In this episode of Healthcare Matters, Dr. Robert Popovian and Ben Blanc unpack the often unpredictable nature of political affiliations in relation to support for patient-centric policies, particularly in the realm of drug pricing and the influence of Pharmacy Benefit Managers (PBMs). They discuss bipartisan efforts to address drug pricing reforms and delve into Governor Newsom's controversial veto of the PBM Reform Bill in California. Additionally, the episode covers the FTC’s lawsuit against PBMs over insulin pricing and assesses its potential implications for patient care. Dr. Popovian also challenges a misleading statement by The Wall Street Journal regarding drug rebates.

Among the highlights in this episode:

01:03: Dr. Popovian dives into the critical issues surrounding drug policy, emphasizing how political affiliation sometimes doesn't align with effective health care policy for patients, highlighting the cross-party collaboration and conflict within drug pricing reforms

02:09: Dr. Popovian elaborates on the complex nature of drug pricing policies, pointing out the unusual alliances formed across political lines. He discusses how both conservative and liberal politicians have joined forces to address issues with Pharmacy Benefit Management companies (PBMs), which he identifies as major contributors to the problems within the drug pricing system

03:56: Dr. Popovian challenges a statement by The Wall Street Journal concerning rebate contracting in drug pricing, clarifying that while rebates are permitted there is no legislative requirement forcing PBMs to adopt rebate contracting. Dr. Popovian points out that alternative pricing models like net price contracting are viable and used by large insurers like Kaiser in California without relying on rebate contracts

You can find Dr. Popovian’s LinkedIn posts on this topic below:

- https://www.linkedin.com/feed/update/urn:li:activity:7246621458792165376/

- https://www.linkedin.com/feed/update/urn:li:activity:7245454053596422144/

To read the full article from The Wall Street Journal, visit: https://www.wsj.com/opinion/federal-trade-commission-pharmacy-benefit-managers-insulin-43b0a974?mod=opinion_lead_pos1

05:35: Dr. Popovian discusses a controversial veto of the PBM Reform Bill in California by Governor Newsom, analyzing the negative implications for patient care in California and contrasting this with other states' more patient-friendly policies

08:15: Our hosts discuss the FTC's lawsuit against major PBMs regarding insulin pricing, exploring how past practices of PBMs have escalated costs and restricted patient access to essential medications

10:58: Dr. Popovian sheds light on the critical role of patient self-advocacy in navigating a health care system dominated by PBMs and insurers, stressing the importance of patient education and legislative support to safeguard patient rights

12:08: Ben lists a series of tips on navigating health information on social media, emphasizing critical thinking and the importance of sourcing information from credible and knowledgeable sources

14:03: Dr. Popovian shares some final thoughts

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: rpopovian@ghlf.org

Ben Blanc, Associate Director, Digital Production and Engagement at GHLF: bblanc@ghlf.org

A podcast series produced by Ben Blanc.

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to podcasts@ghlf.org

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.

In this episode of Healthcare Matters, join Dr. Robert Popovian and Ben Blanc as they delve into the issue of patient steering by Pharmacy Benefit Managers (PBMs). With firsthand accounts from guests Lou Tharp, Executive Director and Co-Founder of GHLF, and Dr. Anne Sydor, Director of Research Development at GHLF, the discussion highlights how PBM-owned pharmacies and policies like accumulators and maximizers limit patient choice and inflate out-of-pocket costs.

Tune in to learn more about the complex dynamics behind these practices, the impact on patient care, and the ongoing legislative efforts to protect patient rights.

Among the highlights in this episode:

03:01: Dr. Popovian explains the role of Pharmacy Benefit Managers (PBMs) in patient steering and their financial motivations for directing patients to PBM-owned pharmacies over independent ones

04:59: Lou shares his personal experiences with patient steering, explaining the challenges he faced with PBMs and his advocacy efforts that led to local policy changes

09:23: Dr. Sydor recounts the challenges she faced ensuring her son's medication continuity as he transitions to college, highlighting the barriers imposed by insurance companies regarding prescription fills

13:18: Lou discusses his negative experiences with at-home drug delivery due to PBM’s policies

15:26: Dr. Sydor criticizes the inefficiencies and customer service issues within PBMs, sharing her frustration with the lack of access to simple, generic medications due to PBM's mail order requirements

