Drug Pricing and Affordability

Keep up with our comprehensive coverage of administrative and legislative activity and what it means for industry, plans, providers, and patients.

Impact of US Drug Price Policy on Global Market Access

Given the uncertain challenge of future international price referencing by the US, Avalere Health considers implications for global market access.

How MFN Pricing in Part B May Affect Beneficiary OOP Costs

New analysis suggests the GLOBE Model would have limited impact on OOP costs, with over 99% of sampled Medicare Part B FFS beneficiaries seeing no reduction.

Bolstering Efficacy Demonstration for Cancer Drugs at HTA

New Avalere Health research explores the challenges and potential opportunities for demonstrating the value of cancer drugs to HTA agencies.

Emerging Clinical Trial Endpoints in Hemato-oncology at HTA

New research highlights the market access risks faced by manufacturers who use less traditional outcome measures to demonstrate value of innovative hemato-oncology therapies.

Environmental Impact Implementation at HTA and Beyond

Healthcare decisionmakers are increasingly considering evaluation of environmental impact; Avalere Health research explores the implications for manufacturers.

Updated Resource: State Statute Oncology Drug Coverage Report

A detailed Avalere report offers insights into state-specific statutes guiding commercial payer coverage for off-label use of oncology drugs/biologics.

Zachary Klein

Direct to Consumer Drug Purchasing: What Comes Next

The growth of DTC drug purchasing programs may shift the patient access and affordability landscape, with implications for manufacturers, payers, and other stakeholders.

Michael deMilt

Uniting US and Global Pricing Teams in a Post-MFN World

Increasing interplay between US and ex-US drug pricing requires manufacturers to shift to a truly globalized model to future-proof their access strategies.

White Paper: Provider Survey on Part B Negotiation Impacts

In a survey, providers say MDPNP may heighten financial pressures, raising concerns around provider sustainability and patient access

340B Rebate Guidance Poses Risks and Rewards for Stakeholders

HRSA’s new 340B rebate pilot for negotiated drugs in 2026 introduces reporting and payment rules, introducing both transparency and new risks for stakeholders.

340B Cuts Could Increase Other Payments for Most Hospitals

Reducing 340B reimbursement to ASP-28.7%, as previously proposed, may increase other payments, especially to small rural and urban hospitals.

Independent Pharmacy Challenges and Adaptive Strategies

Facing financial pressures, independent pharmacies adapt to remain viable, offering home delivery, vaccinations, compounding, and medication synchronization.

Brook Getachew

The New Stakeholder Economics of Part D After the IRA

The implementation of the IRA’s Part D redesign and Medicare drug price negotiation in 2026 will have varying impacts across plan types and therapeutic areas.

Nicole Betor

Adapting Economic Models for Medicare Negotiation

Manufacturers have several strategies at their disposal to adapt and leverage cost effectiveness evidence in preparation for Medicare drug price negotiation.

Global Market Access Teams as Enablers of Patient Access

With global market access teams navigating a rapidly changing environment, there are several key concepts reshaping how access teams think, plan, and operate to deliver real-word patient access.

Amy Schroeder

Video: Inside Compendia: Introduction to Clinical Drug Compendia

In the first installment of our Inside Compendia series, Avalere Health Advisory experts discuss how to engage and support life sciences companies in ways of incorporating their products into clinical compendia and guidelines.

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