Drug Pricing

Pharmacy benefit managers (PBMs) can perform many services for health plans such as claims processing, pricing and rebate negotiations, and formulary management. But if the relationship isn’t working, don’t continue to ride it out, speakers said during the AMCP 2025 Nexus meeting, in National Harbor, Maryland.

AMCP opposes government regulation of drug pricing because of the potential for unintended consequences and supports the elimination of barriers to competition to bring down the high cost of prescription drugs.

AMCP CEO Susan Cantrell stresses how collaboration is key in addressing challenges such as high drug prices and healthcare disparities. While there’s no silver bullet, solutions such as tailored population benefit design and value-based contracting can play an important role in making a difference for ordinary Americans looking for affordable access to prescriptions.

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.

Health care expert Fred Goldstein, host of the AMCP Podcast Series — Listen Up! sits down with Melissa Andel, Principal and Founder of CommonHealth Solutions to take a closer look at the recent CMS guidance on drug price negotiation for 2026.

Health care expert Fred Goldstein, host of the AMCP Podcast Series — Listen Up! sits down with Melissa Andel, Principal and Founder of CommonHealth Solutions to take a closer look at the recent CMS guidance on drug price negotiation for 2026.