Intern Perspectives: Cody Madsen, AMCP Foundation/Pfizer, Inc. Managed Care Internship

This summer, I had the privilege of serving as an AMCP Foundation/Pfizer Managed Care Intern with Excellus BCBS. As a student pharmacist interested in managed care and medication access, I valued the opportunity to apply my clinical training within a payer environment. This experience showed me how health plans balance access, affordability, quality, and clinical outcomes across a large patient population.

At Excellus, I worked with Pharmacy Strategy, Quality, Accountable Cost and Quality Agreements (ACQA), Site of Care, and Utilization Management. My PBM experience had already introduced me to some concepts in managed care. However, the health plan perspective gave me a broader view of how other coverage policies, quality initiatives, and cost containment strategies support members and organizational goals.

My work with the Quality team introduced me to Medicare Star Ratings and Medication Therapy Management (MTM). I learned how MTM completion, adherence measures, and targeted interventions affect pharmacy performance. Helping shape strategies to improve Star Ratings showed me how quality initiatives can produce measurable outcomes for members.

My work with Pharmacy Strategy gave me valuable exposure to formulary management and policy development through New Drug Reviews and New Indication Reviews. Presenting these reviews to internal stakeholders and the P&T team demonstrated how clinical evidence, professional judgment, and operational feasibility inform formulary decisions. I also participated in Preapproval Information Exchange (PIE) presentations, which showed me how early clinical and pipeline information can support efficient reviews and timely access following FDA approval. This proactive approach makes me excited about the future of managed care pharmacy.

Through ACQA, I joined client meetings about clinical savings, medical savings, and cost containment programs for groups of different sizes. I also supported formulary reviews and provided recommendations for inflammatory bowel disease treatments. With the Site of Care team, I compared the existing drug list with the NHIA Home Infusion Drug List to identify oncology medications for possible inclusion. I analyzed savings at lower cost facilities and created a grid that ranked facilities by cost across the book of business. During my time with Utilization Management, I reviewed policies and clinical documentation. I also made coverage determinations for commercial and Medicare members.

My participation in AMCP Foundation and Pfizer programming broadened my understanding of the manufacturer perspective in managed care pharmacy. Pfizer sessions covered a variety of topics including specialty pharmacy, drug pricing, market access, and evidence from real world settings. AMCP Foundation Journal Clubs exposed me to a range of clinical and economic topics through presentations and discussions with industry professionals and fellow interns. Preparing my own presentation and written evaluation strengthened my ability to interpret evidence, assess its relevance to payers, and communicate findings clearly.

My capstone project, Healthcare Resource Utilization Trends for Patients with Inflammatory Bowel Disease and Iron Deficiency Anemia: A Real-World Claims Analysis, was the highlight of my internship, and I will be presenting it at AMCP Nexus 2026 from October 26-29. Using medical and pharmacy claims data, I compared IBD-related healthcare resource utilization, therapy adherence, and corticosteroid use between patients who received IV iron and those who did not.

Learning from professionals across Excellus, Pfizer, and the AMCP Foundation made these experiences even more meaningful. I am especially grateful to Christopher Diehl, PharmD, MBA, BCACP and Alyssa Tutino, PharmD from Excellus; Tyson Thompson, PharmD, MBA and Piao Ching, PharmD from Pfizer; and Anne Fentress, MS and Ebony Clay, PMP from the AMCP Foundation. I also appreciate the support of my fellow interns. Although it would be impossible to recognize everyone individually, I am sincerely grateful to the many professionals across Excellus, Pfizer, and the AMCP Foundation whose mentorship, guidance, and support shaped my experience.

This internship reinforced my passion for managed care pharmacy and my desire to improve medication access. Most importantly, I learned how evidence, access, quality, and affordability shape decisions that affect millions of patients. I look forward to applying these lessons in a career focused on thoughtful, patient-centered care.

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