AMCP RELEASES 2025 REPORT HIGHLIGHTING THE VITAL ROLE OF MANAGED CARE PHARMACY IN IMPROVING ACCESS, AFFORDABILITY, AND OUTCOMES

The following information was released by the Academy of Managed Care Pharmacy (AMCP):

The Academy of Managed Care Pharmacy (AMCP), in partnership with the AMCP Research Institute, published the 2025 edition of its annual Access, Affordability, and Outcomes: The Value of Managed Care Pharmacy report, which provides an in-depth look at how managed care pharmacy practices improve patient health outcomes, control prescription drug spending, and promote affordability for millions of Americans.

This year's report reinforces how clinical expertise, data-driven decision-making, and policy alignment are helping patients and payers achieve better outcomesunderscoring the importance of evidence-based tools such as prior authorization, medication therapy management (MTM), and drug utilization review (DUR) in advancing both quality and cost-effectiveness across the health care system.

"Our goal is to develop a more comprehensive understanding of how benefit design influences patient health," said Susan Cantrell, MHL, RPh, CAE, Chief Executive Officer of AMCP. "Doing so helps policymakers and insurers continue to implement strategies that promote accessible and cost-effective care."

Key Findings from the 2025 Report:

U.S. prescription drug spending rose to $450 billion in 2023, a more than a tenfold increase since 1990, yet managed care pharmacy tools helped mitigate sharper cost growth.

85% of Medicaid beneficiaries and 54% of Medicare enrollees were covered under some form of managed care plan in 2023.

Patients who gained insurance coverage filled 1317% more prescriptions after coverage began, demonstrating the clear link between coverage and access.

Medication adherencea core measure of managed care effectivenesswas associated with reduced hospitalizations and improved outcomes across diseases including diabetes, cardiovascular conditions, and cancer.

Specialty drugs and biosimilars continue to reshape the market: specialty drugs now account for nearly 50% of total drug spending, while biosimilars have driven competition and cost savings, with 72 FDA-approved products as of mid-2025.

The report also examines the shifting dynamics between medical and pharmacy benefits, the growth of preferred pharmacy networks, and the use of precision medicine and artificial intelligence in managed care.

About AMCP

AMCP is the professional association leading the way to help patients get the medications they need at a cost they can afford. AMCP's diverse membership of pharmacists, physicians, nurses, biopharmaceutical professionals, and other stakeholders leverage their specialized expertise in clinical evidence and economics to optimize medication benefit design and population health management and help patients access cost-effective and safe medications and other drug therapies. AMCP members improve the lives of nearly 300 million Americans served by private and public health plans, pharmacy benefit management firms, and emerging care models.

About AMCP Research Institute

Building on AMCP's proven track record in research through BBCIC, AMCP Research Institute (ARI) expands AMCP research horizons to encompass comprehensive studies, including cost analyses and policy support. ARI aims to elevate AMCP's mission, drive policy, and enhance member value by delivering robust, unbiased research that empowers practitioners and shapes the future of managed care pharmacy.