Health Policy Challenges and Innovative Solutions at AMCP Nexus 2024

These days, health policy developments are happening so quickly that they’ll keep you up at night—not to mention that the upcoming US election will undoubtedly have implications for health policy research and care delivery.

Kimberly Westrich, MA | Image credit: National Pharmaceutical Council

So perhaps it’s appropriate that next week, we’ll be heading to the City That Never Sleeps* for the AMCP Nexus 2024 conference from October 14-17, where we’ll discuss today’s most pressing policy challenges and ideate innovative solutions with health care leaders and managed care pharmacy professionals.

Here are the things I’m most excited about!

First, I’m eager to participate in thoughtful conversations about how health care decision-makers can remove barriers to care and improve patient access to vital treatments:

• On Tuesday, 10/15, at 8:30 AM PDT, I am moderating “What You Need to Know About Copay Accumulators, Maximizers, and Alternative Funding Programs” with Laura Huff, BA, vice president of Research & Insights, Arthur J. Gallagher & Company; Cody Midlam, PharmD, director in the Pharmacy community, WTW; and Alison Falb, JD, health policy director, Applied Policy. We're discussing the rise of controversial specialty pharmacy management programs, including co-pay accumulators, co-pay maximizers, and alternative funding programs (AFPs). The panel will explore the financial and ethical considerations of the programs, why they have recently gained popularity among employers, and describe ongoing policy and legal developments.
• Also on Tuesday, 10/15, at 3:30 PM PDT, Jonathan James, president and CEO, Hope Charities, will share topically related research on how AFPs impact patient access and overall care experience during the Research Podium Session.
• On Wednesday, 10/16, at 1:00 PM PDT, my colleague James Motyka, PharmD, research manager, National Pharmaceutical Council (NPC), will share a poster exploring the relationship between commercial health plans’ utilization management criteria for specialty drugs and clinical treatment guidelines, “Alignment of commercial health plan utilization management criteria with clinical treatment guidelines.” This analysis found that even when guidelines were favorable, plans applied additional utilization management criteria in most decisions for specialty drugs.

Second, I look forward to participating in the Corporate Member Council Meeting on October 16 at 3:00 PM PT with Melissa Andel, MPP, principal, CommonHealth Solutions LLC; Michael Einodshofer, founder, MERx Pharmacy Consulting LLC; and Andrew McKechnie, partner, Tiber Creek. We will discuss how the upcoming election will shape the policy landscape in the short and long term, including possible lame-duck health packages and the presidential candidates’ potential health care agendas. As a researcher, I believe good policy must rely on sound evidence. At NPC, we conduct policy-relevant research and communicate it with impact. I look forward to hearing more about policies of interest from the decision-makers gathered for this conversation.

Finally, I’m always excited to connect with the next generation of health policy researchers and managed care professionals. NPC is proud to sponsor the student and new practitioner networking event on October 15 at 6:30 pm PT. The reception will provide a forum for young professionals to connect, exchange ideas, and engage in thoughtful discourse. Jackie McRae, PharmD, MS, whom NPC recently welcomed as vice president of Policy and External Affairs, will provide opening remarks to welcome attendees. NPC is deeply committed to creating future health policy leaders and will begin accepting applications for our 2025-2027 Health Policy & Communications Fellowship on October 11.

There is never a dull moment in health policy, and I look forward to sharing NPC’s research and learning from the leaders and researchers at AMCP Nexus next week. If you’re in Las Vegas, please come say hello!

*(Putting on my life coach hat: make sure you get some sleep while in the City That Never Sleeps.)

Kimberly Westrich, MA, is the chief strategy officer of the National Pharmaceutical Council.