The Evolving Landscape of U.S. Payer Coverage Decisions: The Role of Health Economics and Outcomes Research

Although there are a large number of public and private payers in the U.S., medical device and pharmaceutical manufacturers generally focus on two types of payers: (1) Medicare, which is administered by the Centers for Medicare and Medicaid Services (CMS) and covers individuals ages ≥ 65; and (2) private commercial payers (e.g., Blue Cross and Blue Shield plans; […]

Will an Unravelling of the Affordable Care Act Result in Meaningful Organizational Changes in U.S. Medical Care? Implications for Economic Evaluation of Drugs & Devices

In recent years, there has been a shift in U.S. health care markets to a broader, population-based perspective when assessing the costs and benefits of medical innovation. Cost effectiveness analysis and budget impact analysis results can look quite different when viewed from the perspective of a health system or an accountable care organization. […]

Value-Based Payment for Oncology Services

Cancer care is a large part of overall health care expenditures. Of the approximately 18% of U.S. gross domestic product spent on healthcare, more than 5% is attributed to cancer treatments.[1] Considering the premature mortality associated with cancer, the humanistic and economic toll is enormous. Consequently, in recent years there has been increasing attention […]

Why Medical Device Companies Need to Develop Economic Evidence in the U.S.

Although the U.S. lacks a centralized health technology evaluation agency, as many of the European countries maintain, in recent years there has been considerable pressure to control the rising costs of new biopharmaceuticals and medical devices.[1-5] After relatively slow growth in the 1960s, U.S. health care expenditures grew intensely in the decades between 1980 and […]

Avalon CEO John Schneider presented at BMO Capital Markets’ “The Year Ahead in Healthcare: Products, Payment and Politics” on December 15, 2015

Avalon CEO John Schneider, Ph.D. presented at BMO Capital Markets’ “The Year Ahead in Healthcare: Products, Payment and Politics” on December 15, 2015. The day-long symposium was focused on markets for life science products and featured presentations from industry leaders, including Boston Scientific, Medtronic, Abbott and Pfizer. Schneider delivered a lunchtime presentation on the medical […]

Philipp Schuetz joins Avalon Health Economics as a Clinical Director

Avalon Health Economics is happy to announce the addition of Philipp Schuetz, MD, MPH as our Clinical Director. He is a board-certified internist and endocrinologist. He has broad clinical and research interests focusing on the application of new developments in endocrinology, infectious diseases, critical illness and general medicine. He has done extensive research on hormones, […]

Reference Pricing for in vivo and in vitro Diagnostic Tests

Prices in health care vary widely even within the same local market and for similar tests and treatments. This reflects differences among providers in their ability and willingness to leverage bargaining power against private insurers. For their part, consumers and patients often have been indifferent to price since they have been well covered by insurance. […]

Julian Nam and Wenjia Chen join Avalon as health economists

Julian Nam joins Avalon Health Economics as a Health Economist. Julian is a health economist with a core skill set in economic evaluation and epidemiology. This includes study design, analysis and critical appraisal of both applied and methodologic research related to cost-effectiveness and budget impact analyses, particularly: evidence syntheses, economic modelling and statistical modelling. He […]

Purchasing Medical Innovation: The Implications for the Medical Device Industry

  In an earlier blog, we reviewed the recent book by one of Avalon’s directors, James Robinson. Robinson’s book, entitled “Purchasing Medical Innovation: The Right Technology, for the Right Patient, at the Right Price” seeks to unpack the often precarious relationships among medical device makers, the purchasers of those devices, the insurers, who are often the […]

Avalon’s Ivana Stojanovic will be attending the AdvaMed 2015 Med Tech Conference next week in San Diego, CA

The annual AdvaMed Med Tech Conference is the leading MedTech Conference in North America, bringing more than 1,000 companies together to exchange knowledge and ideas on business development, capital formation, economic evaluation, pricing and reimbursement, educational opportunities and networking. More information on the conference is available by clicking here. Please let us know if you […]

Physician Shortages in the U.S.: Disentangling Myth, Folklore, and Fact

Much of the public media and even a substantial part of the medical literature operates on the assumption that there is a shortage of physicians in the U.S., including those specializing in primary care, intensive care, and surgery. One study, for example, estimated that the physician shortfall in the U.S. would reach 90,000 by 2025.[1] […]

Controlling the Costs of Clinical Laboratory Testing in Medical Practice

Today’s clinical laboratory can do much more than you think. Advances in molecular diagnostics, genetics and biomarkers have ushered in a new era of clinical laboratory capabilities. Along with these advances, however, are higher laboratory expenditures. The U.S. Medicare program spent $6.5 billion annually on laboratory in 2006. By 2010, the program was spending $8.2 […]