Prescription for Better Access

著者: Mark Hansan and Dr. Scott Howell
  • サマリー

  • With pharmaceutical and biotech manufacturers launching more high-cost specialty drugs and the insurance industry increasing the use of more restrictive barriers to access, those who need these medicines—the patients themselves—are caught in the middle, not only shouldering the cost of higher copays and deductibles, but for many, rationing or even abandoning treatment altogether. While manufacturers invest in programs to help navigate the challenges impeding access and affordability, the entire healthcare industry can agree -- the status quo is unsustainable. There has to be a better way. And two industry veterans have joined forces to co-host a new interview-focused podcast to help shape the future of patient access and affordability.
    © 2024 Prescription for Better Access Mark Hansan and Dr. Scott Howell
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あらすじ・解説

With pharmaceutical and biotech manufacturers launching more high-cost specialty drugs and the insurance industry increasing the use of more restrictive barriers to access, those who need these medicines—the patients themselves—are caught in the middle, not only shouldering the cost of higher copays and deductibles, but for many, rationing or even abandoning treatment altogether. While manufacturers invest in programs to help navigate the challenges impeding access and affordability, the entire healthcare industry can agree -- the status quo is unsustainable. There has to be a better way. And two industry veterans have joined forces to co-host a new interview-focused podcast to help shape the future of patient access and affordability.
© 2024 Prescription for Better Access Mark Hansan and Dr. Scott Howell
エピソード
  • Global vs. US Drug Pricing and Market Access
    2024/10/22

    In this episode, we sit down with leading Market Access experts and members of ACCESS Forum to compare and contrast the drug pricing and access systems worldwide and the US. Our discussion delves into the distinct approaches taken by government vs. private markets, examining how regulatory environments, pricing controls, and reimbursement processes impact patient access to innovative therapies. We explore the challenges each approach faces, from cost pressures to affordability and access, and how they balance the interests of patients, governments, and pharmaceutical companies. Join us for a deep dive into how the global healthcare landscape is evolving and what lessons can be learned.

    Nikos Maniadakis, Ph.D., Professor, Health Management & Policy, University of West Attica
    Kimberly Baldwin, Senior Vice President, Value & Access, Ipsen Biopharmaceuticals
    Fauzea Hussain, Vice President, Public Policy, McKesson
    CMS (Centers for Medicare & Medicaid Services)
    European Medicines Agency
    Health technology assessments (HTAs)
    IRA (Inflation Reduction Act)
    Medicaid
    Medicare
    National Institute of Clinical Excellence (NICE)
    NCCN guidelines
    P&T committee (Pharmacy and Therapeutics Committee)
    PAP (Patient Assistance Program)
    Part B (Medicare)
    Part D (Medicare)
    Pharmacy Benefit Managers (PBMs)
    Quality-Adjusted Life Years
    Tricare
    Veterans Administration
    Medical terminology referenced in this episode:

    • Cell and gene therapies (CGT)
    • Insulin
    • Orphan drugs

    Questions or comments?
    Email us at comments@prescriptionforbetteraccess.com.




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    54 分
  • 22. Honoring the Work of Healthcare Advocates
    2024/09/12

    In this episode, we explore the evolving role of healthcare and patient advocates and how this profession has become an essential part of the healthcare system. We begin by defining what a healthcare advocate is and tracing the development of the profession over the years. Key milestones are discussed, such as establishing codes of ethics, training, and certification processes. We also share real-world examples of how advocates help patients navigate the complexities of healthcare, making a measurable impact on patient outcomes. The discussion covers the scale of advocacy in the U.S., examining the roles of professional advocates compared to family members and volunteers. We also address how advocates are helping patients overcome barriers to accessing and affording medicines. Finally, we look to the future of advocacy, discussing potential healthcare reforms, the impact of technology, and practical advice for patients seeking an advocate in today's challenging healthcare environment.

    Rachel Westlake, Managing Director, Coalition of Health Care Advocacy Organizations
    Danielle Marshall, Executive Director, Patient Advocate Certification Board
    Fred Larbi, Chief Operations Officer, HealthWell Foundation
    CHCAO
    Patient Advocate Cerification Board
    Healthwell Foundation
    Greater National Advocates
    NAHAC
    HealthAdvocateX
    Umbra
    Solace

    Questions or comments?
    Email us at comments@prescriptionforbetteraccess.com.
    Find us on social media! Follow us on X, LinkedIn, YouTube and Threads.



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    45 分
  • Evolution of PBM's
    2024/08/20

    In this episode, we explore the evolution and future of the Pharmacy Benefit Management (PBM) industry with insights from two seasoned pharma managed care executives. We discuss the early role of PBMs, their acquisition by pharmaceutical companies, and subsequent industry consolidation. We examine how vertical integration of the PBMs transformed their business model, including the restricted formularies that gave rise to rebates. We also address evolving PBM-manufacturer relationships, the effects of public scrutiny, and predictions for key trends. Join us for a comprehensive look at the past, present, and future of PBMs, focusing on the changes needed to better serve patients.

    Steve Stefano, Managing Director, ReprizioRx

    Steve.Stefano@repriziorx.com

    Bill Leonard, Managing Director, ReprizioRX

    wjl@repriziorx.com

    ReprizioRX

    PBMs

    IPA model HMO

    Medco

    Metro Containment Services

    Medicare Catastrophic Coverage Act of 1988

    Merck

    SmithKline Beecham

    Eli Lilly

    340B

    NDC blocks

    Group Purchasing Organizations (GPOs)

    Medicare

    United Healthcare

    FTC

    CostPlusDrugs


    Questions or comments?
    Email us at comments@prescriptionforbetteraccess.com.
    Find us on social media! Follow us on X, LinkedIn, YouTube and Threads.

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    45 分

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