A Blog by AMCP CEO Susan A. Cantrell, RPh, CAE




AMCP Legislative Days Focuses on Passage of PIE Act, Efforts to Reduce Fraud, Waste and Abuse in Medicare Part D




March 7, 2018 

One of AMCP’s key strategic pillars is to advocate for legislation that will help advance the profession of managed care pharmacy. This function is on full display this week during our Annual Legislative Days event. I am proud to join nearly 20 of AMCP’s volunteer leaders and staff in a trek up Capitol Hill to meet with more than 50 House and Senate offices on two crucial issues:  

  • Passage of the Pharmaceutical Information Exchange (PIE) Act of 2018 (H.R. 2026).
  • Initiatives to reduce fraud, waste and abuse under the Medicare Part D program.

The first issue is one you’ve heard me discuss many times. In a nutshell, the PIE Act will allow biopharmaceutical manufacturers to proactively share truthful and non-misleading clinical and economic information about medications in the pipeline with population health decision makers at least 12-18 months prior to FDA approval, during the forecasting and rate setting process. AMCP has been leading advocacy on H.R. 2026 as it will allow decision makers to expedite coverage decisions as soon as new medications hit the market. 

The PIE Act is in a crucial phase. It recently passed the House Energy & Commerce Committee’s Subcommittee on Health, and is now before the full E&C Committee. A vote is expected very soon. During our visits this week we sought bipartisan House support for the bill, as well as a Senate champion.

The second top issue at Legislative Days aims to address ongoing concerns over continued fraud in the Medicare Part D program. In 2016, the federal government spent $1 trillion on Medicare Part D, but CMS estimated that $2.39 billion of that total was for improper prescription payments. CMS has testified that they cannot extrapolate how many claims are actually fraud, waste or abuse, but in 2017, the DOJ and HHS announced charges for more than 400 individuals who claimed more than $1.3 billion in fraudulent billings/payments.

The current Congress has not yet introduced specific legislation to address fraud, waste and abuse in Part D, but has expressed great interest in addressing the problem. AMCP supports reducing the current practice of “pay and chase,” to recover fraudulent payments. Part D Prescription Drug Plan (PDP) sponsors can and should play an important role in fighting fraud in the Medicare Part D Program. Greater involvement by PDP sponsors will reduce the incidence of fraud and result in substantial savings for beneficiaries and taxpayers.

AMCP works continuously on behalf of our members, including on these issues and others. We are cementing our reputation in Washington as the “go-to” organization for population health management and design of medication benefits. Stay tuned for more details on Legislative Days 2018, and visit http://amcp.org/AMCPPositions/


PIE Act Addresses Lag Between FDA Approval and Patient Access; Cantrell Makes Case for H.R. 2026 in The Hill 



February 7, 2018 

The FDA approved 46 novel drugs in 2017, a 21-year high. However, it could take as long as six months for some of these groundbreaking medicines to reach patients, as pharmaceutical review committees work their way through complex clinical information to determine how, when, and why a new drug should be prescribed. The way things stand now, the insurers and pharmacy benefits managers (PBMs) that set copayments, premiums, and reimbursement rates do not receive reliable data about a new treatment until it is approved by the FDA. But it can take months to assess that information and establish appropriate prescribing standards, meet state health insurance rate filings, fulfill Medicare and Medicaid requirements, and negotiate contracts with health care purchasers.

Read Cantrell’s full op-ed at bit.ly/2DQpuIZ  


New Strategic Plan Built on Close Look at Sector Changes and Challenges 


January 5, 2017 

I am delighted to announce the release of our new strategic plan, AMCP 2020, which will guide and strengthen the Academy as we enter our 30th year of serving thousands of professionals who make up managed care pharmacy. Read more.


