Legislative & Regulatory Positions
The Legislative & Regulatory Positions series represents AMCP's positions on a wide range of issues impacting managed care pharmacy. AMCP's position statements are regularly reviewed and updated by the AMCP Board of Directors.
Our legislative and regulatory positions are presented in alphabetical order, below:
Addressing Racial and Health Disparities
AMCP stands against racial and health care injustice. AMCP is committed to 1) mitigating disparities related to optimal medication use, 2) advancing conversations by calling for pertinent submissions to the Journal of Managed Care + Specialty Pharmacy (JMCP) and conducting partnership forum(s), 3) incorporating health equity goals into the strategic plan, and 4) supporting impactful education and policy.
Any Willing Provider Legislation
AMCP opposes any willing provider/pharmacy legislation. AMCP supports the ability of managed care organizations to selectively contract with only those providers necessary to enable the organization to provide patients with adequate access to pharmacy services, and quality, cost-effective health care.
Best Price Requirement of the Medicaid Drug Rebate Program
AMCP believes that to provide the greatest value to Americans who need prescription drugs, market forces must effectively ensure that manufacturers of similar drugs compete with one another to establish reasonable pricing levels and maintain consumer access to needed therapies.
Biosimilar Drug Therapies
AMCP supports an abbreviated licensure pathway for the approval of biosimilar biologic drug therapies by the U.S. Food and Drug Administration (FDA). Biological products play an increasingly important role in the country's health care system - both in terms of scientific improvements in the treatment of disease and increased drug costs.
Comparative Effectiveness Research and Patient-Centered Outcomes Research
AMCP supports scientifically sound research that compares the effectiveness and value of prescription drugs, as well as research aimed at tailoring treatment options to individual patients’ needs.
AMCP believes that a health care delivery system that is based upon a competitive marketplace will provide greater value to patients and payers than a system that is one-size-fits-all that relies on centralized governmental controls and regulatory mandates.
Co-Payment Offset Programs
AMCP believes that manufacturers, philanthropic organizations, plan sponsors, managed care organizations, and retail pharmacies should have the common goal of improving patient access by making medications affordable. AMCP also recognizes that many patients today depend on high-cost specialty medications that rarely have therapeutic alternatives.
Criminalization of Medication Dispensing
Following the Supreme Court’s 2022 decision in Dobbs v. Jackson Women’s Health Organization, AMCP is concerned about potential negative repercussions for patient care that extend beyond the immediate scope of reproductive care. AMCP finds it unconscionable that pharmacists have been threatened with the loss of their licenses and, in some cases, imprisonment for dispensing safe, effective medication approved by the Food & Drug Administration (FDA).
AMCP discourages the use of direct-to-consumer advertising that promotes specific prescription drug products, but supports ads that educate the public about disease symptoms and available treatment options.
Fraud, Waste, and Abuse in Prescription Drug Benefits
Fraud, waste, and abuse are problems that plague almost every sector of health care in the United States. The Centers for Medicare and Medicaid Services (CMS) estimates that fraud, waste, and abuse cost taxpayers billions of dollars annually within Medicare and Medicaid.
AMCP encourages the use of generic drugs as safe, cost-effective alternatives to the equivalent brand-name products. Generic drugs are approved by the U.S. Food and Drug Administration (FDA). When a generic drug is used, patients and health care professionals can expect to see a clinical result and safety profile equal to that of the brand-name drug.
Mail Service Pharmacies
AMCP believes that managed care organizations (MCOs) must have the flexibility to use mail service delivery of prescription drugs as a component of their prescription drug benefit.
The Management of Opioids
AMCP supports opioid management initiatives that ensure appropriate patient access and treatment of uncontrolled pain, while limiting abuse and diversion of opioids and opioid potentiators.
Maximum Allowable Cost (MAC) Pricing
MAC pricing is a payment model contractually agreed to in the marketplace by all participants. It includes payers and pharmacies and ensures employers and consumers – those purchasing health insurance benefits – get the lowest possible price on generic drugs.
AMCP supports the concept of medication synchronization as one tool that may improve adherence.
Medication Therapy Management
AMCP supports medication therapy management (MTM) programs, which are a distinct service or group of services that optimize therapeutic outcomes for individual patients.
Off-Label Use of Pharmaceuticals and Related Products
AMCP supports off-label use of FDA-approved pharmaceuticals and related products when medically appropriate, safe and necessary. AMCP opposed government-mandated coverage of specific pharmaceuticals and related products, whether for FDA-approved or off-label uses, which can fail to consider safe, effective and lower-cost alternatives.
Patient Care Services Provided by a Pharmacist
AMCP supports compensation for pharmacists providing direct patient care services. Prescription medications have become the primary option for the treatment of the vast majority of chronic conditions and pharmacists are uniquely qualified by virtue of their specialized training to serve as the medication expert within the patient care team.
Pharmaceutical Manufacturer Rebates
AMCP believes in competitive marketplace solutions to lower costs for Americans and recognizes the critical need to address the rising cost of prescription medications. Rebates represent a way to negotiate drug discounts and constitute an important tool to control drug costs.
Preferred Pharmacy Networks
AMCP supports the ability of health plans to offer preferred pharmacy networks for their enrollees as a way of providing additional options and cost savings without diminishing quality or patient access.
Prescription Drug Importation
AMCP has concerns with legislative and regulatory proposals that would allow the commercial importation of prescription drugs for sale in the United States.
Provider Status for Pharmacists
AMCP supports the recognition of pharmacists as providers under the Social Security Act. When pharmacists are recognized as important members of the health care team, patient outcomes improve, patients report higher rates of satisfaction and overall health care costs are reduced.
Regulation of the Prescription Drug Benefit
AMCP believes that government should encourage an environment in which pharmacists working within managed care organizations, including pharmaceutical benefit management companies, can continue to develop innovative and integrated strategies to manage prescription drug benefits for a given patient population.
AMCP supports the use of therapeutic interchange programs as part of a comprehensive approach to quality, cost-effective patient care. Therapeutic interchange is the practice of replacing, with the prescribing physician’s approval, a prescription medication originally prescribed for a patient with a chemically different medication.
Transparency Within Health Care
AMCP supports efforts to encourage transparency within health care. Transparency enables payers, providers, and patients to make informed decisions regarding health care choices, including decisions regarding the use of prescription drugs.
Use of Technology
AMCP supports the implementation and expanded use of health information technology (HIT), including electronic health records, electronic prescribing, electronic prior authorization, real-time benefit check, telehealth, remote patient monitoring, digital therapeutics and other technology advancements that promote efficient use of healthcare resources, improve quality and patient and provider satisfaction.
AMCP supports the use of frameworks as a resource for determining the value of pharmaceuticals and other health technologies when the frameworks are based on sound methods using good scientific evidence and economic models.