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: How ACIP Policies, Processes Shape the US Vaccine Landscape
A new white paper examines the historical role of the Advisory Committee on Immunization Practices and its evolution following key federal policy changes.
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.
CMS Recognized Greater Savings in IPAY 2027 Relative to the First Year of Negotiation
Competitive dynamics of selected drugs in 2027 drove greater savings than 2026.
PDABs Affect Nearly 8 Million Commercial and Medicaid Lives
State legislators are attempting to reduce patient costs through Prescription Drug Affordability Review Boards.
State Copay Accumulator Bans Now Affect At Least 17% of Commercial Lives
State legislators are attempting to reduce patient costs and increase access through policies that block copay accumulators and maximizers.
AI Across Payers, Providers, and PBMs: Turning Pilots into Progress
Healthcare stakeholders are increasingly using AI in front- and back-office applications, but few tools have been able to achieve expected results once organizations deploy them at-scale.
RWD Integration in Reimbursement Decisions across EU4 and the UK
European countries are advancing real-world data use in healthcare decision-making, but face challenges from differing national frameworks and regulations
Digital Health Evolution in Remote Monitoring and AI Codes
Evolving digital health codes are reshaping how technology and care connect.
Sociodemographic Factors and Healthcare Costs Among Rare Epilepsies
Distinct patient characteristics and cost profiles across rare epilepsies reinforce the value of disease-specific approaches in rare disease research.
Novel Antibiotic Use Is Low, Even for Complex Cases
An Avalere Health analysis determined that less than 1% of patients with community-acquired bacterial pneumonia were treated with novel antibiotics.
Belief Mapping: Elevating Value Engagement Strategies
Uncovering beliefs underpinning payer decision making can help global access teams achieve optimal and equitable patient access, faster.
Part D Formulary Management Tightens in 2026
Coverage for top brand drugs is tightening slightly in 2026, along with increased utilization management and continued shifts from copays to coinsurance.
2026 MPFS Rule: Part B MFPs Included in ASP, but Questions Remain
The 2026 MPFS final rule clarifies how MFP discounts will be included in ASP, confirming stakeholder expectations and introducing new market uncertainties.
Updated Resource: Commercial Payers’ Use of Oncology Compendia
Our updated dashboard provides insights into trends in commercial payers’ use of clinical drug compendia for off-label oncology coverage decisions.
How Can Stakeholders Engage with USPSTF Recommendation Development
The USPSTF develops independent, evidence-based preventive recommendations through an evidence-based review process. Avalere Health helps organizations successfully navigate, engage, and influence these processes.
IDWeek Atlanta 2025: Perspectives on Access and Evidence in Infectious Disease
At IDWeek, Avalere Health connected with industry and academic leaders on the evolving vaccine policy, access, value, and evidence landscape.
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.