The Strategic Planning That Goes into Developing AMCP's New Strategic Plan

Dec. 6, 2017

The Academy will soon unveil a new strategic plan to guide our organization over the next several years. As it’s rolled out ‒ more on that next month ‒ I thought I would highlight some of the deliberations that went into developing the plan. Read more.


Speech at General Session of AMCP Nexus 2017 

October 31, 2017

It’s wonderful to be here in Texas. AMCP has many longtime members and friends from the great Lone Star State, including many from right here in the Dallas region. We also have many members from the Houston area. Our heart goes out to everyone in Texas affected by Hurricane Harvey, as well as all of the other recent storms and now the wild fires in California. Read more.



As the ACA's Future Remains in Limbo, PIE Legislation Moves Steadily Forward

September 28, 2017

Health care reform historically has been one of the most contentious issues on Capitol Hill. The current fight to repeal the Affordable Care Act (ACA) is just the latest in a string of battles that reaches back many decades, including to the founding of Medicare and Medicaid. Read more.


AMCP Offers Prayers, Collects Items for Victims of Hurricane Harvey; Will Deliver Portion of Socks Collected by AMCP Foundation to Houston Charities

September 5, 2017

Like everyone across the country, AMCP members and staff share a deep concern for the safety and wellbeing of thousands of people displaced by Hurricane Harvey. Read More.

NEJM Article on ‘Accelerated Approvals and Expensive Drugs’ Misses Promising Solution 


August 21, 2017  

A recent article in The New England Journal of Medicine (NEJM) caught my attention for a couple of reasons. Read More


Leading on Today’s Most Pressing Challenges: AMCP Partnership Forum Develops Action Plan for Advancing Value-Based Contracting 


June 29, 2017 

One of the many things that I’m proud of at AMCP is our role as a convener. We bring together several times a year key stakeholders representing a diverse range of positions to address common health care challenges. Read More. 


My Recent "Field Trip" to Arizona Highlights AMCP's Breadth and Depth


May 31, 2017 

One maxim I hold dear is the value of getting out of the office now and then to see how things are working in the field. I had that opportunity recently with a “field trip” to the beautiful state of Arizona, where I participated in several events: a workshop on strategies to strengthen association governance, a conference on integrating data in pharmacy practice, a visit with student pharmacists, and a tour of an innovative MTM service center. ... Read more


AMCP Nexus 2017 Theme Announced: “Changing the Way We Pay for Health Care”


May 2, 2017 

Volume to value, quantity to quality: such transitions in health care today are like a rock tossed in a pond. The ripple effects are far-reaching and unstoppable. So important is this transformation that we’re dedicating a significant amount of programming to the topic at our fall conference in Dallas (Oct. 16-19). In fact, we’re calling it “AMCP Nexus 2017: Changing the Way We Pay for Health Care.” ... Read more.


Eye on the Hill: AMCP Sees Progress in PIE Bill and Will Continue to Promote Comprehensive Pharmacy Benefit in Health Care Reform Efforts


April 11, 2017 

Whoever said, “May you live in interesting times,” could have been talking about Congressional health care policy debates circa 2017. Never a dull moment!

Many things are happening on the health care legislative front, and AMCP has been in the thick of it. ... Read more.


Ripped from the Headlines - Annual Meeting Sessions Tackle Real-life Issues 


March 1, 2017 

Every morning — like many of you — I settle behind my desk, take a sip of coffee and read the AMCP Daily Dose. This publication, full of valuable news and information, frequently highlights issues and individuals we’re featuring at our Annual Meeting, March 27-30, in Denver. Several caught my eye recently. ... Read more.


AMCP Celebrates Early Win: FDA Issues Draft Guidance to Improve Communications Between Biopharmaceutical Companies and Population Health Decision Makers


February 1, 2017 

Sometimes the best laid plans are upended when you least expect it!

In mid-January, the FDA released draft guidance to facilitate the sharing of information between biopharmaceutical companies and population health decision makers. To say we were pleasantly surprised is an understatement. ... Read more.


