Healthcare Matters

In this episode of Healthcare Matters, Dr. Robert Popovian and Ben Blanc sit down with Dr. Alison Bailey, Chief of Cardiology for Centennial Heart at Parkridge in Chattanooga, Tennessee and a Physician Director of Cardiovascular Disease for HCA Healthcare, to explore how policy decisions can help—or hinder—innovation in cardiovascular care.

They discuss the hidden consequences of the Inflation Reduction Act (IRA) for small molecule drug development, the promise of gene-targeted therapies like siRNA, and why medical research funding remains vital for turning new science into life-saving treatments.

Tune in to learn why smarter incentives and stable funding are key to tackling America’s growing cardiovascular crisis.

Among the highlights in this episode:

03:28: Dr. Bailey shares her passion for cardiovascular prevention, emphasizing how patient education and access shape outcomes

04:12: Dr. Bailey discusses the concerning rise in cardiovascular death rates in the U.S. despite advances in treatment, pointing to lifestyle factors and health inequities

05:35: Ben asks about the impact of small molecule therapies in cardiology and how the Inflation Reduction Act may affect future drug development

06:04: Dr. Popovian explains how the IRA’s Maximum Fair Price (MFP) policy shortens market exclusivity for small molecules, reducing incentives for new cardiovascular treatments

08:40: Dr. Bailey expands on how genetically targeted small molecules, like siRNA therapies, are game-changers for cholesterol and rare cardiac conditions, but policy must support their development

10:50: Ben asks about the consequences for patients if companies shift focus away from small molecules. Dr. Bailey warns that fewer innovations could limit treatment options and worsen health disparities

12:15: Dr. Popovian explains how small molecules remain essential for oral medications that improve adherence, affordability, and widespread access—especially in chronic conditions like heart disease

13:00: Ben brings up the bipartisan MINI Act, which aims to align protections for certain targeted small molecule therapies with biologics to maintain incentives for innovation

14:45: Dr. Bailey supports the MINI Act as a practical fix that would encourage more investment in next-generation therapies and benefit cardiovascular patients

16:20: Dr. Popovian highlights the risk of medical research funding cuts, stressing that NIH funding drives discoveries that pharma can’t tackle alone

18:05: Dr. Bailey gives real-world examples of now-standard heart medications that came from decades of NIH and industry collaboration, underscoring the need for stable funding

19:00: Dr. Popovian adds that even widely used generic drugs like beta blockers for heart failure exist today because of federally funded research

20:40: Dr. Popovian and Dr. Bailey agree that more clinician voices are needed to help policymakers see the real impact of drug policy on patient care

22:00: Dr. Bailey closes by stressing that these therapies are not hypothetical—they are real and available now but require supportive policy to reach all patients who need them

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: [email protected]

Ben Blanc, Director, Digital Production and Engagement at GHLF: [email protected]

A podcast series produced by Ben Blanc.

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to [email protected]

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.

In this episode of Healthcare Matters, Dr. Robert Popovian and Ben Blanc dive into a recent paper published in the Journal of Health Economics and Outcomes Research that explores the unintended consequences of drug price-setting under the Inflation Reduction Act. Using real-world modeling focused on Eliquis and Xarelto—two widely used anticoagulants—Dr. Popovian discusses how Pharmacy Benefit Managers (PBMs) may shift costs onto patients in response to federal pricing reforms, potentially increasing the risk of treatment abandonment, hospitalization, and death.

Tune in as our hosts break down how pricing policy, rebates, and transparency intersect—and why policymakers must act now to protect patient access.

