CER Daily Newsfeed

Value Viewpoint November – December 2025: Recent Developments in US Healthcare Value and Access with Kimberly Westrich

(1/12, Kimberly Westrich, The Evidence Base) comments “...We’re living in a period of remarkable scientific innovation, with emerging medical treatments that could substantially improve life expectancy and quality of life. At the same time, healthcare benefit designs and value assessment methods increasingly shape how and whether patients can access these advances. Under many current benefit designs, patients may face high out-of-pocket costs and access restrictions such as prior authorization or step therapy, which can delay or disrupt clinically appropriate care. In parallel, research on value assessment methods highlights the limitations of relying on static, early evaluations to guide long-term coverage and pricing decisions, particularly as evidence on efficacy, utilization, and real-world pricing evolves over time. Together, these dynamics can constrain access to high-value medical care.” Full

Value Viewpoint: January 9, 2026

(1/9, Kimberly Westrich, LinkedIn) comments “...A new study published in Value in Health proposes a practical solution to a barrier limiting the use of Generalized Risk-Adjusted Cost-Effectiveness (GRACE): the lack of visual analogue scale health measures in most cost-effectiveness analyses (CEAs)...They show that conventional approaches tend to understate the GRACE value of health improvements for the sickest patients, while overstating value for milder conditions, relative to traditional QALY-based CEAs. The paper argues that this bias has practical and policy relevance, particularly in settings where QALYs are constrained by concerns about discrimination against people with disabilities.” Full

Updated CKD Management Guideline Focuses on Pharmacotherapy

(1/12, Nancy A. Melville, Medscape) reports “...The guideline, recently published in the Annals of Internal Medicine, stems from a systematic evidence review conducted by the multidisciplinary VA/DoD Evidence-Based Practice Work Group in order to update the group’s 2019 clinical practice guideline for CKD management...The work group noted, however, that ‘in the absence of comparative effectiveness studies between SGLT2i and GLP-1 RA, SGLT2i [are favored] as add-on therapy to ACEI or ARB before considering GLP-1 RA.’” Full

Emerging Trends in Real-World Data and AI’s Expanding Role

(1/12, Clinical Trials Arena) reports “...[Guenter Sauter, PhD] explains that pharmaceutical companies are coming to understand that the real value in data-driven insights lies not in collecting the largest datasets, but in ensuring their data is truly representative and of the highest quality. According to Sauter, high-quality data, particularly closed claims datasets, is desired for both its completeness and reliability, which enables researchers to make confident, well-informed decisions.” Full

HHS Signals Reconsideration of Drug Rebate Plan Hospitals Oppose

(1/12, Nyah Phengsitthy, Bloomberg Law) reports “...The health department and hospitals are engaged in discussions about returning the 340B Rebate Model Pilot Program back to the government for reconsideration, according to a letter from the Department of Justice sent Monday to the US Court of Appeals for the First Circuit. ‘The agency intends to resolve such proceedings promptly,’ Maxwell Baldi, a Justice Department attorney representing the HHS, said in the letter. ‘Therefore, the parties do not believe that expediting this appeal is warranted at this time and plan to dismiss the appeal in short order.’” Subscription Required