Prescription for Better Access

Specialty drug benefit design isn't just one decision — it triggers a domino effect impacting employer and health plan costs, patient access, care delivery and patient cost-sharing. In this episode, we unpack PSG’s latest research on how employers and health plans are rethinking specialty strategies amid rising pressure: cost management as a top priority, movement toward rebate alternatives, shifting site of care models, and evolving approaches to affordability and utilization management. Our guests break down where the biggest shifts are happening, what’s still missing, and how smarter benefit design can create better outcomes across the healthcare system. PSG (Pharmaceutical Strategies Group) 2025 Trends in Specialty Drug Benefits Report Specialty Drugs Drug Utilization PBM (Pharmacy Benefit Manager) Copay Assistance (Maximizers & Accumulators) Drug Rebates Drug “Carve Outs” Value-Based Agreements Utilization Management Step Therapy Biosimilars Site-of-Care Questions or comments?Email us at comments@prescriptionforbetteraccess.com.Find us on social media! Follow us on X, LinkedIn, YouTube and Threads.

In this episode, we interview Brian Reid, the founder of Reid Strategic and the creator and editor of our favorite industry newsletter, the Cost Curve. Brian shares his journey to create the Cost Curve and how he navigates the onslaught of information to identify the most important issues of the day. We also get his take on what he calls the highest “importance-to-attention” healthcare stories, highlighting critical topics that are undercovered related to their significance. We also get the opportunity to understand his perspectives on the threats to innovation, the risks to patient affordability programs, and what all of us should be doing to be better healthcare consumers. Brian Reid- Reid Strategic Cost Curve Newsletter Martin Shkreli & Daraprim BioPharma Dive: Biotech and Pharma Industry News GLP-1s Net Price– “a drug’s net price equals the actual revenues that a manufacturer earns from a drug after rebates, discounts, and other reductions” Source: Drug Channels Armamentarium Pharmacy Benefit Managers (PBMs) Mark Cuban Pharmacy Psuedo-Generic Medication CVS Cordavis Quallent Nuvalia Biosimilars Lilly Direct Novo 340B Drug Pricing Program Copay maximizers AFPs Questions or comments?Email us at comments@prescriptionforbetteraccess.com.Find us on social media! Follow us on X, LinkedIn, YouTube and Threads.

In this episode, we explore the complex and often debated concept of value in prescription drugs. They discuss how different stakeholders—payers, manufacturers, providers, regulators, and patients—define value, and how methodologies like health technology assessments (HTA) and cost-effectiveness analyses shape drug pricing and access. With insights from leading experts, the conversation examines the controversies surrounding value-based pricing, including the role of real-world evidence, quality-adjusted life years (QALYs), and innovation incentives. Can we strike a balance between affordability, innovation, and patient access? And what does the future hold for value-based drug pricing in the U.S.? Tune in for a deep dive into one of the most critical issues in healthcare today. Daniel Ollendorf, Chief Scientific Officer and Director of HTA Methods and Engagement Lou Garrison, Professor Emeritus at University of Washington CHOICE Institute for Clinical and Economic Review (ICER) FDA GLP-1 Drugs Medicare Biosimilars Generics Versus Biosimilars PBMs (Pharmacy Benefit Managers) 340B Drug Pricing Program Questions or comments?Email us at comments@prescriptionforbetteraccess.com.Find us on social media! Follow us on X, LinkedIn, YouTube and Threads.

In this episode, we interview Sarah Emond, MPP, President and CEO of the Institute for Clinical and Economic Review (ICER). Sarah joined ICER over 15 years ago as Chief Operating Officer and was appointed to lead the organization following the retirement of Dr. Steven Pearson. Sarah outlines her vision for ICER and the priorities for strengthening the framework and collaboration to achieve their mission of evaluating the comparative effectiveness of new medicines. Sarah also discusses ICER’s efforts to expand patient engagement and the evaluation of payers to ensure fair access to medicine. Sarah Emond, MPP, President and CEO, Institute for Clinical Economic Review (ICER) Dr. Steven Pearson, Founder, President, Institute for Clinical and Economic Review (ICER) Barriers to Fair Access Report Gross-to-Net Bubble Pharmacy Benefit Managers (PBMs) Humira biosimilars Institute for Clinical and Economic Review (ICER) 340B Drug Pricing Program Questions or comments?Email us at comments@prescriptionforbetteraccess.com.Find us on social media! Follow us on X, LinkedIn, YouTube and Threads.

