Meet
Nicole Letourneau

Associate Principal

Nicole Letourneau, MPH, advises clients on policy and market-based strategies related to Medicaid drug policy and pricing, state policy, cell and gene therapy (CGT) development, value-based contracting, and innovative approaches to patient access.

In recent projects, Nicole has supported manufacturers assess how drug pricing reforms, including the interaction of the Inflation Reduction Act, and recent regulatory final rules will impact pipeline products. She has also helped CGT manufacturers identify and understand target patient populations, design and validate value- and outcomes-based contracting arrangements, anticipate reimbursement scenarios across channels and care settings, and develop stakeholder engagement strategies. Nicole also supports broader state engagement strategies to help life science manufacturers identify and develop state specific engagement strategies for Medicaid and commercial populations with respect to patient access.

Before joining Avalere, Nicole served as a public policy intern at ML Strategies, where she assessed the impact of public policy developments to support the client's advocacy priorities. Nicole also represented clients at congressional hearing and key stakeholder meetings. She holds a Master of Public Health in health policy from the George Washington University Milken Institute of Public Health and an BA in Human Development and Family Sciences and Public Health from Oregon State University.

Authored Content

July 10, 2026 | Insights & Analysis > Federal and State Policy

Navigating State Variability in Medicaid Work Requirements
State discretion over work requirement implementation may create significant variability, impacting patients, providers, and health plans.
June 23, 2026 | Insights & Analysis > Coverage and Payment

How Can Manufacturers, Payers, Providers, and Patient Groups Prepare for Medicaid Work Requirements?
Stakeholders can prepare for the upcoming implementation of federal Medicaid community engagement requirements, which are planned to go into effect January 1, 2027.
March 5, 2026 | Insights & Analysis > Cell and Gene Therapy

Evolving Policy Trends in Cell and Gene Therapy
Changes in state and federal policies will drive patient access, financing, and provider reimbursement of cell and gene therapies.
September 3, 2025 | Insights & Analysis > Drug Pricing and Affordability

Independent Pharmacy Challenges and Adaptive Strategies
Facing financial pressures, independent pharmacies adapt to remain viable, offering home delivery, vaccinations, compounding, and medication synchronization.
July 11, 2025 | Insights & Analysis > Coverage and Payment

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.
July 7, 2025 | Insights & Analysis > RWE and Patient-Centered Outcomes

White Paper: Estimated Federal Savings from the Special Diabetes Program
Avalere Health finds that research funded by the Special Diabetes Program has yielded more than $50 billion in federal healthcare savings
April 22, 2025 | Insights & Analysis > Federal and State Policy

Revisiting Medicaid Work Requirements
Federal policymakers are considering Medicaid work requirements as a mechanism to reduce spending; recent state experiences offer important considerations.
April 1, 2025 | Insights & Analysis > Coverage and Payment

Expiration of Enhanced Tax Credits Would Impact 18M Americans
If the ACA marketplace enhanced premium tax credits are made permanent, nearly 5 million people ages 50–64 will be eligible to receive premium subsidies in 2026.
September 24, 2024 | Webinars > Regulatory Strategy and FDA Policy

Webinar: Exploring RNA-Based Therapies: Innovations and Impact
Join us for a webinar exploring the RNA-Based Therapy landscape.
August 27, 2024 | Insights & Analysis > Cell and Gene Therapy

Examining Variation in Gene Therapy Access Across States
State Medicaid programs take a range of approaches to gene therapy coverage, management, and reimbursement.
August 26, 2024 | Insights & Analysis > Coverage and Payment

125,000 in MS Could Gain Medicaid Coverage Through Expansion
If Mississippi expands Medicaid to 138% federal poverty level, Avalere estimates 125,000 uninsured individuals, ages 19-64, could gain coverage in 2025.
June 3, 2024 | Insights & Analysis > Regulatory Strategy and FDA Policy

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.
February 23, 2024 | Videos > Federal and State Policy

Video: How Policies Shape the Rare Disease Treatment Landscape
In this installment of our 2024 Trends Influencing Rare Disease series, Avalere experts explore policies shaping rare disease drug development and access.
February 5, 2024 | Insights & Analysis > Cell and Gene Therapy

Understanding the CMS Cell and Gene Therapy Access Model
The CGT Access Model will allow CMS to negotiate outcomes-based agreements on behalf of state Medicaid programs for CGTs, beginning with sickle cell disease.
December 19, 2023 | Insights & Analysis > Federal and State Policy

Proposed Changes to Best Price Could Shift Market Dynamics for Stakeholders
The MDRP proposed rule's Best Price "stacking' provision has direct and indirect impacts on Medicaid rebate liability across drug classes.
November 14, 2023 | Insights & Analysis > Federal and State Policy

Medicare HI Trust Fund Solvency Assuming MA Utilization
The Hospital Insurance Trust Fund would remain solvent until 2048 if FFS utilization levels were similar to Medicare Advantage utilization levels.
October 20, 2023 | Insights & Analysis > Federal and State Policy

CBO Considers Cost of Increasing Anti-Obesity Medication Use
Insurance coverage of anti-obesity medications is increasing, but patient access under Medicare remains uncertain.
July 26, 2023 | Insights & Analysis > Drug Pricing and Affordability

CMS Best Price Discount Stacking Proposal May Trigger AMP Cap
Requiring manufacturers to stack all discounts provided through the supply chain could increase Medicaid rebate liability and complicate rebate dynamics.
July 6, 2022 | Insights & Analysis > Drug Pricing and Affordability

The Rare Disease Market: Policy Changes and Coverage Trends
Changes to rare disease policies and payers’ approaches to coverage could have significant impacts on product development, patient access, and reimbursement.
June 27, 2022 | Insights & Analysis > Drug Pricing and Affordability

Value-Based Arrangement Pricing Flexibilities Will Take Effect July 1
Starting July 1, manufacturers can report multiple best prices for some value-based arrangements, which may encourage broader use of innovative contracting.
July 13, 2021 | Insights & Analysis > Drug Pricing and Affordability

Series of Changes to Drug Pricing Metrics Will Interact in Coming Years
The intersection of upcoming changes to drug pricing metrics will require new methods of calculating and reporting government pricing with implications for net pricing and contracting strategies.
September 14, 2020 | Insights & Analysis > Federal and State Policy

Fall Medicaid Outlook: Key Events to Watch
Medicaid will continue to experience considerable changes at the state and federal levels, both in terms of beneficiary demographics and the payer landscape. Stakeholders should consider how upcoming elections, policy proposals, and COVID-19 will impact benefits and payer dynamics.
May 20, 2020 | Insights & Analysis > Federal and State Policy

Manufacturers Must Navigate Evolving State Approaches to Medicaid Drug Benefit Management
As control of the Medicaid drug benefit continues to shift from managed care organizations to states, manufacturers should understand unique benefit dynamics in each state, particularly as Medicaid enrollment is likely to increase amid the COVID-19 pandemic.