20:20: Dr. Popovian discusses state-level anti-steering legislation and federal initiatives aimed at reforming PBM practices, including a significant bill that proposes prohibiting PBMs from owning pharmacies to reduce conflicts of interest and promote patient care over profits

23:27: Dr. Popovian shares some final thoughts

If you want to use GHLF's interactive tool to explore health care premium cost trends state by state and learn more about patient assistance programs, visit: https://ghlf.org/copay-assistance-protection/

To learn more about House Committee on Oversight and Accountability Chairman James Comer’s call on the CEOs of the three major PBMs, go to: https://oversight.house.gov/release/chairman-comer-calls-on-pbm-executives-to-correct-hearing-testimony/

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: rpopovian@ghlf.org

Ben Blanc, Associate Director, Digital Production and Engagement at GHLF: bblanc@ghlf.org

A podcast series produced by Ben Blanc.

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to podcasts@ghlf.org

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.

In this episode of Healthcare Matters, join Dr. Robert Popovian and Ben Blanc as they dissect the critical role of Pharmacy Benefit Managers (PBMs) in the health care system, guided by recent findings from the Federal Trade Commission (FTC). The episode delves into how PBMs control a significant portion of the U.S. prescription market, discussing the implications of their dominance on drug prices, and the viability of independent pharmacies. Featuring a thorough examination of the FTC's recent report, Dr. Popovian explores the deep-seated issues of market concentration, anti-competitive practices, and the need for substantial regulatory reform.

This episode aims to shed the light on the powerful influence PBMs have over drug access and affordability, proposing pathways for more equitable health care practices.

Among the highlights in this episode:

01:45: Dr. Popovian delves into the FTC's report, revealing that three major PBMs control 80% of the retail prescription market in the U.S., highlighting issues of market concentration and limited competition

02:46: The conversation shifts to the impact of PBMs on drug prices and pharmacy operations, focusing on the FTC's concerns over anti-competitive practices

03:14: Dr. Popovian explains the effects of vertical and horizontal integration among PBMs, affecting drug access and pricing

06:35: Our hosts discuss the struggles faced by independent pharmacies due to PBM practices, as revealed in the FTC report

09:59: Dr. Popovian explores how PBMs use formulary design to manipulate which drugs patients can access and at what cost

11:59: Dr. Popovian criticizes the current rebate practices by PBMs, discussing their detrimental effects on the availability of generic and biosimilar drugs

14:25: Dr. Popovian calls for greater transparency and potential regulatory reforms to ensure fair drug pricing and maintain pharmacy viability

16:44: Dr. Popovian shares some final thoughts

To read the full FTC report “Pharmacy Benefit Managers: The Powerful Middlemen Inflating Drug Costs and Squeezing Main Street Pharmacies,” go to: https://www.ftc.gov/reports/pharmacy-benefit-managers-report

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: rpopovian@ghlf.org

Ben Blanc, Associate Director, Digital Production and Engagement at GHLF: bblanc@ghlf.org

A podcast series produced by Ben Blanc.

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to podcasts@ghlf.org

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.

In this episode of Healthcare Matters, join our hosts as they explore the innovative world of gene therapy with guest Dr. Anne Sydor, Director of Research Development at GHLF. Together, they delve into the complexities of gene therapy treatments, the reasoning behind their high costs, and the challenges posed by current regulatory environments. They also discuss whether there is a need to reevaluate payment models to support the sustainable deployment of these life-altering therapies.

This episode provides a deep dive into the future of gene therapy and the regulatory model for manufacturing processes.

Among the highlights in this episode:

02:34: Dr. Popovian discusses the impressive number of gene therapy trials currently listed in the National Institutes of Health database, indicating significant research activity in this field

03:07: Dr. Popovian explains the impetus behind his collaborative paper on gene therapy value and pricing models, highlighting the need to understand pricing in the context of long-term health outcomes and societal benefits

04:43: Dr. Sydor provides a comprehensive overview of gene therapy, explaining its different types and methodologies, emphasizing their transformative impact on patient care

07:47: Dr. Popovian addresses why gene therapies are notably expensive, focusing on the high costs of research, development, and the significant value they bring to patients and society

09:28: Dr. Sydor highlights the societal and economic benefits of gene therapies, noting their potential to extend lives and improve quality of life for patients with rare diseases

11:15: Dr. Sydor elaborates on regulatory challenges impacting gene therapy accessibility and suggests potential improvements to ease these burdens

16:24: Dr. Popovian questions the adequacy of current payment models for gene therapies in the U.S. and suggests that a reevaluation might be necessary to accommodate the unique costs and benefits of these treatments

20:14: Dr. Sydor and Dr. Popovian discuss the broader implications of gene therapy pricing, emphasizing the need to balance upfront costs against long-term benefits in health care policy discussions

22:53: Dr. Popovian shares some final thoughts

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: rpopovian@ghlf.org

Ben Blanc, Associate Director, Digital Production and Engagement at GHLF: bblanc@ghlf.org

A podcast series produced by Ben Blanc.

