Healthcare Matters

Mary’s story is familiar to far too many senior citizens who are living on fixed incomes. They have no choice but to pay thousands of dollars a year on medications that are not covered by insurance. What could be done to help them?

In the Medicare program, "we tend to cover everything cheap, which is basically the generic medicines. When patients require more expensive drugs. the coverage becomes less and less,” says Dr. Robert Popovian, Chief Science Policy Officer at Global Healthy Living Foundation. “That means they're exposed to those prices more and more, which makes absolutely no sense because it goes against the premise of what insurance should be.”

Among the highlights in this episode:

1:47: Listener review

3:05: Setting the stage: a senior citizen named Mary pays $200/month for a single heart disease pill

3:39: Why are seniors on fixed incomes forced to pay high costs for life-saving medications?

4:36: Describing the prescription drug coverage from Medicare Part D

5:44: Medicare and Medicaid recipients do not have access to patient assistance programs

7:24: In layman’s terms, the health care system covers cheap drugs and not expensive ones

9:24: The convoluted mechanism surrounding brand-name medications

9:56: How Mary ends up paying more for brand-name, life-saving medications

10:57: AARP’s conflict by having a partnership with the three large pharmacy benefit management companies

11:38: How we can help provide hope for Mary and other seniors on fixed incomes

12:36: Seniors need to vote to impact legislation

Contact our hosts:

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

Conner Mertens, Patient Advocate and Community Outreach Manager at GHLF: [email protected]

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.

Getting diagnosed and properly treated for a mental health condition is grueling enough without having to deal with non-medical switching, or having to change your medication for no other reason than money, says Dr. Robert Popovian, Chief Science Policy Officer at the Global Healthy Living Foundation. In the second of two episodes on this topic, we examine what can be done to change this practice of non-medical switching. 

"Diagnosis of mental health takes a while. It's a trial-and-error period…to find the best therapies. And simply, to change a formulary and substitute patients off a drug that has worked for them and force them to take something different — for the sole purposes of fattening the bottom line — is criminal,” says Robert.

Among the highlights in this episode:

1:42: Listener review

2:12: How non-medical switching impacts patients with mental health conditions

2:36: A reminder of the definition of non-medical switching

3:14: How is this a growing problem for patients who suffer from mental health conditions?

4:16: "We are embarking in an era where we are going to see a lot of mental health issues — especially with regard to depression and anxiety," says Robert

4:33: Conner gives an example of a patient who lives with a mental health condition, and how non-medical switching has impacted her

5:28: Robert explains who benefits from non-medical switching among mental health patients 

6:32: What can be done for mental health patients when it comes to non-medical switching issues?

7:44: What kind of legislation is being considered?

9:43: Robert shares his final thoughts

Contact our hosts:

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

Conner Mertens, Patient Advocate and Community Outreach Manager at GHLF: [email protected]

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.

It’s frustrating for chronically ill patients, like those living with mental health disorders, when their proven drug therapies are switched or substituted—sometimes justifiably, other times for companies to make more money. In the first of two episodes on this topic, we examine what’s behind non-medical switching and how it could harm patients.

"Non-medical switching is basically substituting one molecule for another for the sole purpose of an economic outcome that is favorable to the insurer or the pharmacy benefit management company," says Dr. Robert Popovian, Chief Science Policy Officer at the Global Healthy Living Foundation.

Among the highlights in this episode:

1:44: Listener review

3:12: What is generic substitution?

3:37: Looking at the difference between switching a medication and a substitution

3:55: The difference between therapeutic substitution and non-medical switching

5:07: Who benefits from non-medical switching?

5:40: Recognizing the importance of shared decision-making with patients 

6:26: Conner speaks about how a patient was negatively impacted by non-medical switching, and how it increased this patient's costs

7:47: Robert discusses how changing the formulary causes patients to suffer 

6:46: What legislation is being passed to protect patients?

10:12: Study: 60% of patients who experienced non-medical switching reported a medical complication

11:03: Robert shares his final thoughts

Contact our hosts:

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

Conner Mertens, Patient Advocate and Community Outreach Manager at GHLF: [email protected]

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

Catch up on past episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.

In the United States, data analytics are used to determine the price of drugs. But many patients don’t fit into neatly organized statistics, especially ones who have multiple diseases and, as a result, are denied therapies. In this week’s episode, we explore the method used in the U.S. to set drug prices, called the Cost per QALY or cost-effectiveness.