In this episode, we sit down with Stacie Dusetzina, Ph.D., a leading health economist from Vanderbilt University Medical Center to discuss the critical healthcare and policy trends shaping 2025. From shifts in federal leadership to the evolving impact of the Inflation Reduction Act, our guest provides expert insights on what to expect in drug pricing, health insurance, and patient access in the coming year. We explore how the public and private sectors are addressing affordability challenges and highlight innovative approaches to improve access to essential medications. With a focus on the future, this conversation offers a thoughtful outlook on the policies and market dynamics set to redefine healthcare in 2025. Stacie Dusetzina, Ph.D., Vanderbilt University Vanderbilt University Medical Center A primer on copay accumulators, copay maximizers, and alternative funding programs CMS FDA IRA Medicare Part D Pharmacy Benefit Managers (PBMs) Medicaid CMMI’s Medicaid group negotiation COVID-19 Statins PCSK9 inhibitors Imatinib 340B Drug Pricing Program Questions or comments?Email us at comments@prescriptionforbetteraccess.com.Find us on social media! Follow us on X, LinkedIn, YouTube and Threads.

In our second of three episodes in conjunction with members of ACCESS Forum, we engage with leading experts to uncover the multifaceted challenges of access and affordability in cell and gene therapies. Our conversation investigates how these treatments' innovative yet complex landscape leads to challenging regulatory pathways, pricing models, and reimbursement strategies. Alicia Silver, MPP, Head of Cell and Gene Therapy, ADVI HealthEric Faulkner, President, Passage Health AssociatesADVI HealthAlliance for Regenerative MedicineARPA-HBespoke Gene Therapy ConsortiumBlue Bird BioBlue Cross Blue ShieldMedicare DRG RatesNICE (National Institute for Health and Care Excellence)NovartisPassage Health AssociatesREMS ProgramSingle Case AgreementsSpark Therapeutics Medical terminology referenced in this episode: Alzheimer's Aspheresis CAR T therapy Hemophilia Hepatitus C Luxturna Metachromatic leukodystrophy Myeloablative Conditioning Sickle Cell Disease SMA treatment Spinraza Vaso Occlusive Crises Zolgensma

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 AtticaKimberly Baldwin, Senior Vice President, Value & Access, Ipsen BiopharmaceuticalsFauzea Hussain, Vice President, Public Policy, McKessonCMS (Centers for Medicare & Medicaid Services)European Medicines AgencyHealth technology assessments (HTAs)IRA (Inflation Reduction Act)MedicaidMedicareNational Institute of Clinical Excellence (NICE)NCCN guidelinesP&T committee (Pharmacy and Therapeutics Committee)PAP (Patient Assistance Program)Part B (Medicare)Part D (Medicare)Pharmacy Benefit Managers (PBMs)Quality-Adjusted Life Years TricareVeterans AdministrationMedical terminology referenced in this episode: Cell and gene therapies (CGT) Insulin Orphan drugs Questions or comments?Email us at comments@prescriptionforbetteraccess.com.

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 OrganizationsDanielle Marshall, Executive Director, Patient Advocate Certification BoardFred Larbi, Chief Operations Officer, HealthWell FoundationCHCAOPatient Advocate Cerification BoardHealthwell FoundationGreater National AdvocatesNAHACHealthAdvocateXUmbraSolace Questions or comments?Email us at comments@prescriptionforbetteraccess.com.Find us on social media! Follow us on X, LinkedIn, YouTube and Threads.

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.

