On January 31, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the Draft Guidance titled “Draft Part D Redesign Program Instructions (Program Instructions)”, concurrently with the Advance Notice. The Draft Part D Redesign Program Instructions provide draft guidance regarding the implementation of certain Inflation Reduction Act (IRA) provisions relating to the Part D drug benefit. CMS is soliciting comments on all aspects of the Guidance, and notes that policies established in the final Guidance are for 2025. AMCP submitted comments in response to this rule on March 1, 2024.
On January 31, 2024, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule titled “Advance Notice of Methodological Changes for Calendar Year (CY) 2025”. Each year, CMS is required to update MA payment rates and regularly conducts technical updates through the Advance Notice and Rate Announcement process. AMCP submitted comments in response to this rule on March 1, 2024.
In 2021, the AMCP Listen Up! podcast was introduced to keep health care leaders updated on the latest developments in our rapidly evolving health care system. It focuses on new pharmaceuticals, policies, payment models, and integrated delivery systems. Here are three reasons why listening to this podcast can enhance your knowledge of the managed care pharmacy landscape.
AMCP recognizes that many patients today depend on high‐cost specialty medications that often do not have therapeutic alternatives. Medication cost-share offset programs provide out-of-pocket discounts or free product at the point of sale.
This Valentine’s Day we are showing our appreciation for the dedicated managed care professionals —medical directors, pharmacists, nurses, case managers, health care administrators and more — who work every day to optimize and improve patient health.
AMCP convened key stakeholders in managed care to address the balance between patient access and payer requirements in the FDA Accelerated Approval (AA) pathway program. Experts from various fields participated, aiming to identify gaps between FDAAA requirements and payer-valued treatment outcomes, explore evidence ecosystem opportunities, and evaluate policy options. The forum emphasized supporting drug development innovation while recognizing payer needs and promoting stakeholder trust in the AA review process. Notably, incentivizing confirmatory trials emerged as a potential impactful policy solution.
The FDA continues to approve novel therapies, but concerns arise due to the costs of certain treatments. To address this, the AMCP organized a forum to explore solutions. Stakeholders recognize the benefits of high-investment medications, but uptake of payment strategies has been slow. Gradual changes, education, and collaboration are essential to improve predictability, affordability, and accessibility for patients.