'Bad data in, means bad data out'—pharmacists on the limits of AI in managed care

Managed care pharmacy teams are using AI to work faster, but the pharmacists overseeing those tools still own the decisions, according to two experts who presented on the topic last week at AMCP Nexus 2026, the Academy of Managed Care Pharmacy's annual meeting.

In this video interview with Managed Healthcare Executive, Annesha White, Pharm.D., M.S., Ph.D., senior associate dean and professor at the University of North Texas Health College of Pharmacy and Health Professions, and Fredrick Manasseh, Pharm.D., MBA, BCGP, senior vice president of pharmaceutical strategies at USI Insurance Services, discuss AI's benefits, its risks and the skills pharmacists need to manage it.

Asked where AI is helping today, White pointed to pipeline forecasting and prior authorization review. However, when payers and employers use AI for decisions such as prior authorization, validation and clinical oversight are critical because those decisions affect whether patients can get their medications, she said.

Manasseh noted studies in which decisions made with AI tools were later reversed. White warned of automation bias, in which people check a tool's work less often as they get used to it.

“We know that bad data in means bad data out,” she said.

Building trust in AI tools

Asked whether all that checking cancels out AI's time savings, both said the effort pays off. A strong governance process can save time, as long as professionals can explain what a tool is doing and stand behind its answers, according to White.

“The heavier lift is in the beginning,” Manasseh added.

That trust also depends on knowing whether a tool is ready to use. White said many organizations are using AI tools without a formal readiness review. She urged leaders to assess tools before use and recheck them one and two years later.

Looking ahead to the workforce, the conversation turned to training. When asked what skills pharmacists will need, White said AI literacy is now a core competency that schools of pharmacy are promoting. Manasseh said clinicians should ask why an AI tool made a recommendation, what data it used and how its performance is tracked.

“AI is not replacing their role,” he said. “It's almost an enhancement or a tool to be used to make better decisions.”