Managed Care Pharmacy Issues

From the AMCP Policy Digest, AMCP's policies regarding collaborative practices.

From the AMCP Policy Digest, AMCP's policies regarding the management of medication therapy.

From the AMCP Policy Digest, AMCP's policies regarding fraud waste and abuse programs.

From the AMCP Policy Digest, AMCP's policies regarding specialty pharmacy and biosimilars

Recognizing the widespread and devastating nature of the opioid crisis, AMCP formed the Addiction Treatment Advisory Group in 2015 based on the recommendation from the AMCP Partnership Forum, Breaking the Link between Pain Management and Opioid Use Disorder.

AMCP CEO Blog: We live in an interconnected world where the marketplace for all things is global. But we must also make sure the global system works for the benefit of the patients we serve. That includes taking steps to ensure the long-term stability and integrity of our critical pharmaceutical supply chain.

Medication errors are among the most common medical errors, harming at least 1.5 million people every year. The extra medical costs of treating drug-related injuries occurring in hospitals alone are at least to $3.5 billion a year, and this estimate does not take into account lost wages and productivity or additional health care costs.

The Academy of Managed Care Pharmacy (AMCP) is concerned about the harmful effects that medication stockpiling could have on individual patients, as well as the population as a whole. The Academy is providing this document as a means of educating the public about the unintended and potentially harmful results of medication stockpiling, and to remind health care providers of the role that they play in preventing these occurrences.

Population health management (PHM) is a key concept in managed care. Improving population health, enhancing the patient experience, and reducing per capita cost are the primary goals of a philosophy called the Triple Aim. PHM extends beyond healthcare organizations, requiring the cooperation of other types of institutions, such as public health departments and social service entities.

The purpose of outcomes research per the Patient Centered Outcomes Research Institute (PCORI) is to assist patients, clinicians, purchasers and policy makers in making informed health decisions by advancing quality and relevance of evidence. The Agency for Healthcare Research and Quality (AHRQ) defines the purpose of outcomes research as a tool to provide evidence about benefits, risks, and results of treatments so clinicians and patients can make more informed decisions.

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.