Among the highlights in this episode:

00:45: Ben introduces the topic of the episode: how new drug pricing rules that aim to lower costs could unintentionally increase out-of-pocket expenses and reduce access for patients

01:12: Robert discusses GHLF’s recent paper, which he co-authored and that was published in the Journal of Health Economics and Outcomes Research, on the potential risks of the IRA’s Maximum Fair Price (MFP) policy

To access he full paper, visit: https://jheor.org/article/125251-could-the-inflation-reduction-act-maximum-fair-price-hurt-patients

02:16: Robert explains how the MFP allows the federal government to set prices for high-spend Medicare drugs and how this disrupts the current rebate model used by PBMs

03:38: Robert describes how PBMs and insurers may respond to lower drug prices by shifting medications to higher formulary tiers or increasing patient cost-sharing to make up for lost rebate revenue

05:10: Ben transitions to the study’s real-world modeling and asks why Eliquis and Xarelto were chosen as the focus

05:42: Robert explains that these two anticoagulants were selected because they are widely used among older adults and come with serious risks if treatment is abandoned

06:55: Ben highlights the human cost of non-adherence and prompts Robert to detail the real-world health outcomes if patients stop taking these drugs

07:23: Robert cites published data showing that increased out-of-pocket costs lead to medication abandonment—and in the case of Eliquis and Xarelto, that can mean higher risks of stroke, heart attack, and death

09:16: Ben asks about transparency in drug pricing and how the current system makes it difficult to understand what patients actually pay

09:38: Robert explains how PBMs deliberately obscure drug pricing, rebates, and patient costs, calling it a “black box” that benefits from secrecy and ultimately harms patients

12:07: Robert calls on Centers for Medicare and Medicaid Services (CMS) to monitor both formulary coverage and out-of-pocket costs for MFP drugs, ensuring that price controls don’t backfire by limiting access or shifting costs to patients

13:20: Robert references a real-time tracking tool from the Pioneer Institute that supports the findings of his study and shows actual increases in out-of-pocket costs for MFP drugs

You can access the Pioneer Institute’s tool here: https://pioneerinstitute.org/the-inflation-reduction-act-ira-overview/

14:59: Robert reinforces that the IRA’s price-setting goals are noble—but without oversight of PBM behavior, patients could be harmed by unintended policy consequences

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: [email protected]

Ben Blanc, Director, Digital Production and Engagement at GHLF: [email protected]

A podcast series produced by Ben Blanc.

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to [email protected]

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.

In this special live episode of Healthcare Matters, Dr. Robert Popovian and Ben Blanc bring you insightful conversations from the 2025 World Vaccine Congress in Washington, DC. Joined by leading experts—including Richard Hughes, Abby Bownas, Rekha Lakshmanan, and Tommy Acciani—they explore the current landscape of adult immunization policy, funding threats to vaccine infrastructure, misinformation challenges, and what’s next for vaccine innovation.

From coalition-building and provider reimbursement to legal barriers and access equity, this episode unpacks the complex, cross-sector challenges and solutions shaping the future of adult vaccines in the U.S.

Among the highlights in this episode:

02:00: Ben provides an overview of the World Vaccine Congress and its cross-sector focus on vaccine equity, innovation, and public health policy

04:00: Abby Bownas shares that one of the most urgent needs in adult vaccination policy is restoring and protecting funding for immunization infrastructure, from doses to education to data

05:30: Abby highlights how cross-sector partnerships between public health and healthcare systems are key to maintaining vaccine access, especially amid funding cuts

06:50: Robert reflects on Abby’s interview, emphasizing the rising hesitation around adult immunization and the importance of education and legislative engagement

08:00: Tommy Acciani shares that successful policy innovation must come from collaboration—not silos—and that events like the Congress create space to unite stakeholders

09:00: Tommy identifies major remaining barriers to adult vaccination, including outdated policies, lack of provider reimbursement, and under-supported patient-provider conversations

11:15: Tommy flags the coming end of the CDC’s Bridge Access Program as a major funding threat, particularly to local clinics and federally qualified health centers

12:40: Tommy reflects on hearing vaccine pioneer Dr. Stanley Plotkin speak, underscoring how vaccines remain one of the most impactful public health interventions of our time

14:00: Rekha Lakshmanan explains that many state-level vaccine policy fights now center on efforts to weaken school immunization requirements and increase opt-outs

16:10: Rekha shares that coalitions play a critical role in fighting misinformation by serving as trusted, community-embedded messengers—not government entities

17:00: Rekha argues that the U.S. lacks a national culture of adult immunization and calls for normalizing vaccine conversations across all age groups

