A dynamic community of managed care professionals, payers, manufacturers, and healthcare innovators gathered at the AMCP 2025 Annual Meeting in Houston to explore the evolving landscape of market access. As the industry continues to navigate challenges around healthcare policy, value-based care, pricing transparency, and the integration of real-world evidence, our team of Nexus strategists was onsite, serving as your eyes and ears. We captured key sessions and took part in real-time discussions. The Nexus team can transform these actionable insights into tailored solutions for your evolving market access needs.

We have highlighted the main themes and emerging trends relevant to market access stakeholders, shedding light on the future of access strategy and the shifting expectations shaping today’s healthcare environment. We look forward to continuing this dialogue with you at Asembia next week!

· GLP-1s truly are everywhere! The GLP-1 market continued to captivate attention at this spring’s AMCP Annual meeting. The market is growing substantially with GLP-1s’ potential value extending into new areas. Beyond diabetes and weight loss, GLP-1s may enter sleep apnea, binge-eating disorder, substance use disorder, MASH, heart failure, osteoarthritis, cystic fibrosis, polycystic ovary syndrome (PCOS), and neurocognitive disorders. Rapid growth and the potential for broad utilization are prompting payers to implement tighter access controls as they look to manage rising costs and ensure sustainable coverage strategies.

· While interest in AI for managed care is growing, there is uncertainty around appropriate implementation.

1. The application of AI continue to expand, potentially streamlining utilization management, supporting reviews and appeals, and enhancing patient portals with document summarization.

2. However, challenges such as variable outcomes, patient concerns, oversight, and the absence of clear, consistent regulatory guidance limit broader adoption.

· Price transparency, patient affordability, and the volatile healthcare landscape were common concerns. With new specialty drugs and the rise in specialty drug spend, management of high-cost categories, such as oncology and rare disease, remains top of mind for payers. Costly oncology therapies, including CAR-T, will continue to be managed with a variety of tools, including PA best practices, site of care networks and centers of excellence requirements, and enhanced care management. It is expected that more states will establish prescription drug affordability boards (PDABs) to explore ways to increase accessible to patients while controlling costs. The anticipated rise in drug shortages over the next five years, coupled with a decline in retail pharmacy locations, may limit patient access and reduce affordability, underscoring the need for proactive strategies to ensure continuity of care.

· Stakeholder perspectives extend beyond the traditional payer. Employers are increasingly influencing market access strategies for specialty drugs, driving demand for greater value and transparency. At the same time, ongoing PBM reform efforts may restrict the cost-management tools traditionally leveraged by PBMs. Additionally, potential changes to the 340B program—and the growing dialogue surrounding it—are poised to significantly impact stakeholders across the hospital system.

Speak with the Nexus Health strategy experts at Asembia to transform your market access challenges into tailored solutions.

About Nexus Health

The Nexus Health Group provides an integrated, simplified approach to comprehensive market access strategies, offering solutions in strategic
consulting, value communications, and patient access and affordability. Nexus experts combine deep market access experience in complex therapies with a foundation in science to provide the strategic advantages manufacturers need to launch and differentiate their products in today’s marketplace. Launched in 2025, Nexus may be a new company, but with an average of 21+ years of experience, the team is far from new to market access.

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