A handful of PBMs have nearly 70% share in 3 product markets
New evidence sheds light on the need for more transparency and oversight of pharmacy benefit manager (PBM) policies and practices. Learn more.
Your powerful ally
The AMA helps physicians build a better future for medicine, advocating in the courts and on the Hill to remove obstacles to patient care and confront today’s greatest health crises.
AMA finds competition decline among drug middlemen
AMA releases updated analysis of competition and vertical integration in commercial PBM markets
Delivery reform: Council on Medical Service reports
Download PDFs of council reports that advocate policies on emerging delivery systems that protect and foster the patient/physician relationship. Key Council reports on this topic have addressed patient-centered medical homes, precision medicine, APMs, telemedicine, and retail and store-based health clinics.
Council on Medical Service reports
Download PDFs of Council on Medical Service reports and issue briefs.
Drug coverage & spending: Council on Medical Service reports
Download PDFs of council reports that have proposed strategies to address high and escalating prescription drug prices and costs, including promoting transparency and pharmaceutical market competition, combating anti-competitive practices, and outlining criteria for value-based pricing and prescription drug importation.
AMA praises CMS for prior authorization reforms in Medicare Advantage
New final rule includes provisions toward right-sizing the prior authorization process imposed by Medicare Advantage plans
March 24, 2023: National Advocacy Update
CMS issues new guidance on PHE unwinding, including important implications for audio-only services and more in the latest National Advocacy Update.
Jan. 27, 2023: National Advocacy Update
Medical organizations urge Congress to prioritize Medicare physician payment reform and more in the latest National Advocacy Update.