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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

March 25, 2019 | Insights & Analysis > Drug Pricing

Understanding the Combined Effects of Drug-Pricing Reforms
The interaction of recently announced drug pricing reforms will have differential implications for stakeholders.
February 11, 2019 | Insights & Analysis > Drug Pricing

Drug Rebate Proposal Fundamentally Changes Current System, Raises Critical Questions
The swift proposed implementation timeline will require stakeholders to evaluate quickly operational requirements, behavioral responses, cross-program implications, and impact on contractual arrangements.
February 1, 2019 | Press Releases > Drug Pricing

HHS Proposes to Remove Safe Harbor for Drug Manufacturer Rebates
Yesterday, the Department of Health and Human Services Office of Inspector General released a proposed rule redefining the current safe harbor for pharmaceutical manufacturer discounts and rebates to entities like health plans and pharmacy benefit managers (PBMs).
December 4, 2018 | Insights & Analysis > Federal & State Policy

Out-of-Pocket Costs for Oncology Drugs Vary Substantially Between Employer and Non-Employer Based Part D Plans
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.
October 25, 2018 | Webinars > Drug Pricing

Webinar: Drug Pricing Policy: What's on the Horizon?
Avalere experts examine the current drug pricing policy landscape and what potential changes stakeholders should prepare for.
October 24, 2018 | Insights & Analysis > Value Assessments

Alternative Financing Models for Durable Cures
Transformative medicines, like gene and cell therapies, are beginning to be approved in the US, and more are expected to come.
February 2, 2018 | Insights & Analysis > Federal & State Policy

Our Take on the 2019 Advance Notice and Draft Call Letter
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.
October 2, 2017 | Insights & Analysis > Federal & State Policy

Avalere’s Take on the MA/PD Landscape Files Release
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.
August 1, 2017 | Insights & Analysis > Federal & State Policy

Part D Premiums Update: What You Need to Know
On July 31, the Centers for Medicare & Medicaid Services (CMS) announced that the base Part D premium will be $35 for 2018.
October 18, 2016 | Press Releases > Federal & State Policy

CORRECTION: Premium Increases for Most Popular Medicare Drug Benefit Plans, Market for Medicare Advantage Plans Appears Stable in 2017
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.
September 22, 2016 | Insights & Analysis > Federal & State Policy

Avalere Analysis on Recently Released 2017 Medicare Advantage Landscape Files
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.
September 12, 2016 | Insights & Analysis > Federal & State Policy

Avalere Analysis on MedPAC's Proposed Part D Reforms to Modify Beneficiary Cost Sharing
Avalere recently analyzed two different Part D policy proposals outlined in The Medicare Payment Advisory Commission (MedPAC) June 2016 report to Congress.
August 31, 2016 | Insights & Analysis > Value-Based Care

Medicare Part B Drug Payments Implicated in CMMI Models
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.
June 14, 2016 | Press Releases > Federal & State Policy

MedPAC Proposes Changes for 42 Million Medicare Beneficiaries Enrolled in Part D
Cost-sharing changes could increase costs for many beneficiaries.
March 30, 2016 | Insights & Analysis > Federal & State Policy

Proposed Changes to Part D Would Increase Beneficiary Costs
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
March 10, 2016 | Press Releases > Federal & State Policy

Majority of Drugs Now Subject to Coinsurance in Medicare Part D Plans
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.
February 17, 2016 | Insights & Analysis > Federal & State Policy

Veterans Administration and California Medicaid Drug Lists Cover Less than 60 Percent of Drugs Available to California Public Employees
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.
July 2, 2013 | Insights & Analysis

Six States Expected to Start Duals Demos In 2013
Overall, implementation of the duals demonstrations is slower than expected and states continue to delay.