CER Daily Newsfeed

Value Viewpoint: November 21, 2025

(11/21, Kimberly Westrich, LinkedIn) comments “A new study published in the Journal of Market Access & Health Policy highlights persistent gaps between formal insurance coverage and real-world affordability. In a mixed-methods survey (n=146) and focus group (n=29) study of U.S. patients with chronic disease, participants reported high deductibles, variable cost-sharing, and unpredictable out-of-pocket costs that left them feeling ‘insured but not covered.’...Respondents broadly supported redesigning benefit structures to reduce cost exposure for chronic disease treatments, even if it required modest premium increases. Patients consistently emphasized predictability, transparency, and affordability as core features of an insurance design that meets the needs of people managing chronic illnesses.” Full

Prior Authorization Reform Heats Up

(11/24, Leila Sullivan, Zeynep Celik, Amy Killelea, Health Affairs Forefront) comments “...In response to growing concerns about PA abuses, policy makers at the federal and state levels are increasingly implementing reforms that target the processes insurers use, the substance of their requirements, or both. This article explores key trends in PA reform and what those reforms mean for consumers. We primarily focus on the commercial health insurance market, although some policies apply more broadly.” Full

Preparing Effective Systematic Literature Reviews and Indirect Treatment Comparisons for Joint Clinical Assessment (JCA)

(11/24, The Evidence Base) reports “...In their ISPOR Europe 2025 presentation, Caroline von Wilamowitz-Moellendorff, Paulina Bajko, Eva Gonzalez Viana, and Sohan Deshpande from PPD™ Evidera™ Health Economics & Market Access team, Thermo Fisher Scientific offer timely guidance on how teams can navigate JCA requirements. Drawing on recent experience, they highlight practical lessons for designing compliant SLRs, performing credible ITCs, and planning robust submissions.” Full

UK: NICE Endorses Vutrisiran for ATTR-CM Treatment

(11/21, Annie Lennon, Medscape) reports “The National Institute for Health and Care Excellence (NICE) has issued final draft guidance recommending vutrisiran for patients with wild-type and hereditary transthyretin amyloidosis with cardiomyopathy (ATTR-CM). The drug becomes the second disease-modifying therapy approved for routine NHS use, joining tafamidis.” Full