18:00: Rekha ends on a hopeful note, saying the passion and collaboration on display at the Congress reaffirm the strength of the vaccine ecosystem

19:00: Robert emphasizes Rekha’s unique experience at the intersection of pharma, policy, and grassroots coalitions in Texas—the epicenter of a measles outbreak

20:00: Richard Hughes says this year’s Congress feels different, with more concern about regulatory uncertainty and federal political interference in vaccine policy

21:00: Richard shares that his legal background allows him to spotlight access, reimbursement, and constitutional issues that affect vaccine policy at all levels

22:10: Richard explains that questions are mounting about the legal boundaries of what the administration can and cannot do around mandates, access, and injury compensation

23:10: Richard expresses deep concern over misinformation and disinformation coming from high levels of government, calling it one of the greatest current threats to public health

25:00: Ben turns the spotlight on Robert, who shares key findings from his presentation on adult immunization research

26:00: Robert highlights that pharmacies—not physician offices—are the most accessible vaccination sites for adults, especially in low-income communities

27:00: Robert calls out two major policy barriers: risk-based recommendations and Shared Clinical Decision Making (SCDM), both of which limit access in pharmacy settings

28:30: Robert also shares that GHLF research found a 26% cost premium when patients receive vaccines in physician offices vs. pharmacies, showing why pharmacy access is also a cost issue

29:30: Robert recaps a panel he moderated about provider support in underserved communities, where key themes were vaccine hesitancy and reimbursement issues

30:00: In closing, Robert says the one word that sums up the energy at this year’s Congress is “optimism”—with the private sector showing renewed commitment to driving progress in adult vaccine access

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: [email protected]

Ben Blanc, Director, Digital Production and Engagement at GHLF: [email protected]

A podcast series produced by Ben Blanc.

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to [email protected]

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.

In this episode of Healthcare Matters, hosts Dr. Robert Popovian and Ben Blanc are joined by Peter Pitts, former FDA Associate Commissioner and President of the Center for Medicine in the Public Interest. Together, they unpack the sweeping personnel cuts at HHS, ongoing instability at the FDA, and how it all may threaten the future of drug innovation in the U.S. With delays in leadership appointments, policy misalignment across agencies, and increased uncertainty from pricing reforms like the Inflation Reduction Act, pharmaceutical companies may hit pause—and patients may pay the price.

Tune in for a timely discussion on how chaos in science policy reverberates through clinical innovation and patient access.

Among the highlights in this episode:

03:09: Peter Pitts shares his FDA background and warns against viewing staff consolidation through a purely numerical lens—emphasizing the nuance of function and legal responsibility

04:07: Peter breaks down FDA’s structure, clarifying that the majority of its 18,000 staff are non-political, career public health officials—not industry influenced

06:33: Peter explains that gutting senior leadership slows down innovation and drug approvals, as regulatory coordination is weakened

07:42: Peter details ongoing leadership instability across FDA’s key centers (drugs, biologics, devices), and notes the loss of progressive voices like Dr. Peter Marks and Dr. Patrizia Cavazzoni

08:32: Dr. Popovian adds that short- and long-term uncertainty in biopharma is significant, especially in oncology—a therapeutic area critical to innovation and patient survival

09:53: Peter warns that chaos and unpredictability undercut investor confidence, which could delay development in oncology, gene therapy, and rare diseases

11:10: Dr. Popovian reinforces that cancer care is now chronic care, and disruptions in FDA operations could rob patients of critical time and treatment options

11:42: Peter highlights misalignment between FDA and CMS, especially when CMS questions the validity of FDA-approved data—jeopardizing reimbursement

12:43: Dr. Popovian and Peter urge alignment between FDA and CDC guidance, citing conflicting vaccine messaging as a source of confusion for patients and providers

13:37: Peter underscores the need for improved communication and coordination between public health agencies to rebuild trust

15:06: Dr. Popovian raises concerns that instability and underappreciation will deter top scientists from public service roles at agencies like the FDA

17:21: Dr. Popovian explains that pharmaceutical companies are delaying R&D and trial investments due to regulatory uncertainty

18:35: Peter adds that companies may also pause research into new uses for existing drugs—despite their public health value—due to unclear FDA pathways

19:21: Dr. Popovian discusses how the Inflation Reduction Act (IRA) further complicates investment decisions, creating a “perfect storm” with FDA uncertainty

23:19: Ben emphasizes that policy uncertainty delays hope for patients awaiting new treatments—and that public accountability is more important than ever

24:03: Dr. Popovian shares some final thoughts

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: [email protected]

Ben Blanc, Director, Digital Production and Engagement at GHLF: [email protected]

A podcast series produced by Ben Blanc.