 

"Data in health care has never been meant to be static. We need to provide even greater scrutiny concerning these models and how they’re applied and make coverage decisions for life-saving biopharmaceuticals,” says Dr. Robert Popovian, Chief Science Policy Officer at the Global Healthy Living Foundation.

Among the highlights in this episode:

1:42: Listener review

2:15: Organizations that have global influence over patient care and access

3:30: How do these organizations define value in the marketplace?

4:07: A chronic patient doesn’t always benefit from this analytic approach to pricing drugs

4:35: “If the patient doesn’t fit the profile, they’re denied the therapy,” says Robert

5:00: Are these analytical tools misleading?

5:25: What happens if it ends up on a list in the U.S.? 

6:18: From year to year, medications on these lists change

7:25: Robert shares his final thoughts

Contact our hosts:

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

Conner Mertens, Patient Advocate and Community Outreach Manager at GHLF, [email protected]

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.

Majority of insurance and pharmacy benefit management companies offer copay accumulator adjustment programs. However, for patients, what these programs do and what they mean is shrouded in mystery. In this week's episode, we break down copay accumulator adjustment programs, and how they impact you as a patient.

"The patient is the one that is going to get stuck in the middle. And at some point, they are going to suffer- both financially and also in a way to be able to get care that is necessary to them," says Dr. Robert Popovian, Chief Science Policy Officer at the Global Healthy Living Foundation.

Among the highlights in this episode:

1:32: Listener review

2:05: What are copay accumulator adjustment programs?

3:17: How are these programs impacting patients negatively? 

3:53: An explanation of how deductibles are still costing patients

4:40: Why do these programs still exist and who are they benefiting?

5:32: Which patients are most impacted by copay accumulator adjustment programs? 

6:23: What these programs mean for patients living with chronic disease  

8:19: A look at what's being done politically

9:58: How a large portion of patients are being impacted by this

11:22: Is there evidence that these bans in certain states are raising premiums? 

11:55: Robert shares his final thoughts

Contact our hosts:

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

Conner Mertens, Patient Advocate and Community Outreach Manager at GHLF: [email protected]

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 your favorite podcast channel.

See omnystudio.com/listener for privacy information.

New treatments are being developed by the biopharmaceutical industry in collaboration with the government and FDA to help treat COVID-19 and new variants. In this week’s episode, we break down these new treatments and therapies, and discuss what they mean for patients. 

"It is important for us to have multiple therapies-even within those classes-to make sure that patients have choice and that physicians, pharmacists, and nurses have choices that can then appropriately treat the patient," says Dr. Robert Popovian, Chief Science Policy Officer at the Global Healthy Living Foundation.

Among the highlights in this episode: 

1:32: Listener review

2:07: A look at the treatments and therapies that are being developed for COVID-19

3:38: What therapies are currently available? 

4:34: Will these treatments stay effective as the virus changes into different variants? 

5:46: What are some of the concerns about these treatments?

6:41: "Science evolves, and it's important to evolve our treatment choices as science evolves," says Robert.

7:16: Were these treatments developed specifically for COVID-19?  

9:31: What have we learned from the COVID-19 vaccines to make the treatments more accessible?  

11:13: Since COVID-19 is a virus that is likely here to stay, how important are treatments for the long-run?

12:08: Robert shares his final thoughts

Contact our hosts: 

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

Conner Mertens, Patient Advocate and Community Outreach Manager at GHLF: [email protected] 

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.

Vaccinations have proven to reduce the severity of symptoms, hospitalizations, and death for people who contract COVID. But for some, the debate surrounding the vaccines has kept them from getting a booster, let alone the initial round of vaccinations. In this episode, we explore how the vaccines were developed so quickly, the differences between them, and how they work.

"They're helping us every day. They're reducing hospitalizations and mortality and don't kid yourself: the chances of you being hospitalized or dying from COVID is much greater if you are not vaccinated. The data is very clear on that, and it has held up throughout this last twelve months," says Dr. Robert Popovian, Chief Science Policy Officer at the Global Healthy Living Foundation.

Among the highlights in this episode:

1:21: Listener review

1:54: What is the difference between early-use authorization and FDA approval in the U.S. market when it comes to vaccines?

3:02: Discussion about the Novavax vaccine

3:41: An explanation on how these vaccines for COVID-19 work

4:35: "The vaccine delivers a tiny piece of genetic code from the SARS-COVID2 virus to the host cells in the body, essentially giving those cells blueprints for making copies of the spike proteins," says Dr. Robert Popovian

4:49: An explanation on how the genetic code from the SARS-COVID2 virus works within the vaccines

5:18: How is this COVID-19 vaccine different than other vaccines on the market for the virus? 

