Kayla Amodeo

Kayla Amodeo serves as a key subject-matter expert on Medicare Part B, drug pricing, and value assessment policy-related issues impacting the pharmaceutical industry, physicians, the federal government, and other stakeholders.

She supports clients with health policy research and analysis that spans a variety of therapeutic areas. Specifically, she provides clients business and advocacy strategies to solve complex issues related to legislative and regulatory policy.

Prior to joining Avalere, Kayla was the director of regulatory affairs at the American College of Rheumatology, where she provided expertise and guidance on issues impacting provider reimbursement and patients access to care. Kayla also previously worked for the Arthritis Foundation as the legislative research manager for the Advocacy and Access division and with Anthem in the Disease Management Program.

Kayla has a PhD in health education and promotion from the University of Alabama, an MA in health education, and a BS in public health from East Carolina University.

Authored Content

In the third episode of the Specialty Pharmacy Stakeholder Perspectives podcast series, Avalere is joined by Dr. Colin Edgerton to discuss the specialty pharmacy dynamics with a focus on the provider outlook.

In the second episode of the Specialty Pharmacy Stakeholder Perspectives series, Avalere is joined by Marc Boutin, CEO of the National Health Council, discussing the specialty pharmacy dynamics with a focus on the patient perspective.

Avalere analysis finds that Medicare fee-for-service (FFS) patients with an RA diagnosis and conditions associated with undermanaged disease have 121% higher medical costs than other RA patients. Part D costs were 30% higher for those with undermanaged disease than for other RA patients.

As COVID-19 deaths increase, the FDA is evaluating and considering approval of treatments more quickly, but the rush to find treatment options is creating new access considerations for patients and providers.

Avalere experts will examine evolving stakeholder-specific considerations for reshaping how patients with autoimmune conditions receive care during and after the COVID-19 pandemic.

The large-scale disruptions resulting from COVID-19 are significantly reshaping how patients receive care. In particular, patients taking infused and injectable drugs administered by a healthcare professional at a physician office, infusion center, or hospital outpatient department now face greater challenges receiving their medications.

The Centers for Medicare & Medicaid Services (CMS) issued a new Interim Final Rule (IFR) that is intended to allow additional beneficiaries, especially those who are at high-risk, to receive home infusions amid COVID-19 transmission concerns. Specifically, the CMS clarified the definition of “homebound” under the Medicare Home Health Benefit and temporarily suspended enforcement of the National and Local Coverage Determinations (NCD and LCD) related to home infusion services. Uncertainties remain as to how these new flexibilities will be utilized, as well as how these flexibilities could impact treatment outcomes.

ICER is eager to position itself as the primary comparative and cost-effectiveness research body in the US. While their activity has been traditionally more limited to product-specific reviews, the Institute is increasingly looking to shape the broader debate around value and drug pricing.