Speech at General Session of AMCP Nexus 2017

It’s wonderful to be here in Texas. AMCP has many longtime members and friends from the great Lone Star State, including many from right here in the Dallas region. We also have many members from the Houston area. Our heart goes out to everyone in Texas affected by Hurricane Harvey, as well as all of the other recent storms and now the wild fires in California. 

It’s gratifying to know that so many pharmacists have rolled up their sleeves during these events to help and care for vulnerable patients. Managed care pharmacy also stepped up, with PBMs and health plans ensuring their members could get medications under dire conditions. You can help too. This week, a portion of the socks we collect through the AMCP Foundation’s sock drive will go to needy residents in Houston and the Gulf Region. 

One final bit of housekeeping: October is American Pharmacist Month and AMCP has the pleasure of celebrating it with you here at Nexus. Congratulations to all the pharmacists with us today. 

“AMCP Nexus 2017: changing the way we pay for health care.” So why this theme? And why this year? 

We are in the midst of a revolution in reimbursement. The shift towards value-based health care is transforming the entire health care system, including how we go about our work. And let’s be honest. A primary impetus behind this sea change is cost. 

Health care costs are rising faster than inflation. And the general consensus is that this trend is unsustainable!

We agree. AMCP is deeply engaged in finding solutions to rising costs. And we know that costs are on your minds as you work to ensure the wise use of health care resources. 

Given the urgency of this issue, the AMCP board of directors and staff recently engaged in a deep dive of the cost question from many angles. What was the response? 

In a word, “value.” 

We’ve long said that cost shouldn’t be viewed in isolation. A medication with a high cost isn’t necessarily a bad thing, if, for example, it cures the disease and avoids far more expensive treatments down the road. That’s simply good value!

Our three value messages are:

FIRST: Managed care creates better value by maximizing health outcomes for patients.  

• This can be seen through such things as our members’ MTM practices that reduce the number of medicines some patients have to take, while ensuring they receive the most appropriate options.

SECOND: We identify and reward therapeutic value by promoting the use of real-world evidence and tools. 

• This can be seen every day in the evidence-based work of P&T committees, which evaluate therapies to identify and incentivize the most effective and cost-effective options. 

And THIRD: We advocate for value through a competitive marketplace, along with policies that promote access to multiple treatment options. 

• This can be seen in efforts to help ensure that the increasing number of lower-cost biosimilars in the market are widely utilized and accepted. 

These are just some of the examples of how AMCP and managed care pharmacy are addressing costs by providing value. Stay tuned…you’ll be hearing more from us on this topic in the near future.

Still on the topic of value, I’d like to mention our work in the area of value-based contracting.

A decade ago, the idea of linking the cost of a therapy to its performance was considered revolutionary. Today, value-based contracting is seen as a potential solution to both improving patient care and better managing costs. 

I’m proud to say AMCP has taken a leadership role in this arena. Our recent partnership forum on this topic brought together diverse stakeholders who made significant progress in such areas as: 

• Defining value-based contracting; 
• Understanding performance metrics for value; 
• Overcoming patient-management hurdles; 
• Identifying “early adoption” opportunities; and 
• Addressing legal and regulatory changes needed to drive adoption of these contracts. 

The proceedings from this event are hot off the presses and available on our website. We will be following up on this topic…again, stay tuned.

And, of course, this year’s Nexus programming reflects our deep commitment to value:  

• The AMCP Foundation yesterday, for example, held a research symposium on “Value-Based Health Care: Identifying Benefits for Patients, Providers & Payers.” 
• Today’s keynote panel of experts will discuss new and emerging payment models, including those based on value. 
• We have an entire track on “changing the way we pay for health care.”
• The current issue of the Journal of Managed Care & Specialty Pharmacy is titled “Value: Changing the Way We Pay for Health Care.”
• And at the conclusion of Nexus, we will hold another partnership forum on “Patient Reported Outcomes – The Missing Link in Defining Value.”

Yes, value is our new mantra! 

My grandfather had an old Texas saying: “all hat and no cattle.” I can assure you that AMCP is not simply wearing a hat on the cost question! We are deeply engaged in the grasses — where the cattle are — looking for solutions, testing new ideas, bringing stakeholders to the table. We won’t rest until we can ensure all Americans:  

• Have access to affordable medicines. 
• Have improved health outcomes. 
• And that we’ve fulfilled our mission of “improving health care for all!”

Thank you for listening, and have a wonderful conference!