Prescription for Better Access

In this episode, we explore the 340B Drug Pricing Program, an essential yet complex component of the American drug supply landscape that aims to enable healthcare entities to offer more affordable medication to underserved populations. We interview Antonio Ciaccia, a drug pricing and 340B expert who provides an in-depth look at how the program works, its financial incentives, and how stakeholders have exploited this well-intentioned program, all to the detriment of patients. Antonio Ciaccia, President, 3 Axis Advisors and CEO, 46brooklyn Research, an Ohio non-profit Corporation46brooklynOhio Pharmacist Association3 Axis AdvisorsMedicaid340B Program340B Litigation340 Eligibility, HRSACovered EntitiesMedicaid Drug Rebate ProgramObamacare Indian Health Service"Money from Sick People," Report from 46Brooklyn MedicarePharmacy Benefit Managers (PBMs) Jamie Robinson, Health Economist Medical terminology referenced in this episode: Novolog Questions or comments? Email us at comments@prescriptionforbetteraccess.com. Find us on social media! Follow us on X, LinkedIn, YouTube and Threads.

In this important podcast episode, we interview Victor Bulto, President, US for Novartis, to discuss the company's efforts to develop groundbreaking treatments while ensuring accessibility and affordability for patients. We delve into how the pharmaceutical industry navigates numerous post-FDA approval barriers to launch new drugs and the importance of market access, patient support services, and a commitment by manufacturers to provide patient assistance and other support for patients. Victor Bulto, President, Novartis Novartis FDA Institute for Clinical and Economic Review (ICER) American Heart Association (AHA) Inflation Reduction Act (IRA) Pharmacy Benefit Manager (PBM) Medicare Medical terminology referenced in this episode: Cell therapy: CART-T Radioligand therapy RNA Entresto Molecular glues Targeted protein degradation Antisense oligonucleotides Small interfering RNAs: siRNAs LDL cholesterol COVID Hematological malignancies Refractory autoimmune diseases Questions or comments? Email us at comments@prescriptionforbetteraccess.com. Find us on social media! Follow us on X, LinkedIn, YouTube and Threads.

Biosimilars are entering the market at their fastest pace ever. In this episode, we interview a renowned health economist and an expert consultant in biosimilar distribution and patient support to explore the complex landscape of biosimilars, including examining the hurdles and breakthroughs in achieving acceptance by payers and providers and how best to improve patient access and affordability in a market dominated by established brands. Dr. Jason Shafrin, Senior Managing Director, Center for Healthcare Economics and Policy at FTI Consulting Marina Allen, SVP, Fingerpaint Market Access, Patient Support & Access Strategy Leader in Pharma-Biotech Biosimilars The Biologics Price Competition and Innovation Act of 2009 PBMs (Pharmacy Benefit Managers) Medicare Advantage Humira (biosimilars) 340B program Inflation Reduction Act Medicare Part D "brown bagging and white bagging" Mark Cuban (CostPlusDrugs) GoodRx average sales price (ASP) electronic health record (EHR) system Questions or comments? Email us at comments@prescriptionforbetteraccess.com. Find us on social media! Follow us on X, LinkedIn, YouTube and Threads.

Scott and Mark welcome Dr. Mark McClellan, a distinguished health policy expert who has served as the Commissioner of the FDA and the Administrator of CMS, to look ahead at the major policy activities in 2024. They discuss how the government's role as regulator and purchaser of drugs will influence the drug industry and the patient's ability to access and afford medicines this year. They also discuss the challenges and opportunities for improving public health and the emerging role of artificial intelligence. Dr. Mark McClellan, PhD, Director and Professor of Business, Medicine and Policy at the Duke-Margolis Center for Health Policy at Duke University IRA Medicare Part D Pharmacy Benefit Managers (PBMs) Medicare Advantage FDA commissioner Rob Califf The Ryan White HIV/AIDS Program (RWHAP) Part B Medicare Modernization Act FDA FDA's Office of Regulatory Affairs Centers for Medicare & Medicaid Services (CMS) Centers for Disease Control and Prevention (CDC) Per Member Per Month (PMPM) billing Questions or comments? Email us at comments@prescriptionforbetteraccess.com. Find us on social media! Follow us on X, LinkedIn, YouTube and Threads.

