Resources for students such as educational tools covering a variety of managed care topics and information on professional opportunities (internships, APPEs, fellowships and residencies) related to managed care pharmacy.
The Academy of Managed Care Pharmacy (AMCP) supports policies that encourage the incorporation of cost-effectiveness considerations into health care decision-making. Cost-effectiveness analysis (CEA) is a method to assess the value of the clinical outcomes of a treatment relative to the cost. This type of analysis aligns with managed care objectives to optimize patient outcomes, maintain affordability, and encourage sustainability. CEA offers guidance to decisions about coverage and pricing to support managed care strategies—like formulary design, prior authorization, step therapy, and value-based contracting. Policies that promote cost-effectiveness help to ensure patients have access to treatments that deliver meaningful health outcomes at sustainable costs.
The Academy of Managed Care Pharmacy (AMCP) supports scientifically-sound research that compares the effectiveness and value of medications and treatments, as well as research aimed at tailoring treatment options to individual patients’ needs. Prescribers and patients need this information to evaluate and select treatment options most likely to achieve a desired therapeutic outcome. Health care decision-makers use this information when designing benefits to ensure that safe and effective medications with the best value are provided for all stages of treatment. Such research encourages optimal medication use while also promoting the prudent management of financial resources within the health care system. AMCP believes that the following principles apply to both comparative effectiveness research (CER)1 and patient‐centered outcomes research (PCOR)2 in the context of managed care: the appropriate role of the federal government and other entities (both public and private) in coordinating, funding, and disseminating the results of such research; the characteristics of research design; and the use of research results by patients, providers, and health care decision-makers.
On Dec. 19, the Trump administration closed out a year of international pharmaceutical reference pricing announcements with the publication of CMS’s proposed Global Benchmark for Efficient Drug Pricing (GLOBE) and Guarding U.S. Medicare Against Rising Drug Costs (GUARD) models, as well as the release of nine additional Most-Favored-Nation (MFN) pricing arrangements with major pharmaceutical manufacturers. The announcements align with the Trump administration’s goal of lowering the prices that American patients pay for prescription drugs to the prices paid in similarly developed countries, as well as May 12 Executive Order on delivering MFN prices to patients.
On Dec. 4, Senators Mike Crapo (R-ID) and Ron Wyden (D-OR), Chair and Ranking Member of the Senate Committee on Finance, introduced the PBM Price Transparency and Accountability Act (S. 3345). The bill’s introduction signifies Congress’ appetite towards passing pharmacy benefit manager (PBM) reform, with many of the bill’s provisions included in earlier reform proposals adopted at the state level. This includes bans on the use of spread pricing arrangements, delinking PBM compensation from the price of a drug, and increased transparency into PBM contracts and business practices.
On Friday, November 21, the Centers for Medicare and Medicaid Services (CMS) released CY 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) payments Final Rule, updating Medicare rates and announcing policy changes. The rule includes payment increases for hospitals and ASCs meeting quality reporting requirements and outlines significant reforms related to drug payment and procedural lists. There is a 30-day notice for comments on IRA negotiation factors for 2028 (comment period will begin once forms are published).
On December 9, 2025, the Food and Drug Administration (FDA) released final guidance on promotional labeling and advertising for prescription biological reference products, biosimilar products, and interchangeable biosimilar products (Final Guidance).
AMCP Legislative & Regulatory Briefing — November 2025
As mostly non-pediatric organizations representing public health, older adults, patients, family caregivers, consumers and healthcare workers, we support everyone having access to every vaccine they need, regardless of their age. In the United States alone, routine childhood vaccinations for children born between 1994 and 2023 are projected to prevent about 1.13 million deaths, and hundreds of millions of illnesses and hospitalizations. Put simply, childhood vaccines make healthy adults.
On December 4 and 5, 2025, the Advisory Committee on Immunization Practices (ACIP) met to discuss and vote on the committee’s recommendations for the hepatitis B birth dose and the childhood and adolescent vaccination schedule.