6:04: What is a protein adjuvant?

6:50: How can we put people's minds at ease that these are vaccines people can trust?

8:25: "Without a doubt, these vaccines were approved in a record time, but there was also very unusual circumstances where this country was going through. And the world was going through," says Dr. Robert Popovian

9:28: Looking at how many people were behind developing these vaccines, and what tools were used to develop them

10:25: Robert shares his final thoughts

Contact our hosts:

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

Conner Mertens, Patient Advocate and Community Outreach Manager at GHLF: [email protected]

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.

As we start a new year and a new season, we take a look at how drugs are developed and why time is the most important part of the formula when it comes to biopharmaceutical research. In other words, the more we delay, the longer it takes for patients to get the treatment they need.

"The researchers concluded that statin therapy, which is used everyday by patients toward lowering their cholesterol, reduced deaths by 40,000. There were 60,000 fewer hospitalizations and heart attacks and 22,000 fewer hospitalizations for strokes," says Dr. Robert Popovian, Chief Science Policy Officer at the Global Healthy Living Foundation.

Among the highlights in this episode:

1:13: Listener review

1:39: How do biopharmaceutical companies go about developing their drugs and what are the three most important steps in developing a drug?

2:04: Stage two for biopharmaceutical companies when developing a drug

2:51: Why time matters when it comes to developing a drug

3:16: The importance of time when it comes to analyzing the cost and value of the development of drugs

3:50: What's the definition of value when talking about drug development?

4:17: A look at how long it takes to get value from a drug

5:11: What does it mean for innovation when drug patents come to an end?

6:31: How does biopharmaceutical research evolve?

7:37: Robert shares his final thoughts on this legislation

Contact our hosts:

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

Conner Mertens, Patient Advocate and Community Outreach Manager at GHLF: [email protected]

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.

At the start of 2022, there’s renewed hope that President Biden’s social spending and climate policy bill can survive in some form. In this episode, we explore three of the bill’s shortcomings and how it impacts patients.

"Some estimates say that we spend more on administrative burden in the US marketplace than actually pay for pharmaceuticals in the US market, which is astounding to me," says Dr. Robert Popovian, Chief Science Policy Officer at the Global Healthy Living Foundation.

Some highlights in this episode:

1:02: Listener review

2:58: What is rebate contracting and why is it important?

3:50: What else can be done about Medicare to help negotiate drug prices?

5:29: A big mess was the federal government not mandating audit rights to see where money is flowing in order to help patients

6:11: Transparency in the supply chain

6:47: What is outcome based contracting and why would it help patients?

7:17: Pharma companies need to explain their pricing models in a transparent manner

8:39: Examining administrative burdens in healthcare

9:09: “Some estimates say that we spend more on administrative burden in the US marketplace than actually pay for pharmaceuticals in the US market, which is astounding to me” says Robert Popovian

10:26: What the Build Back Better Act misses

10:53: Robert shares his final thoughts on this legislation.

Contact our hosts:

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

Conner Mertens, Patient Advocate and Community Outreach Manager at GHLF: [email protected]

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.

One Senator has held up the passage of President Biden’s social spending and climate policy bill, known as Build Back Better. We examine how the current bill would help patients and where it stops short.

"It is a major issue for consumers. Every day, patients through no fault of their own are not able to afford their medicines," says Dr. Robert Popovian, Chief Science Policy Officer at the Global Healthy Living Foundation. “And it does cause complications down the road if they're not taking their medicines because of outrageous out-of-pocket costs that they’ll have to pay.”

Some episode highlights:

1:09: Listener review

2:02: How would the Build Back Better plan help patients and the healthcare industry?

3:42: What this bill would and wouldn’t do to help the average patient

4:23: “Patients really care about what they pay out of their pocket when they show up to the pharmacy counter and this legislation does not address”

5:50: People react to funding research and development of drugs

7:11: 44% of patients skip filling prescriptions because of their high costs

7:42: How states and the federal government differ in data keeping and transparency

8:14: Priority one should be to contain out-of-pocket costs

9:26: This legislation, as is constructed, will negatively impact research and development

11:36: Robert shares his final thoughts on this legislation

Contact our hosts:

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

Conner Mertens, Patient Advocate and Community Outreach Manager at GHLF: [email protected]

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 your favorite podcast channel or on our website.

See omnystudio.com/listener for privacy information.