Maximum Fair Price Strategies for IPAY2027 Readiness

As Medicare’s drug negotiation program enters its second year, stakeholders face growing uncertainty about how maximum fair price (MFP) determinations will reshape drug access, market competition and regulatory expectations.

The shift from Year 1 to Year 2 introduces new challenges around pricing methodology, stakeholder alignment and downstream financial implications across the healthcare ecosystem.

Join this webinar to explore the impact of Year 2 MFP decisions, including comparisons with Year 1, stakeholder impact and broader effects on competitiveness, coverage and patient access.

The featured speakers will examine how the Centers for Medicare & Medicaid Services’ (CMS) approach has evolved, including shifts in price-setting logic and lessons learned from IPAY2026.

They will assess how different stakeholders may be affected by these changes, particularly in terms of who stands to gain or face new constraints under fixed pricing.

The webinar will also consider how the Trump administration might influence Medicare pricing policy and whether more aggressive approaches to MFP determinations could emerge.

Using real-world observations, the panel will highlight how current MFP decisions are influencing contracting strategies and shaping competitive responses across therapeutic areas.

Register for this webinar to learn how the MFP process is evolving and what it means for manufacturers, payers and policymakers navigating the Medicare landscape.

Speakers

Mike Ciarametaro, Policy Managing Director, Avalere Health (Moderator)

Michael Ciarametaro advises life sciences clients on value strategy, evidence generation and navigating the Inflation Reduction Act (IRA), drug pricing and payment reform. He helps companies prepare for Medicare drug pricing negotiations by evaluating and improving therapy value propositions, identifying opportunities to engage policymakers and delivering strategic recommendations. Mike also guides clients in developing value strategies for the Institute for Clinical and Economic Review product evaluations. Prior to Avalere, he was the Vice President of Research at the National Pharmaceutical Council, managing a portfolio focused on innovation and market access challenges. He has held roles at WellPoint NetRx and Evidera, where he led financial analysis supporting Pharmacy and Therapeutics committees and developed strategies for drug pricing and device market access.

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Neil Lund, Senior Advisor, Avalere Health

Neil Lund provides clients with actuarial, payer and pharmacy benefit manager insights across a range of projects. Before joining Avalere, Neil held senior actuarial roles and recently retired as Chief Actuary at CVS Health. He holds a BS in Mathematics from the University of Minnesota and is a fellow of the Society of Actuaries and the Conference of Consulting Actuaries, as well as a member of the American Academy of Actuaries.

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Milena Sullivan, SVP, Healthcare Policy Practice Director, Avalere Health

Milena Sullivan leads strategic advisory services for life sciences clients navigating the evolving US healthcare policy landscape. With over two decades of experience in policy and advocacy, she specializes in Medicare policy, drug pricing reforms and access strategies. Milena provides insights on key developments such as the Inflation Reduction Act (IRA) and Medicare drug pricing negotiations, contributing to Avalere Health’s thought leadership. Previously, she led Avalere’s IRA Negotiation team, supporting manufacturers with risk assessment, planning, negotiation strategy and implementation. Milena also served as Associate Director for Oncology Policy and Market Access at Bristol-Myers Squibb. She held positions at Novartis Vaccines and Diagnostics, advising clients on a range of policy, operational and strategy issues, including Affordable Care Act implementation.

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Taylor Schwartz, Evidence & Strategy Managing Director, Avalere Health

Taylor Schwartz collaborates with clients to design and execute epidemiological, health economics, outcomes research and health policy analyses across diverse therapeutic areas. He specializes in epidemiological methods, survey research, health policy and value assessment frameworks. Before joining Avalere, Taylor was a Senior Research Scientist at Precision Health Economics, conducting studies on the value of innovative health technologies and the impact of policy changes on innovation and population health. He has also researched chronic and infectious diseases, substance misuse, adolescent risk behaviors and mental health at Tufts University School of Medicine and UCSF. Taylor holds an adjunct appointment at American University and has previously taught courses in epidemiology, public health, biostatistics, health policy and research methods at several universities including UNC Chapel Hill, San Francisco State University, University of San Francisco, San Jose State University and the University of New England.

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