More than 3,000 leaders from across the healthcare ecosystem, including pharmacists, payers, providers, biopharma and health-tech innovators, gathered at the Academy of Managed Care Pharmacy (AMCP) Nexus from October 27-30 in Washington, D.C. For the first time, the agenda also included a full-day Policy Summit to discuss how key polices will reshape patient access, reimbursement and drug spending for years to come.
The Center for U.S. Healthcare Policy Research had a major presence at the event, presenting several studies that brought data-driven insight to some of the most pressing issues facing patients and policymakers today. Center experts presented five research posters exploring questions that impact patients, payers and policymakers:
- Is prescription drug spending driving state Medicaid budgets?
- Are 340B hospitals expanding into communities most in need?
- Why do many insurance plans fall short for patients with chronic conditions?
- How can employers better support their employees with chronic disease?
- Are cost-effectiveness thresholds fit for purpose in the decentralized U.S. payer system?
Healthcare stakeholders expressed substantial interest in data from J&J studies, specifically data showing that drug spending is not the main driver of healthcare spending in Medicaid. AMCP organizers decided to feature the J&J poster as the lead story in the official AMCP daily brief, distributed to 8,000 managed care stakeholders in the U.S. The results were further discussed in an article by Managed Healthcare Executive. Meanwhile, conversations around the 340B Program gained momentum following last week’s Senate hearing on the need for reform, as well as a recent report by the Congressional Budget Office (CBO), both of which included important findings from a recent J&J study raising concern about 340B child site growth.
How did the Center’s research connect to the broader themes presented at AMCP?
- 340B Reform and Hospital Transparency: The 340B panel discussed proposals from state and federal policymakers to reform or protect 340B and was framed as an exploration of the “Tale of Two Cities,” highlighting two starkly different views of the program. The panel’s moderator, William Sarraille, Professor of Practice at the University of Maryland Francis King Carey School of Law, noted that even after adjusting for drug, patient and geographic factors, the markup at 340B hospitals for physician-administered drugs was more than 6 times that at independent physician practices. J&J’s 340B research was referenced in discussions of the program’s massive expansion and limited patient benefit, reinforcing the need for accountability and transparency in how 340B profits are used.
- Pharmacy Benefit Manager (PBM) Reform: Congress has discussed several reforms to the commercial market and PBMs over the last few years, while state legislators have also increasingly scrutinized PBM practices. With the announcement that Cigna’s Express Scripts intends to move away from traditional rebate models, panels explored how reforms can ensure savings reach patients. J&J believes that reforms should focus on meaning fully reducing out-of-pocket expenses, holding PBMs accountable to ensure discounts are shared with patients.
- Inflation Reduction Act (IRA): In addition to concerns about IRA price setting, experts cautioned that increased utilization management as a result of increased plan liabilities under the IRA could, ultimately inadvertently result in reduced access for many patients. The panelists expressed significant concerns about the unintended impact of IRA changes to the Medicare Part D benefit, discussing a study modeling potential formulary restrictions that could result in high rates of non-medical switching and therapy abandonment, with broader implications for patient care.
- Patient-Centered Research and Insights: Sessions on “Unlocking the Value of Patient-Centered Research for Payer Decision Making” mirrored the Center’s focus on understanding real patient experiences. Experts recognized opportunities for patient-centered research to inform healthcare decision-making and policy. J&J research featured at AMCP included participants recruited from J&J’s Patient Engagement Research Council (PERC), which revealed how insurance too often fails to meet the needs of chronic disease patients.
From state Medicaid policy to chronic disease coverage, AMCP Nexus showcased how rigorous, patient-centered research is essential to inform smarter policy decisions.
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