In our 2023 podcasts, there have been a series of revelations about the complexity and unintended consequences related to drug access and affordability. This episode explores the essential underlying tension between the notion that affordability and access are deteriorating while science is advancing so rapidly. We interview Rachel King, CEO of Biotechnology Innovation Organization (BIO), to explore the priorities for the industry and how the challenges related to patient access and affordability could jeopardize innovation for patients today and in the future. Rachel King, CEO, BIO (Biotechnology Innovation Organization) John Crowley, Executive Chairman, Amicus Therapeutics James Robinson PhD, MPH, Chair, Health Policy and Management Division, Berkeley School of Public Health The Inflation Reduction Act Orphan Drug Act Orphan Cures Act PBM (pharmacy benefit management) Medicare Part D Step Therapy Cystic Fibrosis Foundation Therapies mentioned in this episode: RNAiAntisensemRNAMonoclonal antibody Email us at comments@prescriptionforbetteraccess.com. Find us on social media! We’re on X as @RX4BetterAccess, LinkedIn and YouTube.

In this episode, we investigate the rise of Alternative Funding Programs (AFPs) that bypass coverage for vital specialty drugs. Kyle Crowell, an expert consultant on AFPs, discusses how payers avoid their responsibility for costs by collaborating with third-party companies to exclude specific drug coverage and directing patients towards manufacturer-sponsored patient assistance programs (PAPs). Patient advocate, Amy Niles from the PAN Foundation, describes how the mounting tension caused by AFPs are leaving patients to navigate the uncertain waters of their medication coverage and access, potentially risking their health and even their lives. Kyle Crowell, Principal (Partner) at ZS Associates Amy Niles, Chief Advocacy and Engagement Officer, PAN Foundation Patient Assistance programs (PAPs) Alternative funding programs (AFPs) “AFP Caution For Patients” “Pharma faces tough choices as alternative funding programs exploit charitable giving” Medicare Part D “AbbVie sues a behind-the-scenes company for exploiting its patient assistance program” Federal Trade Commission Carl Schmidt from the HIV and Hepatitis Policy Institute Copay Accumulator Adjustment Programs Lawsuit Like this episode and want to hear more? Listen to past episodes here! Do you have a prescription for better access? Share your comments and episode ideas with us at: comments@prescriptionforbetteraccess.com. Find us on social media! We’re on X as @RX4BetterAccess, LinkedIn and YouTube.

Patients are experiencing remarkable weight loss thanks to the new generation of GLP-1’s and the downstream health benefits may go well beyond diabetes. In spite of the dramatic results for patients, insurance plans have started to put up more barriers and are even denying the drugs on a more consistent basis. For this special Obesity Week 2023 episode, we interview Dr. Angela Fitch, President of the Obesity Medicine Association, a faculty member at Harvard Medical School and most recently a Co-Founder and Chief Medical Officer for knownwell, a new obesity-focused primary care company. Show Notes: Dr. Angela Fitch, President, OMA Obesity Week Obesity Medical Association Dr. Fitch’s patient care center: Knownwell Seeking treatment for obesity? Find a clinician here or here. The Treat and Reduce Obesity Act of 2023 The drugs discussed in this episode: GLP-1WegovyVictoza An article on the use of “bootlegged” Semaglitude: Demand Rising for 'Bootlegged' Weight-Loss Drug | MedPage Today Questions or comments? Email us at comments@prescriptionforbetteraccess.com. Find us on social media! We’re on X as @RX4BetterAccess, LinkedIn and YouTube.

