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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The Evolving Role of Global Value Communication
As national reimbursement is no longer the only priority for global teams, value communication materials may evolve to enable meaningful, timely patient access.
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.
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.
State Oversight of AI in Healthcare: Status and Impacts
State oversight of AI in healthcare has primarily focused on prior authorization, disclosure and operations requirements, and scope of practice.
Clinicians and Several Lawmakers Unify in Support of USPSTF
Policymakers, professional societies, and advocates support the preservation of USPSTF’s evidence-based recommendations and independence amid reported plans for a sweeping overhaul.
Unlocking Global Access to GLP-1 AOMs Requires Moving Beyond Disease Recognition to Demonstrating Broader Value
To enable global access to GLP-1 AOMs, manufacturers must demonstrate multidimensional value along the full care continuum and across the range of obesity linked-indications.
CMS Rulemaking Can Have Immediate Impact on Site-of-Care Trends
A case study of musculoskeletal surgery site-of-care regulations indicates that proposed changes to the Medicare OPPS could trigger immediate site-of-care shifts.
EHDS Aims to Transform Data Access Across EU Health Systems
The European Health Data Space aims to enable secure, unified health data access across Europe, supporting research, innovation, and improved patient outcomes.
What Would a USPSTF Overhaul Mean for Preventive Care Access?
Reported plans to reshape the USPSTF align with recent changes to ACIP and may shape the future of preventive care recommendations and access.
CMS Modifies Part D Premium Stabilization Demonstration
Continued NAMBA increases and changes to the Part D Premium Stabilization Demonstration may signal further destabilization of the standalone PDP market.
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.
FDA Eliminates CAR-T REMS Requirements, Ushering in a New Era
Elimination of REMS requirements signals growing confidence in the safety of CAR-T, and potential for expanded access to CAR-T therapies.
OBBBA and Medicare Negotiation Eligibility: Considerations for Manufacturers
For IPAY 2028 and beyond, the OBBBA expands the exclusion for orphan drugs subject to Medicare negotiation, with implications for negotiation selection timing.
OBBBA Provider Tax Provisions Impact on Medicaid Stakeholders
The changes to provider tax provisions included in the One Big Beautiful Bill Act will impact state Medicaid funding, and its effects will be felt by plans and providers.
2025 Update: Biosimilar Substitution State Statute Report
The 2025 edition of the annual report provides insights into state statutes on point-of-service substitution of biosimilar products and is available
Anti-Obesity Medication Coverage Varies Across Markets and Payers
Limited access to AOMs across markets and a growing AOM pipeline will necessitate collaboration across manufacturers, payers, and the state/federal government.
Strategic Entry Points for Shaping USPSTF Recommendations
Avalere Health helps innovators shape USPSTF recommendations, driving preventive care access, payer coverage, and clinical adoption.
White Paper: Vaccine Access Challenges Amid Medicaid Unwinding
The unwinding of COVID-era Medicaid continuous enrollment policies resulted in insurance coverage losses and challenged vaccine access for adults.