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to [email protected]

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.

Are well-intentioned vaccine policies making access harder instead of easier? In this episode of Healthcare Matters, hosts Dr. Robert Popovian and Ben Blanc unpack a new report from the Global Healthy Living Foundation (GHLF) on how Shared Clinical Decision Making (SCDM) and risk-based recommendations may unintentionally reduce adult vaccination rates—particularly in underserved communities. From real-world data showing a 10 percent drop in pneumococcal vaccine uptake to sharp disparities in meningitis coverage, the findings are hard to ignore.

Tune in as we explore how these policies may create confusion, widen health inequities, and hinder access—and what can be done to fix it.

Among the highlights in this episode:

03:00: Dr. Popovian explains what Shared Clinical Decision Making (SCDM) is and the role of Advisory Committee on Immunization Practices (ACIP), noting the challenges of expecting time-strapped physicians to hold complex conversations with patients

06:00: Dr. Popovian expresses concern that SCDM can lead to decreased immunization rates due to misaligned expectations and informational imbalance

07:15: Dr. Popovian cites a 10 percent drop in pneumococcal vaccine uptake after its recommendation changed from “routine” to SCDM, and notes a striking difference in coverage between the quadrivalent meningococcal vaccine (60.8%) and MenB (11.9%) meningitis vaccines, the latter being subject to SCDM

10:03: Dr. Popovian explains that pharmacists and clinic-based providers often lack access to patients’ full medical records—making risk-based decisions difficult in practice

13:47: Dr. Popovian explains that patients in underserved areas often rely on pharmacies or federally qualified health clinics, where continuity of care is lacking and risk assessments are harder to verify—exacerbating health inequities

15:59: Dr. Popovian predicts the administration will double down on SCDM and patient-led decisions—likely leading to lower vaccination rates and reduced herd immunity

17:58: Dr. Popovian warns that some states (like Louisiana) are banning public health messaging about vaccines, making the role of advocacy organizations even more critical in providing accurate information

19:00: Ben emphasizes the importance of education, outreach, and advocacy to bridge the gap between policy and real-world vaccination practices

19:00: Dr. Popovian calls for aligning ACIP recommendations with FDA labels and tracking the public health consequences of recent policy changes

20:02: Dr. Popovian shares some final thoughts

For more information about “Enhancing Adult Vaccine Uptake: Challenges in Shared Clinical Decision Making and Risk-Based Recommendations,” and to access the full report, visit: https://ghlf.org/issues/vaccines/enhancing_adult_vaccine_uptake/

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: [email protected]

Ben Blanc, Director, Digital Production and Engagement at GHLF: [email protected]

A podcast series produced by Ben Blanc.

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to [email protected]

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.

Did you know that millions of adults may have missed crucial vaccines due to restrictive state policies on pharmacist vaccination authority? In this episode of Healthcare Matters, hosts Dr. Robert Popovian and Ben Blanc sit down with Vibhu Tewary and Conrad Bhamani from the IQVIA Institute for Human Data Science to discuss new research conducted by the IQVIA Institute and GHLF on how these restrictions impact vaccination rates. They break down key findings from the report, revealing that states with tighter regulations see significantly lower vaccine uptake — by as much as 14% for RSV vaccines.

Tune in as they explore real-world consequences for underserved communities, why pharmacists are essential to public health, and what policy changes could help expand vaccine access.