Making PIE to Better Serve Patients


January 11, 2017 

Let’s imagine you’re a big city mayor and it’s time to order a new fleet of police cars for next year. Applying due diligence, you set out to compare various models from a variety of manufacturers. ... Read more.


Century Cures Act Advances AMCP's FDAMA Goals, Improves Value-Based Communications Between Manufacturers and Managed Care Pharmacy


December 22, 2016 

Who says Congress can’t get anything done…and with bipartisan support to boot? With impressive speed and purpose, the House and Senate overwhelmingly passed the 21st Century Cures Act in the waning days of the 114th Congress, followed by President Obama’s prompt signature. ... Read more.


Pharmacy Profession Comes Together to Help Document and Improve Patient Outcomes Through Medication Therapy Management


November 7, 2016 

People can accomplish remarkable things when they work toward a common goal. That’s what happened recently when a diverse group of pharmacy stakeholders gathered to develop standardized terms for medication therapy management (MTM) services. ... Read more.


AMCP really knows how to get things done!


October 13, 2016 

Not long ago a respected individual in the health care arena told one of my senior staff: “Compared to other associations I work with, AMCP really knows how to get things done.” You cannot imagine how proud I felt ... Read more.


AMCP Volunteers Are a Happy Lot


September 20, 2016 

There are many ways to measure the health and vitality of a professional association. The most crucial indicators, I’ve found, center on the engagement of an organization’s volunteers. This can be measured in the number of volunteer opportunities provided, the number of members who sign up, and the level of satisfaction they get from volunteering. ... Read more.


The Post Cites Pharmacists’ Expanding Role on Medical Teams


August 26, 2016 

Last week I saw a headline that jumped off the page: “America’s other drug problem: Giving the elderly too many prescriptions” (Washington Post, Aug. 15). I couldn’t read it fast enough and encourage members to do likewise, as it highlights two of the most important developments in health care. ... Read more.


Seizing Opportunity: AMCP Nexus 2016 Offers Knowledge, Advancement and More


August 3, 2016 

“Healing is a matter of time, but it is sometimes also a matter of opportunity,” said the great Hippocrates, father of western medicine.

Opportunity, in fact, is a crucial element in the work that managed care pharmacy professionals engage in every day to improve the health, wellbeing and “healing” of millions of patients. We seize opportunities to find the right medicines for the right patients at the right time. ... Read more.


BRC Now Lets You Look It Up


July 13, 2016 

It was only ten years ago when biosimilars were so new that the New York Times described them as “so-called.” As late as five years ago newspapers put quotation marks around the term, as in “biosimilars.” At the time some still called them “follow-on” biopharmaceutics. ... Read more.


Is FDAMA Section 114 Finally Ready for Prime Time?


June 24, 2016 

Information is the life blood of managed care pharmacy. Of the “competent and reliable scientific” variety, that is.

Our profession operates best when we have broad access to the latest evidence-based data on the multitude of products coming to market today. We can plan, we can assess. With this information, managed care pharmacy professionals can help health care providers and patients select the right drug for the right patient at the right time, while making appropriate use of our scarce health care dollars. ... Read more.


Getting it straight with the updated AMCP Format!


May 19, 2016 

Using the best evidence possible to make informed health care decisions is a hallmark of managed care pharmacy. But making sense of the data often is no easy task, especially when it comes to analyzing pharmaceuticals and the value they bring to patients and the health care system... Read more.


CEO Susan Cantrell Addresses AMCP Annual Meeting


May 10, 2016 

New&Views announces a new monthly column by CEO Susan A. Cantrell, RPh, CAE, on breaking news and critical issues. Her first column presents her recent address―her first to the membership―at AMCP’s recent Annual Meeting.

“It is truly an honor to be standing before you today as the Academy’s new CEO. While new to the AMCP staff, I’ve been an observer and at times a participant in the terrific work of this organization. ..." Read more.