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to podcasts@ghlf.org

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.

In this episode of Healthcare Matters, Dr. Robert Popovian and Ben Blanc bring you essential takeaways from the World Vaccine Congress. Joined by guests Abby Bownas, leader of the Adult Vaccine Access Coalition (AVAC) and the American Disease Prevention Coalition (ADPC), and Dr. Thomas Acciani, Director of U.S. Vaccine Policy at GSK, they delve into their significant roles within the vaccine landscape and discuss the overarching importance of the congress. Dr. Popovian highlights the latest advancements in vaccine research conducted by GHLF and their research partner IQVIA Human Data Sciences.

This episode offers a comprehensive overview of the current state and future directions of vaccine development and deployment. Tune in to gain a deeper understanding of the challenges and opportunities that lie ahead in the field of vaccines.

Among the highlights in this episode:

01:20: Dr. Popovian shares his recent participation to the World Vaccine Congress, including his roles as a presenter and panel moderator, offering insights into the significance of the event

02:43: Dr. Popovian and Abby Bownas discuss the importance of increasing adult vaccination rates and the federal and policy opportunities that can help achieve this goal

04:13: Abby explains the role of the American Disease Prevention Coalition (ADPC) in supporting pharmacists as vaccinators across different states, highlighting the variation in vaccination rules and authority levels

05:06: Dr. Popovian and Abby discuss the broad coalition of partners involved in ADPC, including pharmacists, vaccine makers, patient groups, and advocacy organizations. They emphasize the coalition's efforts to harmonize state laws on pharmacist vaccination authority before federal temporary provisions expire

06:53: Abby stresses the collaborative effort required among all providers to improve vaccine access and uptake, making the case for pharmacies and physicians to work together effectively

08:23: Dr. Acciani describes his role at GSK and the importance of addressing policy barriers to enhance patient access to vaccines, stressing the collaboration with public and private sectors to remove these obstacles

09:17: Dr. Popovian and Dr. Acciani discuss the need to eliminate unnecessary policy barriers to improve vaccination accessibility, advocating for a "no wrong door" policy where patients can receive vaccinations immediately upon request

11:20: Dr. Popovian presents findings from a study on Medicaid reimbursement and its correlation with vaccine uptake, emphasizing the impact of economic incentives on vaccination rates

13:50: Dr. Popovian discusses GHLF’s research on immunization access and its correlation with reimbursement strategies, particularly focusing on the disparities in vaccination rates among different socio-economic groups

15: 57: Dr. Popovian discusses the challenges faced by immunocompromised patients in accessing vaccines, discussing the significant barriers that persist despite insurance coverage

17:27: Dr. Popovian shares insights on future research directions for GHLF, including a study on vaccine uptake challenges among immunocompromised patients and the potential policy interventions to reduce barriers to vaccination

20:10: Dr. Popovian reflects on the broader implications of vaccine research beyond infectious diseases, pointing to exciting developments in oncology vaccines and their potential impact on public health

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: rpopovian@ghlf.org

Ben Blanc, Associate Director, Digital Production and Engagement at GHLF: bblanc@ghlf.org

A podcast series produced by Ben Blanc.

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to podcasts@ghlf.org

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.

In this episode, Dr. Robert Popovian and Ben Blanc are joined by Kate Hudson, Associate Vice President and Counsel for Government Relations and Public Policy at the Association of American Universities, to dissect the complex issue of march-in rights. They delve into how this regulation negatively influences the partnership between public research and private sector investment, which is crucial for supporting biopharmaceutical innovation from university labs to a patient’s bedside. The episode reveals march-in rights' potential risks and benefits, especially how the policy might impact innovation and patient access to future therapies.