In this episode, we dive into the pharmaceutical industry's research and drug development side and the real threat that today’s access and affordability challenges and policies pose to innovation. While innovation often starts in universities with government support, biotech, and pharma companies take on the tough, costly job of clinical trials, development, and approval of new drugs. Investment dollars are limited, only the most promising projects get funded, with an expectation there will be a return. However, our current drug payment process and policies like the IRA have added new considerations for investors, risking fewer new drugs being developed. Without changes, patients could face the closing of our nation's medicine cabinet, with fewer new treatments available. This would be an outcome that would be catastrophic for all of us. Erin Mistry, EVP and Chief Commercial Officer, Cormedix, Inc. Imran Nasrullah, JD., formerly VP & US Head of BD&L at Bayer, and now Founder, SNAP Life Sciences Research and development (R&D) FDA CF Foundation Vertex NIH AMR (antimicrobial resistance) The Pasteur Act HIV Malaria Flagship Pioneering Launches Metaphore Biotechnologies to Unlock the Therapeutic Potential of Biomimicry Novo Nordisk Bets Up to $600 Million on Ozempic 2.0. Here's Why the Stock Is a Buy. Genentech Genzyme (Now Sanofi) Medicare IRA (Inflation Reduction Act) COVID-19 Questions or comments?Email us at comments@prescriptionforbetteraccess.com.Find us on social media! Follow us on X, LinkedIn, YouTube and Threads.

This is the second of two episodes dedicated to Asembia’s AXS24 Summit, where we were honored to be a media partner. In this episode, we learn from Sarah Butler, Chief Commercial Officer of ADVI Health and Lindsay Greenleaf, JD, MBA, Head of Federal and State Policy for ADVI Health how the 2024 election will impact patient access and affordability. Umar Afridi, Founder and CEO of Foundation Health, summarizes his session, From Opaque to Transparent: Transforming the Way We Pay for Drugs. Finally, we get a few minutes with Joe Boswell, the President of ACCESS Forum, leading an effort to create a network for market access professionals. ADVI:Sarah Butler (Chief Commercial Officer)Lindsey Greenleaf (Consulting and Government Affairs Head)R&DInflation Reduction ActNCCN CompendiaPart DCMSPharmacy Benefit Managers (PBMs)Part BFTC and Office of Inspector General (IG)FTC's Section 6B studyFoundation Health:Umar Afridi, Founder and CEOSession: "From Opaque to Transparent: Transforming the Way We Pay for Drugs."Pharmacy Benefit Managers (PBMs)TruepillAPI platformsInternational Access Professional Society:Joe Boswell. PresidentGenMAVAsembia

Asembia’s AXS24 Summit, a pinnacle of specialty drug and healthcare discussions, concluded earlier this month. We are thrilled to share that our podcast was selected as a media partner for this esteemed event. This is the first of two episodes dedicated to AXS24, where Scott and Mark had the opportunity to interview several key speakers and attendees. In this episode, we bring you the insights of Melissa Paige, a seasoned healthcare professional and President of the National Association of Medication Access & Patient Advocacy, who led a session on the Patient Financial Impact of IRA. We also present the perspectives of Renee Rayburg, RPh., VP, Clinical Strategy, Pharmaceutical Strategy Group and Morgan Lee, PhD, MPH, CPH, Senior Director, Research & Strategy, PSG, who are renowned for their study and session on Viewpoints in Specialty Drug Benefit Design. Melissa Paige, President, (NAMAPA)University of Virginia Health SystemAsembiaInflation Reduction ActDr. Madelaine FeldmanRenee Rayburg, Vice President Specialty Clinical Consulting, Artemetrx, Morgan Lee, PhD, Senior Director, PSGPharmacy Benefit Managers (PBMs)GoodRx2024 Trends in Specialty Drug Benefits ReportMedical terminology referenced in this episode:Generic ARBs Multiple SclerosisHumira biosimilarsAlbuterol inhalerEmail us:comments@prescriptionforbetteraccess.com.Follow us on X, LinkedIn, YouTube and Threads.

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 Corporation 46brooklyn Ohio Pharmacist Association 3 Axis Advisors Medicaid 340B Program 340B Litigation 340 Eligibility, HRSA Covered Entities Medicaid Drug Rebate Program Obamacare Indian Health Service "Money from Sick People," Report from 46Brooklyn Medicare Pharmacy 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: RNAi Antisense mRNA Monoclonal 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-1 (Glucagon-like peptide-1) Wegovy (Semaglitude) Victoza (Liraglutide) 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)