Insights from the AMCP Nexus 2025 Meeting

Health policy, specialty drugs, real-world data, PBM reform, Medicare/Medicaid and more health policy. Those were some of the biggest themes at this year’s Academy of Managed Care Pharmacy (AMCP) Nexus meeting last week at the Gaylord National Resort and Convention Center in National Harbor, Maryland.

Almost 3,000 managed care pharmacy leaders came together to discuss these and other issues. New this year was the AMCP Pharmacy Policy Summit on key issues in healthcare, such as the Inflation Reduction Act, Medicaid reform, PBM reform, biosimilars and generics, and the 340B program. In addition, there were more than 400 poster presentations and more than 60 exhibiting companies at the meeting.

With speakers such as Robert Costa, national correspondent for CBS Sunday Morning and chief Washington analyst for CBS News, and former House Speaker Paul Ryan, the Nexus meeting addressed how healthcare has become a battleground.

Costa said during the policy summit that populist movements on both the left and right are fundamentally reshaping healthcare debates in ways that defy traditional partisan frameworks.

“You can’t look at policy as red versus blue anymore," Costa said. “It’s about how populism is informing the parties and the party leaders, and it’s about grievance with the global economy and grievance about cost.” To read more, see our story here.

Ryan was optimistic that reform and innovation that are guided by healthcare leaders and evidence can lead to a sustainable system. He outlined his vision for a more patient-centered and sustainable healthcare system and advocated for state-based risk pools to cover the sickest Americans.

“Healthcare is the core of our social contract as a country,” Ryan said. “Our social contract is a healthy retirement security for all Americans and a safety net for the poor. Medicaid is a big part of the safety net. The challenge we have as a society is that we designed the social contract in the 20th century in a way that is proving fiscally unsustainable in the 21st century.” To read more, see our story here.

One of the more contentious sessions, however, was about PBM reform. There is broad consensus in Congress and among many within the industry about the need for reform of how prescription drugs are managed and how to lower the costs for employers, payers and patients. But there continue to be disagreements about what that should look like.

But even the panelists couldn’t agree on what the issues were or how to bring down costs for patients without causing healthcare costs and premiums to rise for both employers and patients. The panelists included Michael Baxter, M.A., from the American Pharmacists Association; Sujith Ramachandran, Ph.D., from the University of Mississippi School of Pharmacy; and Angela Banks from the Pharmaceutical Care Management Association (PCMA).

They debated PBM reform, disagreeing on spread pricing ethics and rebate transparency while also discussing costs, risks, and whether current contracting models benefit patients. See more here.

In an interview, managing editor Peter Wehrwein talked with Milliman's Jennifer Cruz, Pharm.D., about what health plans should ask for from their PBMs, including being able to track rebates to their book of business and having strong audit rights.

The meeting also highlighted plenty of posters and abstracts on various issues related to drug pricing, use, and payer policies. One abstract from researchers at Tufts Medical Center found that medications with higher rebates may be less likely to face insurance coverage restrictions, while those with higher net prices could be more likely to be limited. Another from the J&J Center for U.S. Healthcare Policy Research found that drug pricing is not the main driver of state Medicaid spending.

AMCP is working with stakeholders to address the challenges for integrating real-world evidence into healthcare decision-making. By the first quarter of 2026, AMCP plans to launch a map for RWE Integration into Formulary Evaluation. This year, the organization developed a standards document to better align payers and pharmaceutical companies on understanding and applying real-world evidence.