Insights on Managed Care from C-Suite Healthcare Executives at AMCP Annual 2025
Managed Care: A Call for Change
Managed care is facing unprecedented challenges as pharmacy benefit managers (PBMs) navigate increasing pressures from various markets, consumers, and an evolving policy landscape. Juan Carlos Scott, the president and CEO of the Pharmaceutical Care Management Association (PCMA), shared these insights during the Academy of Managed Care Pharmacy annual meeting in Houston.
Scott outlined that, “The combination of increasing cost, demand, and political activity creates an environment that's really ripe for disruption and change, and also opportunity to think about how we do the business of PBM differently,” highlighting the critical need for forward-thinking strategies within health systems.
The Role of PBMs in Modern Healthcare
- PCMA serves as the trade association for the established PBM industry.
- PBMs are increasingly scrutinized by lawmakers and antitrust regulators while striving to demonstrate their value.
- Recent data revealed that the median annual launch price of a drug is approximately $300,000 in 2023, which has prompted concerns.
“America's patients are facing an affordability challenge,” Scott asserted, noting that this issue is exacerbated by inflation impacting costs associated with essentials like groceries and housing. The discussion emphasized the importance of addressing these challenges as healthcare executives consider how best to adapt managed care practices moving forward.
For further details on this evolving landscape of managed care, please visit the source.
This article was prepared using information from open sources in accordance with the principles of Ethical Policy. The editorial team is not responsible for absolute accuracy, as it relies on data from the sources referenced.