Among the highlights in this episode:

01:17: Ben introduces the key topic of the episode: how state restrictions on pharmacists’ vaccination authority may be preventing millions of adults from accessing crucial vaccines

02:56: Dr. Popovian explains that pharmacists are the most accessible health care professionals, particularly in underserved communities, and cites data showing that many patients prefer to receive vaccines at pharmacies

05:27: Conrad highlights key statistics from the report, including that states requiring a physician’s prescription for RSV vaccines see a 14% lower vaccination rate, while states requiring a physician protocol see a 9% lower rate

07:41: Vibhu explains how pharmacy access is critical for people in low-income and minority communities, who often face additional barriers to seeing a physician during regular office hours

09:56: Dr. Popovian outlines policy recommendations, including eliminating physician prescription requirements and protocol restrictions, to make vaccinations more accessible

12:39: Dr. Popovian emphasizes the importance of collaboration between pharmacists and physicians and urges pharmacists to advocate for policy changes

14:10: Vibhu discusses how states that grant pharmacists independent vaccination authority tend to have higher immunization rates and how data should drive policy decisions

16:14: Dr. Popovian shares some final thoughts

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: [email protected]

Ben Blanc, Director, Digital Production and Engagement at GHLF: [email protected]

A podcast series produced by Ben Blanc.

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to [email protected]

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.

S6, Ep 1- Vaccine Hesitancy & Access: What Our Latest Survey Reveals

In this season premiere of Healthcare Matters, our hosts are joined by Seth Ginsberg, President and Co-Founder of the Global Healthy Living Foundation (GHLF), to discuss the critical role of vaccines in public health and the persistent challenges of misinformation, access barriers, and vaccine hesitancy. They also delve into the concerning findings from GHLF’s latest vaccine quick poll, which reveals that over 11 percent of respondents do not plan to get vaccinated during the 2024-2025 respiratory season. The conversation highlights the urgent need for education, advocacy, and policy reform to rebuild public trust and ensure equitable vaccine access.

Tune in to learn more about the survey results and discover how health care providers, policymakers, and organizations like GHLF can collaborate to drive meaningful change.

Among the highlights in this episode:

01:48: Dr. Popovian, Chief Science Policy Officer at GHLF, explains why vaccines are considered the most cost-effective health care intervention, citing historical examples such as the eradication of smallpox and the economic benefits of high immunization rates

04:37: Ben Blanc, Associate Director, Digital Production and Engagement at GHLF, comments on the results of GHLF’s latest survey, highlighting that 11% of chronic disease patients surveyed do not plan to get vaccinated this respiratory season

06:45: Dr. Popovian breaks down key barriers preventing access, including out-of-pocket costs, logistical and geographic barriers, especially in underserved communities, and policy restrictions preventing pharmacists from administering vaccines in certain states

08:32: Seth Ginsberg, President and co-founder of GHLF, explains why advocacy is crucial in addressing vaccine hesitancy, especially among chronic disease patients. He highlights that 89% of survey respondents trust health care providers for vaccine information — showing that physicians and pharmacists play a key role in combating misinformation

10:37: Seth recommends listeners to listen to the recent second season of GHLF’s Informed Immunity podcast series, designed to provide credible, relatable, and engaging vaccine education

13:30: Dr. Popovian references new CDC data on increasing COVID-19, RSV, and flu hospitalizations and warns that the situation will worsen without increased vaccination rates

14:20: Seth raises the issue of growing distrust in pharmaceutical companies, which contributes to vaccine hesitancy

15:05: Dr. Popovian debunks two major myths:

Myth #1: "If I get vaccinated, I’ll never get sick." Vaccines don’t prevent all infections but significantly reduce severity, hospitalizations, and deaths

Myth #2: "Natural immunity is better than vaccines." Natural immunity may be as effective as vaccine-induced immunity, but it comes with far greater risks — especially for vulnerable populations

16:57: Seth introduces the 50-State Network’s Advocating for Vaccines training, an essential new tool to help patients effectively share their personal story and advocate for policies that improve vaccine access. For more information about the program, visit: https://ghlf.org/vaccine-training-page/

19:01: Dr. Popovian expresses concern over how Robert F. Kennedy Jr.’s anti-vaccine stance could worsen vaccine hesitancy

