Miryam Frieder

Miryam Frieder leads strategic client engagements focused on the drug pricing policy environment, rebate reform models, and Medicare Part D. Miryam advises clients on assessing the impact of the evolving policy landscape to inform business decisions and policy engagement strategies.

Her clients include health plans, pharmacy benefit managers (PBMs), pharmaceutical manufacturers, foundations, and trade associations. Recent areas of focus include qualitative and quantitative assessments of Part D policy and drug rebating system reforms.

Prior to joining Avalere, Miryam worked at The Lewin Group, where she provided strategic consulting to health plans, hospitals, pharmaceutical manufacturers, and PBMs.

Miryam has an MBA from Columbia Business School and an MPH in health policy from the Mailman School of Public Health at Columbia University. Miryam graduated Phi Beta Kappa with a BA in molecular biology and biochemistry from Wesleyan University.

Authored Content

New Avalere analysis finds that beneficiaries enrolled in Employer Group Waiver Plans (EGWPs) have lower out-of-pocket (OOP) costs for select drugs than beneficiaries enrolled in other types of Part D plans.

Avalere experts examine the current drug pricing policy landscape and what potential changes stakeholders should prepare for.

Transformative medicines, like gene and cell therapies, are beginning to be approved in the US, and more are expected to come.

Avalere analysis finds that price of generic drugs has remained flat but the cost to seniors is increasing.

Yesterday, the Centers for Medicare & Medicaid Services (CMS) released Part II of the Advance Notice and Call Letter (ANCL), describing the Agency's proposed 2019 payment policies and other policy updates for the upcoming plan year for Medicare Advantage (MA) and Part D plans.

The Centers for Medicare & Medicaid Services (CMS) just released the annual Landscape Files containing data on plan participation, beneficiary premiums, and benefit designs for the 2018 Part D — Medicare's prescription drug benefit — and Medicare Advantage (MA) markets.

On July 31, the Centers for Medicare & Medicaid Services (CMS) announced that the base Part D premium will be $35 for 2018.

According to a new Avalere analysis of data from the Centers for Medicare & Medicaid Services (CMS), premiums for stand-alone prescription drug plans (PDPs) will increase and the number of PDPs available in 2017 will decrease. Conversely, the Medicare Advantage market appears strong as 8 in 10 beneficiaries have access to MA plans that offer prescription drug benefits with a zero premium.

The Centers for Medicare & Medicaid Services (CMS) just released the annual Landscape Files containing data on plan participation, beneficiary premiums, and benefit designs for the 2017 Part D and Medicare Advantage (MA) markets. Avalere offers the following observations on key trends in the MA and Part D programs that are likely to influence the 2017 market.

Avalere recently analyzed two different Part D policy proposals outlined in The Medicare Payment Advisory Commission (MedPAC) June 2016 report to Congress.

The Center for Medicare & Medicaid Innovation is currently testing a variety of programs which place providers at risk for Medicare spending and may motivate providers to manage Medicare Part B costs, including drug spending and utilization.

Cost-sharing changes could increase costs for many beneficiaries.

Avalere Experts Estimate MedPAC Proposal to Change Calculation of Part D Enrollees' True Out-of-Pocket Spending Would Increase Beneficiary Costs by $4.1 Billion Between 2017-2020

Percentage of drugs in Part D plans that require coinsurance increased significantly since 2014. Medicare Advantage plans require coinsurance far less often than Part D plans.

The CalPERS Basic Plan Drug List, which is the formulary for all California public employees, includes 222 brand drugs and 287 generic drugs. In contrast, drug coverage in the Veterans Administration (VA) and Medi-Cal (California's Medicaid program) is far more limited than the CalPERS drug list.

Overall, implementation of the duals demonstrations is slower than expected and states continue to delay.