Employers are discovering this fall that they are expected to shoulder a 6% health insurance increase for 2024. What can employers do to combat the accelerating cost of health insurance without jeopardizing access to vital drugs? In this podcast episode, we talk with Matt Ohrt, a former HR executive who achieved a 20% reduction in health insurance costs for his employer. Matt has a new book and new company to help other self-funded employers strategically lower their sponsored health insurance costs for 2024 while ensuring employees have optimal access to care and treatments. This is an essential listen for employers seeking to balance cost-efficiency with the provision of comprehensive, high-quality healthcare benefits to their employees. Matt Ohrt, Co-founder, Chief Healthcare Officer, Self Fund Health Self Fund Health Merrill Steel How Does Direct Primary Care Work? Matt Ohrt’s book: “Save Your Company: Don't Feed the Beast: The Employer Healthcare Success Formula” Like this episode and want to here more? Check out our past episodes here! Do you have a prescription for better access? Share your ideas with us at comments@prescriptionforbetteraccess.com Follow us on social media! We’re on YouTube, LinkedIn and @RX4BetterAccess (X)

Many of the most beneficial therapies are prescribed or administered within physician offices yet these providers face a multitude of challenges attempting to get authorization and coverage. In this podcast, we interview a practice manager who is not only on the frontlines of the battle to help patients but is also an award-winning advocate for access. This episode will explore the barriers faced by providers and their offices and what can be done to win the day-to-day battles with insurance companies and PBM’s so patients can access and remain on treatment. Julie Baak, Practice Manager, Arthritis Center Arthritis Center Rheumatoid Arthritis Psoriatic Arthritis Reactive Arthritis The importance of ultrasound in identifying and differentiating patients with early inflammatory arthritis: a narrative review. Growing Shortage of Rheumatologists “Very Concerning” Like this episode and want to here more? Check out our past episodes here! Do you have a prescription for better access? Share your ideas with us at comments@prescriptionforbetteraccess.com Follow us on social media! We’re on YouTube, LinkedIn and @RX4BetterAccess (X)

This episode delves into the intricate web of Washington's influence on patient access, exploring the multifaceted factors that shape healthcare legislation, policies and their impact on patients, other key stakeholders and drug pricing. With an insightful interview from one of Washington’s top healthcare experts, listeners gain insight to the complexities of legislation, such as the Affordable Care Act and Inflation Reduction Act. This is certainly the “wonkiest” podcast episode as we attempt to provide an understanding of the current landscape of patient access and look ahead to how Washington's decisions will shape the future of patient access. Lance Grady, Executive Vice President, Avalere Avalere Cardinal Health. Public Health Emergency (PHE) AMP cap The Affordable Care Act (ACA) Innovation Center The Inflation Reduction Act (IRA) CMS Like this episode and want to here more? Check out our past episodes here! Do you have a prescription for better access? Share your ideas with us at comments@prescriptionforbetteraccess.com Follow us on social media! We’re on YouTube, LinkedIn and @RX4BetterAccess (X)

In this podcast, we interview a consultant and a leading patient advocate to better understand and explore the challenges of copay accumulator and maximizer programs for specialty drugs. We discuss the difference between the two programs and their impact on the various stakeholders including the overwhelming burden placed on patients. We also discuss the legal issues and potential policy changes that could eliminate these programs or minimize their impact on patients. Ultimately, our goal is to shed light on this important issue and identify strategies for improving access to critical medications for patients who need them. Carl Schmid, Executive Director, HIV And Hepatitis Policy Institute Lauren Crawford Shaver, Senior Managing Director, FTI Consulting HIV And Hepatitis Policy Institute FTI Consulting President's Advisory Council on HIV/AIDS National Association of Insurance Commissioners. Department of Health and Human Services (HHS) What are co pay maximizers? Like this episode and want to here more? Check out our past episodes here! Do you have a prescription for better access? Share your ideas with us at comments@prescriptionforbetteraccess.com Follow us on social media! We’re on YouTube, LinkedIn and @RX4BetterAccess (X)

Pharmacy benefit managers (PBM’s) manage the drug benefits for millions of Americans and as a result, they can have a positive or negative impact on patient access. Mesfin Tegenu, an early pioneer in the PBM industry, is interviewed by Scott and Mark and offers his candid perspective on what PBM’s do, their impact on stakeholders and how the PBM industry could evolve over the next few years to better serve patients, employers, health plans and government payers. Mesfin Tegenu, CEO, Chairman, RxParadigm RxParadigm PBM (pharmacy benefit management) PMS (pharmacy management services) Vanquishing Hepatitis C: A Remarkable Success Story Like this episode and want to here more? Check out our past episodes here! Do you have a prescription for better access? Share your ideas with us at comments@prescriptionforbetteraccess.com Follow us on social media! We’re on YouTube, LinkedIn and @RX4BetterAccess (X)

