Shows
Prescription for Better AccessThe Domino Effect: 2025 Trends in Specialty Drug Benefits ReportSpecialty 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 (P...2025-05-2150 minPrescription for Better AccessInside the Cost Curve: An Interview with Brian ReidIn 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 u...2025-04-1745 minPrescription for Better AccessValue in Prescription Drugs – What Does It Really Mean?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 de...2025-03-2051 minPrescription for Better AccessAn interview with Sarah Emond, MPP, President and CEO, Institute for Clinical Economic Review (ICER)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, In...2025-02-2043 minPrescription for Better Access2025 Outlook with Stacie Dusetzina, Ph.D., Vanderbilt UniversityIn 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...2024-12-1847 minPrescription for Better AccessCell and Gene Therapy Access ChallengesIn 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 S...2024-12-0453 minPrescription for Better AccessGlobal vs. US Drug Pricing and Market AccessIn 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...2024-10-2254 minPrescription for Better Access22. Honoring the Work of Healthcare AdvocatesIn 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...2024-09-1244 minPrescription for Better AccessEvolution of PBM'sIn 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...2024-08-2045 minPrescription for Better AccessHow Access Challenges Impact the Drug Development PipelineIn 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 de...2024-07-1649 minPrescription for Better AccessInterviews from Asembia’s AXS24 Summit, Part 2This 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 cr...2024-06-0433 minPrescription for Better AccessInterviews from Asembia's AXS24 Summit, Part 1 of 2Asembia’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 pe...2024-05-2435 minPrescription for Better AccessUnderstanding 340B Programs: An Interview with Antonio Ciaccia, CEO, 46brooklyn ResearchIn 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
...2024-04-2546 minPrescription for Better AccessInterview with Victor Bulto, President, US, NovartisIn 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...2024-03-2843 minPrescription for Better AccessBiosimilar's Role in Improving Patient AccessBiosimilars 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
...2024-02-2742 minPrescription for Better Access2024 Policy Preview: An Interview with Dr. Mark McClellanScott 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...2024-01-3049 minPrescription for Better AccessEpisode 13: The Sustainability of Innovation: An Interview with Rachel King, CEO, BIOIn 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
2023-12-2235 minPrescription for Better AccessEpisode 12: How Alternative Funding Programs Exploit Patient Assistance ProgramsIn 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 As...2023-11-1640 minPrescription for Better AccessEpisode 11: Obesity Week 2023: An Interview with Dr. Angela Fitch, President, Obesity Medicine AssociationPatients 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...2023-10-1755 minPrescription for Better AccessEpisode 10: Empowering Employers to Improve Patient AccessEmployers 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...2023-09-2941 minPrescription for Better AccessPhysician Offices: Fighting for Patient AccessMany 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 Ce...2023-08-1049 minPrescription for Better AccessWashington's Influence on Patient AccessThis 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.
Lanc...2023-07-0653 minPrescription for Better AccessTackling Copay Accumulators and MaximizersIn 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...2023-06-0143 minPrescription for Better AccessPBM Perspective: An Interview with Industry Veteran Mesfin TegenuPharmacy 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 mana...2023-05-0946 minPrescription for Better AccessUnderstanding ICER: An interview with founder Dr. Steven PearsonIn 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 Revi...2023-04-1847 minPrescription for Better AccessUnderstanding Drug Pricing: An Interview with Health Economist James RobinsonIn 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 pati...2023-03-2846 minPrescription for Better AccessBreaking Down Barriers: An Interview with Peyton HowellThis 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
...2023-03-0739 minPrescription for Better AccessPatient Voices: The Value and Challenges of AccessIn 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 y...2023-02-1546 minPrescription for Better Access2023: Looking Ahead in Patient AccessIn 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)2023-01-3151 minPrescription for Better AccessPodcast Preview: Getting to Know Your Co-hostsIn 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, Li...2023-01-2316 min