Mark Gooding provides strategic guidance to life sciences clients on policy developments and reimbursement considerations.

In particular, Mark has extensive experience analyzing federal- and state-level policies and developing market access strategies to drive coverage and patient access. His work at Avalere has focused on a broad range of topics and therapeutic areas, including drug pricing, payer coverage, patient support programs, and payment considerations for CKD and ESRD therapies.

Prior to joining Avalere, Mark was a senior associate at Covance Market Access Services, supporting pharmaceutical manufacturers by conducting market research with payers and providers on issues, including coverage decision-making, reimbursement and financial support program optimization, and alternative payment model implementation. Prior, Mark worked at George Washington University’s Department of Health Policy, where he focused on issues including the development and implementation of the Affordable Care Act, state Medicaid policy, and early childhood development.

Mark earned an MPS in political management from the George Washington University and a BA in political science and philosophy from Wake Forest University.

Authored Content

The Center for Medicare & Medicaid Services (CMS) recently issued its proposed Notice of Benefit and Payment Parameters (NBPP) for the 2021 plan year. The proposed rule would significantly expand commercial payer flexibility to not count manufacturer copay support toward deductibles or out-of-pocket (OOP) maximums.

With new cell and gene therapies poised to revolutionize treatment for a growing number of disease states, stakeholders are working to reimagine existing value and reimbursement models to meet the special challenges these breakthrough services present.

A shifting policy landscape and emerging market forces could introduce significant disruption in the kidney care space in the coming years. Understanding the risks and opportunities that these changes may present will be critical for patients, providers, payers, and manufacturers alike.

Tune in to hear the final episode in our 3-part series that focuses on CMS’s most recent proposed payment rules. In episode 3, we’ll be focusing on the End Stage Renal Disease (ESRD) Prospective Payment System, with a focus on proposed payment changes for innovative drugs, supplies, and equipment and updates to the Quality Incentive Program (QIP).

Manufacturers currently face an almost-unprecedented level of uncertainty in developing contracting strategies for the coming plan years. Avalere’s combination of policy and commercialization expertise, paired with its data capabilities, allow us to support life sciences companies understand this challenging landscape to ensure access to innovative therapies for their patients.

Additional Medicare payment options available for new, high-cost technologies used in the inpatient setting.

Recent developments in the specialty pharmaceutical marketplace merit distinct attention from manufacturers.

The interaction of recently announced drug pricing reforms will have differential implications for stakeholders.