Insights from AVBCC: Shifting Dynamics in Cancer Care

The 2025 Association for Value Based Cancer Care (AVBCC) Conference in New York brought together the industry’s biggest leaders, innovators, and decision-makers to address the rapidly evolving landscape of oncology therapies. From pricing pressures to AI disruption, the sessions revealed both systemic challenges and strategic opportunities—particularly for pharma companies seeking clarity in a turbulent policy environment. Our US Policy experts, William Fleming, Steve O’Malley, and Joe Honcz were on the ground, engaging in thoughtful conversations and gathering insights into this ever-changing space. Here are a few standout moments that caught their attention:

Pricing Shake Up

One of the most striking moments came from manufacturers themselves, who openly acknowledged that U.S. drug prices are not sustainable. Even more notably, they called out the need to rethink ex-U.S. pricing models, which have long been treated as secondary or additive. This signals a shift in tone—away from defensiveness and toward proactive recalibration.

Pharma leaders discussed leveraging the current climate of uncertainty—driven by policy shifts, global economic pressures, and public scrutiny—as a catalyst for change. There’s a growing appetite to use this moment to reset pricing norms, especially around line extensions and legacy discount structures.

Strategic Optionality: Planning for the Unknown

Across sessions, the phrase “strategic optionality” echoed repeatedly. With policy developments unfolding rapidly—MFN, production mandates, and shifting FDA priorities—leaders stressed the need for flexible, forward-looking planning. The ability to model multiple scenarios and pivot quickly is no longer a luxury; it’s a necessity.

Market access is evolving beyond traditional payer engagement. Today’s account executives must be fluent in government policy, capable of translating legislative shifts into strategic implications for coverage, reimbursement, and contracting. It was emphasized that a good market access leader must understand how government decisions shape the market—not just how payers operate. This is a significant expansion of the role, and one that many teams are not yet equipped to handle.

The ongoing government shutdown—now in its third week—has narrowed Congressional priorities and slowed progress, but not halted it. Most insiders expect resolution around Thanksgiving. This climate reinforces the need for strategic optionality, as pharma leaders must plan amid political gridlock and unpredictable policy shifts.

340B: A System in Flux

The 340B program remains a flashpoint, with deep uncertaintly across pharma, providers, and health systems. The complexity of contract pharmacy arrangements, opaque TPA practices, and state-level policy shifts are creating a fragmented and often adversarial environment.

There’s no clear solution yet—but the need for intentional monitoring and strategic guidance is urgent. Pharma companies are seeking clarity on how to engage with 340B entities without exacerbating systemic inefficiencies or compliance risks.

AI in Pharmacy: Investment and Uncertainty

AI is no longer theoretical—over $1B has been invested in pharmacy-related AI initiatives. Oracle’s open AI marketplace approach, aimed at solving clinical trial recruitment and system configuration, is just one example of how tech is reshaping the space.

But not all AI is created equal. The challenge is to discern where AI is truly driving value versus where it’s falling short or creating new risks. Organizations must intentional and analytical in identifying use cases that align with their strategic goals to  separate hype from substance.

What Comes Next

In a landscape defined by complexity and rapid change, clarity is no longer optional—it’s essential. At Petauri, we don’t just observe these shifts, we help our partners navigate them with confidence. From pricing strategy to policy foresight, our team brings deep expertise and actionable insight to every challenge. As the AVBCC conference made clear, the future of cancer care demands agility, strategic optionality, and a willingness to rethink the status quo. Petauri stands ready to guide pharma leaders through this transformation—turning uncertainty into opportunity, and insight into impact. For more information on how Petauri can support you, contact us at info@petauri.com