21:51: Seth emphasizes the need for collaboration between health care providers, patient advocacy groups, policymakers, and manufacturers to improve vaccine uptake

22:30: Dr. Popovian adds that health care professionals must take responsibility by educating patients, having real conversations, and addressing concerns transparently

24:38: Dr. Popovian shares some final thoughts

To read more about GHLF’s latest vaccine survey results, visit: https://creakyjoints.org/living-with-arthritis/coronavirus/patient-perspectives/poll-vaccine-confidence/

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: [email protected]

Ben Blanc, Director, Digital Production and Engagement at GHLF: [email protected]

A podcast series produced by Ben Blanc.

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to [email protected]

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.

In this episode of Healthcare Matters, Dr. Robert Popovian, Ben Blanc, and guest Corey Greenblatt, Director of State Policy and Advocacy at GHLF, dive into the complexities of vaccine guidelines and access. They discuss the role of the Advisory Committee on Immunization Practices (ACIP), with Corey sharing insights on GHLF’s advocacy to make vaccines more accessible. Dr. Popovian underscores the importance of aligning guidelines with FDA labeled indication or to institute more common sense ACIP guidance that can be applied at the community level to improve clarity for health care providers and access for patients.

Tune in to learn how streamlined guidelines, improved patient data access, and empowered health care providers can drive better patient care in the U.S.

Among the highlights in this episode:

02:41: Dr. Popovian explains the role of ACIP and its impact on vaccine recommendations, which are based on expert consensus and cost-effectiveness, emphasizing its relevance for patients with chronic illnesses

04:03: Corey Greenblatt shares GHLF’s feedback to ACIP regarding proposed RSV guidelines, focusing on the need for improved vaccine access for older patients and the limitations of relying on patient self-reporting for eligibility

06:35: Corey highlights the importance of pharmacies in vaccine access, especially in underserved communities, and stresses that empowering pharmacists to make informed decisions could increase vaccine uptake among high-risk populations

07:04: Corey discusses challenges of implementing ACIP’s RSV guidelines in community pharmacy settings, especially for patients aged 60 to 74, stressing the importance of aligning guidelines with FDA recommendations to empower pharmacists

09:01: Dr. Popovian elaborates on the limitations of patient self-reporting in health care, explaining how it can conflict with health care providers' training and undermine clinical judgment

11:57: Dr. Popovian and Ben discuss patient data ownership, with Ben explaining how France’s centralized health care system provides patients with direct access to their medical records, a stark contrast to the fragmented approach in the U.S.

15:35: Ben compares the U.S. and French health care systems, focusing on patient access to medical records, and how France’s centralized system enables better record access and coordination

19:55: Dr. Popovian advocates for alignment between ACIP guidelines and FDA labels, noting that clear, consistent guidelines would aid health care providers, particularly pharmacists, in safely delivering vaccines

24:47: Dr. Popovian shares some final thoughts

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: [email protected]

Ben Blanc, Associate Director, Digital Production and Engagement at GHLF: [email protected]

A podcast series produced by Ben Blanc.

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to [email protected]

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.

In this episode of Healthcare Matters, Dr. Robert Popovian and Ben Blanc unpack the often unpredictable nature of political affiliations in relation to support for patient-centric policies, particularly in the realm of drug pricing and the influence of Pharmacy Benefit Managers (PBMs). They discuss bipartisan efforts to address drug pricing reforms and delve into Governor Newsom's controversial veto of the PBM Reform Bill in California. Additionally, the episode covers the FTC’s lawsuit against PBMs over insulin pricing and assesses its potential implications for patient care. Dr. Popovian also challenges a misleading statement by The Wall Street Journal regarding drug rebates.