In this episode, we interview Dr. Steven Pearson, the founder and President of the Institute for Clinical and Economic Review (ICER). Over the past 16 years, ICER has evolved from a Harvard research program to the independent authority on cost-effectiveness and value of new drugs. Dr. Pearson has been an advocate of “Fair Pricing for Fair Access” and in January 2023, ICER published their 2nd Annual Assessment of Barriers to Fair Access Within US Commercial Insurance Prescription Drug Coverage. Dr. Steven Pearson, Founder, President, Institute for Clinical and Economic Review (ICER) Institute for Clinical and Economic Review (ICER) Barriers to Fair Access Report Gross-to-Net Bubble Like this episode and want to hear more? Check out our past episodes here! Do you have a prescription for better access? Share your ideas with us at comments@prescriptionforbetteraccess.com Follow us on social media! We’re on YouTube, LinkedIn and @RX4BetterAccess (X)

In this foundational episode about drug pricing, we interview Dr. Jamie Robinson, the Leonard D. Schaeffer Professor of Health Economics, and Director of the Berkeley Center for Health Technology at the University of California, Berkeley. Dr. Robinson is the author of 3 books and 150 peer-reviewed articles on health economics and drug pricing. James Robinson PhD, MPH, Chair, Health Policy and Management Division, Berkeley School of Public Health Clarification on term “drug pricing”: Nomenclature for this episode refers to the price of drugs from wholesale acquisition or list price. Other prices include the price of patient cost sharing or hospital/physician administered medication. Biosimilars Generics Versus Biosimilars PBMs (Pharmacy Benefit Managers) Do you have a prescription for better access? Share your ideas and show topics with us at comments@prescriptionforbetteraccess.com Follow us on social media! We’re on YouTube, LinkedIn and @RX4BetterAccess (X)

This episode features an interview with Peyton Howell discussing the evolution of patient access over the past three decades, the creation of the hub industry, and the continuing challenges faced by pharma companies and service providers in supporting patient access to medications. Peyton Howell, Chief Operating and Growth Officer, Parexel Parexel Lash Group Genentech Biologics How Automation Is Transforming Healthcare Jobs Do you have a prescription for better access? Share your ideas and show topics with us at comments@prescriptionforbetteraccess.com Follow us on social media! We’re on YouTube, LinkedIn and @RX4BetterAccess (X)

In this episode, co-hosts Mark Hansan and Dr. Scott Howell interview two patients who share their personal journeys, how medicine has helped them, their challenges related to access, and how both are making a difference for patients. Donna Cryer, JD, CEO, Founder of the Global Liver Institute Reid Jewitt Smith, Ph.D., Patient Advocate and Career Educator Global Liver Institute Cystic Fibrosis Vertex Pharmaceuticals Medications discussed in this episode: Trikafta Decoupling: What is it, and how could it reshape American health care? Do you have a prescription for better access? Share your ideas and show topics with us at comments@prescriptionforbetteraccess.com Follow us on social media! We’re on YouTube, LinkedIn and @RX4BetterAccess (X)

In this episode Mark and Scott interview Dave Moules, former Pfizer SVP, Payer and Channel Access to look at the year ahead in patient access. David Moules, former Pfizer SVP, Payer and Channel Access The Inflation Reduction Act The Affordable Care Act 340B Drug Pricing Program Insulin Affordability and the Inflation Reduction Act Do you have a prescription for better access? Share your ideas with us at comments@prescriptionforbetteraccess.com Follow us on social media! We’re on YouTube, LinkedIn and @RX4BetterAccess (X)

In this preview episode, you will have the opportunity to get to know co-hosts Mark Hansan and Dr. Scott Howell and why they have come together to launch the interview-focused podcast to help improve patient access to medicines. Mark Hansan, Co-founder and Executive Chairman, CareMetx, LLC Dr. Scott Howell, Healthcare and biopharma teacher, researcher, and advisor Prescription For Better Access website Do you have a prescription for better access? Share your ideas with us at comments@prescriptionforbetteraccess.com Follow us on social media! We’re on YouTube, LinkedIn and @RX4BetterAccess (X)