After months of fruitless negotiations to extend Affordable Care Act subsidies that have since expired, congressional leaders announced Tuesday they’d notched a rare bipartisan win to overhaul other parts of the health care system.
On January 23, 2026, the U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) issued three notices: Rescission of Guidance to Nation’s Retail Pharmacies: Obligations under Federal Civil Rights Laws to Ensure Nondiscriminatory Access to Health Care at Pharmacies (Pharmacy Notice), Rescission of Guidance on Nondiscrimination Protections under the Church Amendments (Nondiscrimination Notice), and Rescission of Office for Civil Rights Documents under Executive Order 14192 (Additional Documents Notice).
On January 15, 2026, the White House released its Great Healthcare Plan (the Plan) as a broad framework for congressional action on lowering drug prices, lowering insurance premiums, and increasing price transparency. The Plan outlines several policy ideas for Congress to consider.
AMCP’s Policy Outlook 2026 provides a forward-looking analysis of the political, legislative, and regulatory developments poised to shape managed care pharmacy in the year ahead, from the 2026 midterm elections and government funding deadlines to major policy debates around PBM reform, Medicare drug price negotiation, GLP-1 coverage, direct-to-consumer drug models, and the 340B program. Designed to help managed care professionals anticipate change and plan strategically, the report breaks down what to expect from Congress, federal agencies, and the administration—and what it all means for patient access, costs, and pharmacy operations. Download the full Policy Outlook 2026 to explore the key issues, timelines, and implications that will define the policy environment in the coming year.
On January 5, 2026, the Centers for Disease Control and Prevention (CDC) revised the childhood and adolescent immunization schedule.
On January 5, 2026, the Centers for Disease Control and Prevention (CDC) revised the childhood and adolescent immunization schedule.
The Academy of Managed Care Pharmacy (AMCP) supports policies that encourage the incorporation of cost-effectiveness considerations into health care decision-making. Cost-effectiveness analysis (CEA) is a method to assess the value of the clinical outcomes of a treatment relative to the cost. This type of analysis aligns with managed care objectives to optimize patient outcomes, maintain affordability, and encourage sustainability. CEA offers guidance to decisions about coverage and pricing to support managed care strategies—like formulary design, prior authorization, step therapy, and value-based contracting. Policies that promote cost-effectiveness help to ensure patients have access to treatments that deliver meaningful health outcomes at sustainable costs.
The Academy of Managed Care Pharmacy (AMCP) supports scientifically-sound research that compares the effectiveness and value of medications and treatments, as well as research aimed at tailoring treatment options to individual patients’ needs. Prescribers and patients need this information to evaluate and select treatment options most likely to achieve a desired therapeutic outcome. Health care decision-makers use this information when designing benefits to ensure that safe and effective medications with the best value are provided for all stages of treatment. Such research encourages optimal medication use while also promoting the prudent management of financial resources within the health care system. AMCP believes that the following principles apply to both comparative effectiveness research (CER)1 and patient‐centered outcomes research (PCOR)2 in the context of managed care: the appropriate role of the federal government and other entities (both public and private) in coordinating, funding, and disseminating the results of such research; the characteristics of research design; and the use of research results by patients, providers, and health care decision-makers.
On Dec. 19, the Trump administration closed out a year of international pharmaceutical reference pricing announcements with the publication of CMS’s proposed Global Benchmark for Efficient Drug Pricing (GLOBE) and Guarding U.S. Medicare Against Rising Drug Costs (GUARD) models, as well as the release of nine additional Most-Favored-Nation (MFN) pricing arrangements with major pharmaceutical manufacturers. The announcements align with the Trump administration’s goal of lowering the prices that American patients pay for prescription drugs to the prices paid in similarly developed countries, as well as May 12 Executive Order on delivering MFN prices to patients.