Among the highlights in this episode:

01:03: Dr. Popovian dives into the critical issues surrounding drug policy, emphasizing how political affiliation sometimes doesn't align with effective health care policy for patients, highlighting the cross-party collaboration and conflict within drug pricing reforms

02:09: Dr. Popovian elaborates on the complex nature of drug pricing policies, pointing out the unusual alliances formed across political lines. He discusses how both conservative and liberal politicians have joined forces to address issues with Pharmacy Benefit Management companies (PBMs), which he identifies as major contributors to the problems within the drug pricing system

03:56: Dr. Popovian challenges a statement by The Wall Street Journal concerning rebate contracting in drug pricing, clarifying that while rebates are permitted there is no legislative requirement forcing PBMs to adopt rebate contracting. Dr. Popovian points out that alternative pricing models like net price contracting are viable and used by large insurers like Kaiser in California without relying on rebate contracts

You can find Dr. Popovian’s LinkedIn posts on this topic below:

-       https://www.linkedin.com/feed/update/urn:li:activity:7246621458792165376/

-       https://www.linkedin.com/feed/update/urn:li:activity:7245454053596422144/

To read the full article from The Wall Street Journal, visit: https://www.wsj.com/opinion/federal-trade-commission-pharmacy-benefit-managers-insulin-43b0a974?mod=opinion_lead_pos1

05:35: Dr. Popovian discusses a controversial veto of the PBM Reform Bill in California by Governor Newsom, analyzing the negative implications for patient care in California and contrasting this with other states' more patient-friendly policies

08:15: Our hosts discuss the FTC's lawsuit against major PBMs regarding insulin pricing, exploring how past practices of PBMs have escalated costs and restricted patient access to essential medications

10:58: Dr. Popovian sheds light on the critical role of patient self-advocacy in navigating a health care system dominated by PBMs and insurers, stressing the importance of patient education and legislative support to safeguard patient rights

12:08: Ben lists a series of tips on navigating health information on social media, emphasizing critical thinking and the importance of sourcing information from credible and knowledgeable sources

14:03: Dr. Popovian shares some final thoughts

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: [email protected]

Ben Blanc, Associate Director, Digital Production and Engagement at GHLF: [email protected]

A podcast series produced by Ben Blanc.

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to [email protected]

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.

In this episode of Healthcare Matters, join Dr. Robert Popovian and Ben Blanc as they delve into the issue of patient steering by Pharmacy Benefit Managers (PBMs). With firsthand accounts from guests Lou Tharp, Executive Director and Co-Founder of GHLF, and Dr. Anne Sydor, Director of Research Development at GHLF, the discussion highlights how PBM-owned pharmacies and policies like accumulators and maximizers limit patient choice and inflate out-of-pocket costs.

Tune in to learn more about the complex dynamics behind these practices, the impact on patient care, and the ongoing legislative efforts to protect patient rights.

Among the highlights in this episode:

03:01: Dr. Popovian explains the role of Pharmacy Benefit Managers (PBMs) in patient steering and their financial motivations for directing patients to PBM-owned pharmacies over independent ones

04:59: Lou shares his personal experiences with patient steering, explaining the challenges he faced with PBMs and his advocacy efforts that led to local policy changes

09:23: Dr. Sydor recounts the challenges she faced ensuring her son's medication continuity as he transitions to college, highlighting the barriers imposed by insurance companies regarding prescription fills

13:18: Lou discusses his negative experiences with at-home drug delivery due to PBM’s policies

15:26: Dr. Sydor criticizes the inefficiencies and customer service issues within PBMs, sharing her frustration with the lack of access to simple, generic medications due to PBM's mail order requirements

20:20: Dr. Popovian discusses state-level anti-steering legislation and federal initiatives aimed at reforming PBM practices, including a significant bill that proposes prohibiting PBMs from owning pharmacies to reduce conflicts of interest and promote patient care over profits

23:27: Dr. Popovian shares some final thoughts

If you want to use GHLF's interactive tool to explore health care premium cost trends state by state and learn more about patient assistance programs, visit: https://ghlf.org/copay-assistance-protection/

To learn more about House Committee on Oversight and Accountability Chairman James Comer’s call on the CEOs of the three major PBMs, go to: https://oversight.house.gov/release/chairman-comer-calls-on-pbm-executives-to-correct-hearing-testimony/

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: [email protected]

Ben Blanc, Associate Director, Digital Production and Engagement at GHLF: [email protected]

A podcast series produced by Ben Blanc.

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to [email protected]

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.