The ShiftShapers Podcast

#513 Medication Mandate Madness with Tiffany Ryder


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Understanding Trump's Executive Order on Drug Pricing | ShiftShapers

In this episode of ShiftShapers, host David A. Saltzman welcomes Tiffany Ryder, emergency medicine PA, host of Healthcare Liberty Lab, and writer at Red Flag Hero on Substack. Tiffany breaks down President Trump’s executive order on drug pricing and what it could mean for patients, providers, and pharmaceutical companies.

She explores key issues like most favored nation pricing, transparency in drug costs, and the role of PBMs and middlemen. Drawing from her frontline experience and policy knowledge, Tiffany explains how these changes may impact everything from consumer behavior to research and development in the pharmaceutical world.

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🔑 Key Takeaways from This Episode
📌 Trump’s Executive Order Is Not What It Seems
 Initial reactions framed it as a price control, but deeper analysis reveals an effort to create competitive pricing similar to standard market structures—challenging the global imbalance of U.S. drug costs.

📌 The U.S. Pays More—And It’s Unsustainable
 Americans make up only 4% of the world’s population but generate 75% of pharma’s profits. Tiffany explores how this executive order could shift the burden globally rather than stifling innovation.

📌 Transparency Could Empower Consumers
 One of the most promising aspects of the order is a potential direct-to-consumer model and increased pricing transparency. It may spark a shift in consumer behavior, giving patients tools to understand what drugs should actually cost.

📌 PBMs and Middlemen Drive Up Costs
 Tiffany highlights how pharmacy benefit managers (PBMs) and other intermediaries inflate costs, create confusion, and block consumers from accessing the best value for their medication.

📌 Generational Shift in Patient Trust Is Happening
 Today’s younger patients are skeptical of the healthcare system but often feel powerless. Tiffany argues that consumer apathy is a major barrier—but rising costs could force change from the ground up.

📌 Clinicians and Patients Both Hold the Key
 Tiffany believes change can start with both groups opting out of the broken system. Asking more questions, rejecting rushed visits, and demanding accountability are small acts that can fuel major reform.


⏱️ In This Episode
00:00 – Introduction to Trump's Executive Order on Drug Pricing
01:08 – Meet Tiffany Ryder: From Rural Louisiana to Healthcare Advocate
03:55 – Key Takeaways from the Executive Order
06:40 – Impact of Most Favored Nation Pricing
09:56 – Challenges and Potential Outcomes
15:23 – The Role of Transparency in Healthcare
24:36 – Generational Shifts in Patient Attitudes
27:06 – Future of Healthcare: Incremental Changes or a Major Overhaul?
29:45 – Conclusion and Farewell



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The ShiftShapers PodcastBy David Saltzman

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