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.
Rare Disease Advisory Councils: Opportunities for Engagement
Stakeholders should seek to engage with RDACs to develop a better understanding of rare disease care access, treatment, and populations in different states.
What the Election Results Mean for Health Policy in the Year Ahead
A second Trump administration and Republican Congress will mark a shift in healthcare policy priorities in 2025 on both legislative and regulatory fronts.
Webinar: Part D Patient Access 2025: Drug Formulary Changes
Join Avalere experts to learn about the changes to Part D formularies for 2025 and implications for patient access.
Webinar: Part D Patient Access 2025: Plan Options and Premiums
Avalere experts will examine changes in Part D plan options and premiums for 2025 and will explore how these shifts may affect patient costs and choice.
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.
Key Considerations for MFP Effectuation and the 340B Rebate Model
Stakeholders consider implementation of a 340B rebate model to address duplicate discount risk.
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.
2024 Biosimilar Substitution State Statute Report
Avalere’s report, updated semi-annually, is available now with insights into state policies on point-of-service substitution of biosimilar products.
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.