To discuss managed care approaches to bsAbs with a focus on FL and DLBCL, AMCP Market Insights virtually convened an expert panel of managed care stakeholders in April 2025.
To discuss navigating the rapidly changing landscape of ER+/HER2− metastatic breast cancer (mBC), AMCP Market Insights virtually convened an expert panel of managed care stakeholders in February 2025.
On November 6, 2025, the Centers for Medicare & Medicaid Services (CMS) released the GENEROUS Model (Generating Cost Reductions for U.S. Medicaid Model). The model aims to achieve Most Favored Nation (MFN) international pricing for Covered Outpatient Drugs (CODs) while maintaining or improving the quality of care for Medicaid beneficiaries.
On November 6, 2025, the Centers for Medicare & Medicaid Services (CMS) released the GENEROUS Model (Generating Cost Reductions for U.S. Medicaid Model). The model aims to achieve Most Favored Nation (MFN) international pricing for Covered Outpatient Drugs (CODs) while maintaining or improving the quality of care for Medicaid beneficiaries.
President Donald Trump announced a series of agreements with Eli Lilly and Company and Novo Nordisk to offer Most-Favored-Nation (MFN) prices on two GLP-1 therapies, semaglutide (brand names Ozempic and Wegovy) and tirzepatide (brand names Mounjaro and Zepbound). This marks the fourth and fifth publicly announced agreements between the Trump administration and pharmaceutical manufacturers, joining earlier announcements with Pfizer, AstraZeneca, and EMD Serono. The manufacturers also agreed to cap prices for insulin products and other commonly prescribed diabetes medications.
On October 31, 2025, the Centers for Medicare and Medicaid Services (CMS) issued the Physician Fee Schedule final rule (Final Rule) to be published in the Federal Register on November 5, 2025.
AMCP Legislative & Regulatory Briefing — October 2025
Read the Journal of Managed Care + Specialty Pharmacy (JMCP) - November 2025 Issue
The Academy of Managed Care Pharmacy (AMCP), in partnership with the AMCP Research Institute, published the 2025 edition of its annual Access, Affordability, and Outcomes: The Value of Managed Care Pharmacy report, which provides an in-depth look at how managed care pharmacy practices improve patient health outcomes, control prescription drug spending, and promote affordability for millions of Americans.
On July 4, 2025, President Trump signed H.R. 1, the Reconciliation Bill (aka the “One Big Beautiful Bill Act”) into law, which includes significant policy changes to Medicaid and the Health Insurance Marketplaces.
