Daniel Nam

Daniel Nam supports clients with research and analysis that span a variety of healthcare sectors and stakeholders.

He applies his background as a pharmacist, attorney, and healthcare policy expert to a broad range of client projects, especially those pertaining to pharmacy practice and Medicare Part D.

Prior to joining Avalere, Daniel held a variety of positions. Most recently, as an executive director of pharmacy with America’s Health Insurance Plans, he provided policy, regulatory, and legislative analyses on pharmacy, pharmaceutical, Medicare Part D, and other payment-related issues for health plans. Daniel also has experience as a practicing pharmacist in community pharmacy and clinical hospital settings, as a small business owner, and as a congressional healthcare staffer and fellow.

Authored Content

New Avalere analysis finds Part D redesign via PDPRA would reduce average OOP costs by 23% for non-LIS beneficiaries, especially for certain drug classes and beneficiary groups by race and reason for entitlement.

Avalere analysis finds that when generics in Part D are placed on the preferred brand tier some patients pay the full cost for their drugs.

Reducing health disparities is critical to advancing health equity, and each stakeholder has a role to play.

As Congress renews focus on drug pricing reforms, an Avalere analysis examines recent trends in the Part D program’s subsidy payments and implications on stakeholder liabilities in the program.

Implementation of copay accumulator and maximizer programs continues to increase; recent policy provisions finalized through federal rulemaking and state-level legislation have created new uncertainty for the future of these programs and the stakeholders they affect.

Recent regulatory action released in the final days of the Trump administration related to Medicare Advantage (MA) and Part D could significantly impact plan and manufacturer calendar year (CY) 2022 contracting strategies and stakeholder advocacy priorities.

Avalere analysis finds that 51% of all drug spending for non-LIS beneficiaries using insulins and enrolled in enhanced plans in 2018 was for products not participating in the model.

As policymakers discuss ways to curb program expenditures and improve patient affordability in Medicare Part D, the role of charitable assistance in helping beneficiaries with out-of-pocket (OOP) costs has garnered interest. To understand the relationship between charitable assistance and various Part D metrics, Avalere examined Part D prescription drug claims for beneficiaries without the Low Income Subsidy (LIS) for 2014 and 2018.

As currently written, a proposed rule on rebate reform from January 2019 may impose financial and operational challenges for pharmacies related to cash flow and new technology requirements.

Health plans, including Medicare prescription drug plans, commonly apply utilization management (UM) tools to manage spending on prescription drugs.

Prescription drugs are dispensed to patients through a complex supply chain that involves a broad array of entities, contract arrangements, and payments. The following diagram outlines how a typical prescription drug may flow through the drug supply chain.

Tune into the eighth episode of our series of podcasts that focuses on COVID-19. In episode 8, Avalere experts from the Policy practice discuss the impact of COVID-19 pandemic on retail pharmacy and pharmacists.

As COVID-19 continues to stress the US healthcare system, pharmacists and retail pharmacies may help respond to the pandemic.

Implementation of a preferred specialty tier could have various impacts on Part D plans’ formulary and benefit designs and could affect manufacturer contracting strategies.