly passed S.5939C/A.5882C, commonly referred to as the Patient Access to Pharmacy Act (PAPA), sending the pharmacy benefit manager (PBM) reimbursement legislation to Governor Kathy Hochul for consideration. The Senate previously passed the measure on May 28.
