CER Daily Newsfeed

Value Viewpoint: April 10, 2026

(4/10, Kimberly Westrich, LinkedIn) comments “This week, Kenneth Finegold, Roswell Cole, and I published a new column in The Evidence Base on whether 2026 PBM reforms could finally pry open the pharmacy benefit manager ‘black box.’ The column intentionally serves as a primer for global readers unfamiliar with PBMs before offering a deeper dive into recent reforms for those who have followed them more closely...For decades, the ‘black box’ of PBM operations added complexity to the pharmaceutical supply chain, but the combination of the CAA, the DOL’s transparency mandates, and FTC enforcement may finally pry that box open. For these reforms to take hold, employers in the U.S. need to understand their implications, ask for them by name, and be willing to abandon rebate-driven plans in favor of value-based models. In that new world, how we define value becomes the most important question of all.” Full

Experts See LEAD Model As Strategic Shift To Insert MA Elements Into ACOs

(4/10, Jalen Brown, Inside Health Policy) reports “...A McDermott+ analysis published Wednesday says the new model is the agency’s ‘most direct attempt’ to introduce MA-like flexibility into accountable care, particularly through stable benchmarking, expanded benefit design, and new beneficiary engagement tools. Those features include the ability for ACOs to offer incentives for healthy behaviors, reduce Part B cost-sharing, and eventually buy down Part D premiums -- all of which are tools that have historically been limited to MA plans.” Subscription Required

Why a New Medicare ACO Model Is Exciting Value-Based Care Groups

(4/13, Bridget Early, Modern Healthcare) reports “...LEAD participants will not undergo rebasing, which resets financial benchmarks based on an ACO’s past performance, for the duration of the 10-year model. One side effect of rebasing is that high-savings ACOs must meet benchmarks that are increasingly hard to exceed. This ‘ratchet effect’ has long been the subject of consternation among participants in the Shared Savings program and other models. The organizations have said it jeopardizes long-term participation by reducing incentives for ACOs to produce savings.” Subscription Required

Meeting the Challenge of Clinical Trial Recruitment and Retention

(4/13, Lynn Dosky, Pediatrics Nationwide) “...‘We often work with community leaders to gain access to specific populations to design research that accommodates the population’s language, culture and needs,’ says [Cynthia A. Gerhardt, PhD, chief clinical research officer at Abigail Wexner Research Institute at Nationwide Children’s]...‘Funding agencies such as PCORI (Patient-Centered Outcomes Research Institute) have really focused on community advisory boards to engage the community in designing studies that are important to the population and making sure they are a part of interpreting results. This helps make the study easier to implement.’” Full

UK: NICE Update Doubles Eligible Patients for AZ's Lokelma

(4/13, Phil Taylor, PharmaPhorum) reports “...After a review of real-world evidence for Lokelma (sodium zirconium cyclosilicate), the reimbursement authority has published new draft guidance that more than doubles the number of patients in England and Wales who can access treatment with the drug, used to treat adults with persistent hyperkalaemia caused by chronic kidney disease or heart failure.” Full

UK: A Step Forward, but Not the Finish Line: What NICE’s QALY Update Means for Rare Diseases

(4/9, Ben Whitehouse, Mohit Jain, PharmaPhorum) comments “...Rare disease therapies often require disproportionately high investment relative to the size of the patient population. As a result, HTA bodies must be willing to pay a higher price to provide equitable care for people living with rare diseases. While the increase to NICE’s standard threshold moves us in the right direction, the fact remains that many rare disease treatments will continue to be deemed not cost-effective for NHS use.” Full

Canada’s HTA Agency Launches New Funding To Strengthen Rare Disease Registries And RWD

(4/10, Neena Brizmohun, Pink Sheet) reports “...The funding opportunity from Canada’s Drug Agency marks the third of its kind, building on ‘the strong interest and positive response’ to the two previous open calls delivered in 2024 and 2025, according to the health technology assessment body.” Subscription Required

Ledidi and NordicRWE to Advance Hybrid Real-World Evidence Studies and Pragmatic Trials in the Nordics

(4/13, Katie McCool, The Evidence Base) reports “...The partnership is open to pharmaceutical, biotechnology, medtech, and academic organizations seeking to generate evidence that reflects how treatments perform in routine healthcare settings. Under the preferred partner arrangement, NordicRWE will use Ledidi as its primary platform for prospective data capture and hybrid study execution, while Ledidi will collaborate with NordicRWE on study design, registry analytics, and epidemiological support. This structure is intended to provide an integrated pathway from study planning through data collection to long-term outcome analysis.” Full