Federal and State Policy
As the largest US healthcare payer, the federal government plays a dominant role in shaping the healthcare marketplace, while states take center stage when it comes to developing novel policy approaches. Our experts track, interpret, and model policies that affect insurance coverage, access, and consumer choice so you can see around the bend.
Webinar: 2026 Part D Plan and Manufacturer Contracting Strategies
Join our webinar to learn how Part D redesign and drug price negotiation will shape the Plan Year 2026 market, and what this means for manufacturers and plans.
Video: Kidney Care Agenda: Fall 2024
Ahead of the American Society of Nephrology Kidney Week, Avalere experts dive into the key regulatory and legislative developments related to kidney disease that expect to see action in the remaining weeks of 2024.
Webinar: Part D Patient Access 2025: Preparing for Benefit Changes
Join Avalere for an overview of how the Medicare Part D benefit will be changing in 2025 under the Inflation Reduction Act.
Number of Part D Plan Choices Declines for 2025
The number of PDP and MA-PD options are declining by 26% and 7%, respectively, in 2025.
VP Debate Highlights Healthcare Policy Differences
During the debate, VP candidates outlined their views on healthcare topics such as the ACA, drug pricing, manufacturing, reproductive rights, and mental health.
IRA Inflation Rebate Impact on Part B Beneficiary OOP Costs
Avalere finds that between 0.1% and 0.2% of Medicare FFS beneficiaries would experience lower OOP costs for the Part B drugs subject to Q3 2024 inflation rebates.
Potential Impacts of IPAY 2026 Maximum Fair Prices on Health Plan Formulary Negotiations
With the release of the IPAY 2026 MFPs, health plans should analyze the impact to formularies and identify opportunities for contracting changes.
Health Policy in the 2024 Election: Avalere and Outside Experts Weigh In
With the election fast approaching, former HHS Secretary Alex Azar, Dan Mendelson, and Avalere experts discussed implications for healthcare stakeholders.
PBM, Mail-Order, and Specialty Pharmacy Involvement in 340B
Sixty-nine percent of 340B contract pharmacies were associated with a PBM through vertical integration (53%) or contractual arrangement (16%).
What Will the 2024 Elections Mean for Health Policy?
With key health policy differences between presidential candidates, the 2024 elections are an inflection point for the future of US healthcare.
Webinar: Election 2024: What’s at Stake for Healthcare?
Experts from Avalere, part of Avalere Health, and guests discuss the 2024 elections, exploring the candidates’ health policy approaches and implications for stakeholders.
Avalere Welcomes Industry Veteran Ashley Flint to Policy Team
Ashley Flint brings 12 years of policy experience in the life sciences industry, with deep knowledge of prescription drug pricing, access, and reimbursement.
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.
Webinar: A Closer Look at Patient Support: Upcoming Legislative and Regulatory Changes
Avalere experts explore how potential implications of the Inflation Reduction Act (IRA)’s out-of-pocket cap, in addition to other key regulatory and policy activities shaping benefit design and patient cost-share (e.g., EHB), could impact patient commercial and foundation assistance.
Video: IRA Impacts on Market Access Strategy
Ahead of Asembia 2024, Avalere market access experts discuss the potential impacts of IRA provisions, including Part D redesign and Medicare drug price negotiation, on go-to-market and contracting strategy.
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.
Opportunities to Prepare for Year 2 of Medicare Negotiation
Manufacturers anticipating potential selection or therapeutic impact for 2027 Medicare negotiations should begin preparations and align internal decision-making, applying learnings from Year 1.
Video: Mitigating and Preventing Drug Shortages
Avalere experts provide insights on the dynamics and policy proposals surrounding recent drug shortages.
Video: The Evolution of Value Requirements
Ahead of Asembia 2024, Avalere experts discuss the evolution of biopharmaceutical value requirements and how organizations will need to evolve their business models accordingly.
Research Explores Health Plan Perceptions of PDABs and UPLs
Avalere assessed how health plans may view UPLs, including implementation considerations and impacts on providers and patients (e.g., plan benefit design).