Insights & Analysis
There’s one constant in healthcare: change. Count on us to break down the trends so you can stay up to date. Follow our take on each piece of this deep, intertwined, and often perplexing industry to find opportunities and practical approaches to move healthcare forward.
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White Paper: Infusion Care and White-Bagging Requirements
Avalere surveyed providers on the administrative and economic costs of white-bagging requirements on infusion centers.
Patterns in Patient Access to MS Drugs
Avalere analysis finds that less clinically efficacious MS drugs have better coverage, more advantageous tiering, and lower UM compared to more efficacious drugs.
BIO International Convention Insights: Patient Assistance and Digital Therapeutics
At the 2024 BIO International Convention, Avalere led discussions on post-IRA patient access and affordability and reimbursement pathways for digital therapeutics.
Contract Pharmacy Trends May Help Inform 340B Reform Debate
As federal and state policymakers debate the role of contract pharmacies (CPs) in 340B, Avalere analyzed how CP relationships inform the policy landscape.
Avalere White Paper: RNA-Based Therapy Outlook
A white paper explores the RNA-based therapy pipeline and how FDA classifications can influence product development, commercialization, and patient access.
Addressing Sex and Gender Disparities in Cognitive Health
Women are more likely to experience reduced cognitive health later in life. Recent federal efforts seek to address the paucity of research on this phenomenon.
Can Comprehensive 340B Reform Generate Federal Savings?
Stakeholders are debating potential reforms to the 340B program, with specific policies directly or indirectly impacting federal spending.
MA Plans Increase Use of Step Therapy for Part B Drugs
In 2023, 54% of Medicare Advantage enrollees were in plans that required step therapy for 10 commonly used rheumatoid arthritis drugs covered under Part B.
Medicaid Managed Care Rule: Three Things Plans Should Know
CMS’s new Medicaid and CHIP managed care rule will impact wait time standards, In Lieu of Service and Setting usage, and quality rating.
What’s Next for Value-Based Care in Cardiology?
The prevalence and cost of CVD make cardiology a strong candidate for value-based care. Various clinical and market trends present opportunities for continued uptake.
How is FemTech Driving Innovation in Women’s Health?
FemTech is redefining women’s health. See how technology is powering new solutions in wellness, diagnostics, and reproductive care.
A Paradigm Shift in LDT Regulation
The FDA’s final rule to regulate LDTs as medical devices brings on numerous uncertainties for stakeholders.
Breast Cancer Screening Recommendations May Drive Inequities
New USPSTF breast cancer screening recommendations may not address the disparities experienced by Black women.
Health Plans 2030: Evolving Operational Approaches
The first installment of our Health Plans series explains how plans can evolve their approaches to provider contracting and utilization management for the future.
Adult Seasonal Combination Respiratory Vaccines: Policy Considerations
In a new white paper, Avalere considers key questions related to strain selection, ACIP recommendation, and coverage and reimbursement of adult combination vaccines in development.
Five Data Strategy Questions Pharma Should Ask For 2025
When utilizing and acquiring data, life sciences companies should consider these top questions and key implications for their 2024–2025 strategic plans.
CMMI Quality Pathway Prioritizes Patient-Centered Value
Innovation models will prioritize improving quality and redefine how quality is measured.
Inequities in Medicare Beneficiaries’ Use of Accelerated Approval Products
An Avalere analysis shows the use of drugs approved under the Accelerated Approval pathway across historically underserved Medicare beneficiaries.
CGT Payment Changes Proposed in FY 2025 IPPS Proposed Rule
Medicare CAR-T payment remains stable; CMS proposed structural changes for New Technology Add-on Payments (NTAP).
CMS’s Interpretation of “Qualifying Single-Source Drugs” in Medicare Negotiation
CMS’s definition of a “qualifying single-source drug” in the Medicare Drug Price Negotiation Program may impact manufacturers’ investment strategies.