Among the highlights in this episode:

02:25: Researchers found that 75% of all Food and Drug Administration-approved drugs between January 2008 and December 2017 were funded and researched by private companies, with only 19% of the approved drugs having origins in publicly supported research and development, and 6% originating in companies that were spun from publicly supported research programs

03:48: Kate shares her professional journey and current role at the Association of American Universities

06:06: Kate explains the concept of march-in rights under the Bayh-Dole Act, detailing its purpose, application, and implications for intellectual property generated from federally funded research

09:52: Dr. Popovian describes his involvement with University Pharmco and its mission to promote research commercialization, emphasizing the potential impact of march-in rights on such initiatives

12:19: Kate addresses why the debate around march-in rights is crucial from a patient's perspective, particularly concerning the potential chilling effect on innovation and drug development

17:18: Kate provides her perspective on how march-in rights could influence private sector investment, potentially driving it outside the United States, and discusses the international adoption of similar legislative frameworks

19:54: Dr. Popovian shares some final thoughts

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: rpopovian@ghlf.org

Ben Blanc, Associate Director, Digital Production and Engagement at GHLF: bblanc@ghlf.org

A podcast series produced by Ben Blanc.

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to podcasts@ghlf.org

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.

Join Dr. Robert Popovian and Ben Blanc for a special live episode from the World Vaccine Congress in Washington, DC, where they delve into the latest developments in vaccine policy and economic research. This episode spotlights the congress's role as a vital hub for collaboration and innovation in the vaccine industry.

Tune in to get an insider's view of the pivotal conversations shaping the future of vaccines.

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: rpopovian@ghlf.org

Ben Blanc, Associate Director, Digital Production and Engagement at GHLF: bblanc@ghlf.org

A podcast series produced by Ben Blanc.

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to podcasts@ghlf.org

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.

In this episode of Healthcare Matters, Dr. Robert Popovian and Ben Blanc take a deep dive into GHLF’s latest vaccine study with guests Dr. Wayne Winegarden, Senior Fellow in Business and Economics at the Pacific Research Institute (PRI) and Director of PRI's Center for Medical Economics and Innovation, and Esteban Rivera, Associate Director of Data Science and Economics at GHLF.

Together, they delve into the study, which underscores the pivotal role pharmacists play in vaccination efforts and the urgent need for regulatory reform. They discuss how pharmacies enhance vaccine access and affordability, especially in marginalized communities, the challenges posed by regulatory barriers, and suggest ways to reform these barriers to improve vaccination rates.

Tune in to explore how pharmacies can play a pivotal role in public health through streamlined vaccination processes.

Among the highlights in this episode:

03:04: Dr. Popovian, Chief Science Policy Officer at GHLF, discusses a statistic by the Center for Disease Control that nearly 60% of all flu vaccines were administered in pharmacies in the latest flu season, emphasizing the significant role pharmacists play in combating preventable diseases

03:53: Dr. Popovian explains the reasons behind GHLF’s new report on pharmacy-administered vaccinations, including previous findings on access in low-income communities and the preference for pharmacy vaccinations post-pandemic

06:18: Dr. Winegarden discusses the study's groundbreaking findings, particularly the complex and burdensome state regulations around vaccinations and their health and economic implications

09:10: Esteban Rivera elaborates on the cost-effectiveness of vaccinating patients at pharmacies compared to physician offices and highlights the equitable benefits of increased vaccine accessibility at pharmacies

10:24: Dr. Winegarden provides an example of the RSV vaccine to illustrate specific cost savings and health impacts of pharmacy versus physician office vaccinations

13:27: Esteban Rivera discusses the complexity of regulatory pathways for vaccination, emphasizing the need for simplification to reduce costs and improve accessibility

14:26: Dr. Popovian gives examples of states that have either streamlined or erected barriers for pharmacist immunization, particularly highlighting the negative impact on underserved communities in New York

16:16: Dr. Popovian advocates for state-level regulatory reform to grant pharmacists the same authority to immunize as physicians, stressing the importance of accessibility and convenience for patients

18:24: Dr. Popovian shares some final thoughts

To access the full report, go to: https://ghlf.org/removing_barriers_to_pharmacy_vaccination/

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: rpopovian@ghlf.org

Ben Blanc, Associate Director, Digital Production and Engagement at GHLF: bblanc@ghlf.org

A podcast series produced by Ben Blanc.

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to podcasts@ghlf.org

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.