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.

View the January 2026 issue of JMCP.

Metabolic diseases drive rising costs and disparities, yet evidence‑based care remains inconsistent. AMCP is advancing guidance, education, and collaboration to support aligned coverage, equitable access, and improved outcomes.

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.