Data and workflows have to be aligned for integrated pharmacy benefits | AMCP Annual 2026

When medical and pharmacy benefits are managed separately, each side may maintain its own utilization management policies and criteria. Bringing them together means reconciling different data structures and workflows into a single, unified view, Camille Rabe, Ph.D., clinical account director at Prime Therapeutics, said in an interview ahead of the AMCP Annual Meeting being held in Nashville from April 13, 2026, to April 16, 2026.

On the data side, tools now exist that integrate both medical and pharmacy claims into a holistic picture. An example is the integrated analytics dashboard that consolidates medical and pharmacy claims data for both Prime and its health plan partner, Horizon. Through this dashboard, stakeholders can identify high-cost therapies, track trends, and understand the full downstream impact of benefit decisions. This is especially significant for members managing complex conditions such as oncology or autoimmune diseases, where costs and care settings can vary widely.