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AMCP partners with FormularyDecisions to enhance information sharing and formulary decision-making by creating a platform for current, credible, and compliant information exchange between life science companies and active, qualified healthcare decision-makers.
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Health plans, employers and government-sponsored health care programs are focusing their attention on optimizing patient outcomes through the use of medications that have established evidence of efficacy and safety, while providing the highest value.
Disease management is the concept of reducing health care costs and improving quality of life for individuals with chronic conditions by preventing or minimizing the effects of the disease through integrated care. Disease management programs are designed to improve the health of persons with chronic conditions and reduce associated costs from avoidable complications by identifying and treating chronic conditions more quickly and more effectively, thus slowing the progression of those diseases.
Congress passed the Health Insurance Portability and Accountability Act (HIPAA) in 1996. Within that Act are privacy provisions with which covered entities (including all health plans, health care providers and health care clearinghouses [e.g. PBMs] that transmit any health information in electronic form must comply. HIPAA rules provide guidance to covered entities about how to comply with the Act.
The purpose of this paper is to explain how managed care organizations (MCOs) are able to secure lower drug prices from pharmaceutical manufacturers as part of an effort to control drug expenditures.
Over the past several years, the introduction, utilization and cost share of specialty pharmacy products has been increasing at a rate substantially greater than that of other pharmaceuticals. This paper examines the characteristics of specialty pharmaceuticals; the growth of new expertise to handle and manage these pharmaceuticals; and the needs these products create for patients, health plans and practitioners.
Drug utilization review (DUR) is defined as an authorized, structured, ongoing review of prescribing, dispensing and use of medication. DUR encompasses a drug review against predetermined criteria that results in changes to drug therapy when these criteria are not met.

AMCP believes that payors must have the flexibility to use mail service delivery of prescription drugs as a component of their prescription drug benefit.
Press Release: Focusing on what’s best for the patient, leveraging technology to perform real-time benefit checks, and developing trust and transparency among stakeholders are some of the suggestions to emerge from AMCP’s recent Partnership Forum on “Optimizing Prior Authorization for Appropriate Medication Selection.”
Common managed care terms and their meaning.

Managed care pharmacy and prescription drug coverage is a growing part of the American health care sector. AMCP launched the annual Access, Affordability, and Outcomes report to raise awareness of the existence, prevalence, and importance of managed care pharmacy.
Learn how managed care pharmacy can play a vital role in patient-centered medical homes.
List of Forum topics for 2019. For additional information, contact: AMCP’s Strategic Alliances & Corporate Services Office | busdevelopment@amcp.org | (703) 684-2616