Tradeoffs

Journalist Paula Span, who writes The New Old Age column for the New York Times, shares what she’s learned about how to age well.

Guest:

Paula Span, reporter and The New Old Age columnist for the New York Times

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U.S. companies spend more than $1 trillion annually on health care for their employees. To get this budget-busting figure under control, some companies are experimenting with cutting out insurers, and investing in primary care clinics at the office. 

Guests:

Amy Cooper, NP, Vera Whole Health

Bob Galvin, MD, former Chief Medical Officer, General Electric and Board Chairman, Catalyst for Payment Reform

Dan Mendelson, CEO, Morgan Health

Ann O’Malley, MD, MPH, Senior Fellow, Mathematica

Matt Ohrt, Co-founder, Self Fund Health

Lee Sagraves, Employee, JPMorganChase

Gwen Sagraves

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For decades, the most effective treatment for addiction to methamphetamine or cocaine has been mired in stigma and mostly limited to small research studies. But with deaths involving meth and cocaine on the rise, policymakers across the country are turning to gift cards to fight drug use.

This story has been updated to clarify the research on long-term effects of contingency management and the eligibility requirements to deliver contingency management through CalAIM.

Credits:

Stephen Higgins, PhD, Professor of Psychology and Psychiatry, University of Vermont

Richard Rawson, PhD, Professor Emeritus, UCLA Department of Psychology

Andrew Dertien, Contingency Management Coordinator, HealthRIGHT 360

Bernard Groves

Ayesha Appa, MD, Assistant Professor of Medicine, UCSF and San Francisco General Hospital

Tyler Sadwith, Medicaid Director, California Department of Health Care Services

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Many potent new medicines pose a host of challenges for drug companies trying to copy and sell similar versions on the cheap. Can those companies find a sustainable path forward, or will patients get left stuck paying exorbitant prices?

Guests:

Christine Baeder, MBA, President, Apotex USA

Alfred Engelberg, JD, retired attorney and former counsel to the Generic Pharmaceutical Industry Association

Jeremy Greene, MD, PhD, Professor of Medicine and the History of Medicine, Johns Hopkins University

Candy Meyer, Patient

Bhaven Sampat, PhD, Professor, Arizona State University School for the Future of Innovation in Society

Marta Wosińska, PhD, Senior Fellow, Brookings Institution

Leslie Walker, Senior Reporter/Producer, Tradeoffs

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America pays less, on average, than any other major country for our generic drugs. But selling essential drugs at such low prices comes with hidden costs — from quality problems to frequent shortages.

This is the second episode of Race to the Bottom, a three-part series by Tradeoffs on the problems plaguing the generic drugs we all rely on — and how we could fix them.

Guests:

Christine Baeder, MBA, President, Apotex USA

Laura Bray, MBA, Founder, Angels for Change

Craig Burton, Senior Vice President of Policy and Strategic Alliances, Association for Accessible Medicines

Iilun Murphy, MD, Director of the Office of Generic Drugs, FDA

Leslie Walker, Senior Reporter/Producer, Tradeoffs

Marta Wosińska, PhD, Senior Fellow, Brookings Institution

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Generic drugs are, in many ways, the unsung hero of America’s health care system, bringing powerful medical innovations within the reach of millions more people. These cheaper copies of brand-name drugs — from pills that stop heart attacks to antibiotics that cure life-threatening infections — save America hundreds of billions of dollars a year. But will affordable, high-quality generic drugs continue to be there when we need them?

Some players are abandoning this business while others slash costs by cutting dangerous corners. Shortages of older generic drugs have become the norm, sending doctors scrambling. At the same time, crucial new medicines are proving tougher to copy on the cheap, saddling patients with brand-name prices.

Over the course of “Race to the Bottom,” our new three-part podcast series, we’ll explore why this industry that’s so essential to our health is in trouble — and what could change that.

In part one, we examine the history of this industry. Forty years ago this month, President Ronald Reagan signed groundbreaking, bipartisan legislation that gave birth to a new drug market. Lawmakers made choices back then that help explain the wild success and also the troubles we see today with generic medicines.

Guests:

Christine Baeder, MBA, President, Apotex USA

Alfred Engelberg, JD, retired attorney and former counsel to the Generic Pharmaceutical Association

Leslie Walker, Senior Reporter/Producer, Tradeoffs

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One organization turns to a game to get employees to debate and decide together what health care they most value. 

Guests:

Paul Fronstin, Ph.D., Director, Health Benefits Research, Employee Benefits Research Institute 

Jeanette Janota, Senior Research Associate, American Speech-Language-Hearing Association

Tavril Saint Jean, Senior Research Associate, American Speech-Language-Hearing Association

Janet McNichol, Chief Human Resources Officer, American Speech-Language-Hearing Association

Evan Reid, Senior Director of Analytics, American Speech-Language-Hearing Association

Julia Reilly-Edwards, Data Scientist, American Speech-Language-Hearing Association

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A handful of states allow terminally ill people to take life-ending medications prescribed by a doctor instead of waiting for death. This week, we talk with journalist Steven Petrow about his sister’s choice to use medical aid in dying.

Guest:

Steven Petrow, Journalist and author

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In The Fifth Branch, Tradeoffs explored new ways to respond to people in a mental health crisis, this week we have look at another area of the mental health crisis the country is grappling with. 'Lost Patients', a new podcast from KUOW and The Seattle Times, dives into why so many people with mental illness live on the streets, and lack long-term care.

Heidi Aurand has watched her son Adam spiral from one psychiatric crisis to the next for about eight years, bouncing between emergency rooms, jails, and homelessness. Now, after treatment at the state's largest psychiatric hospital, Adam was just released back onto the streets of downtown Seattle. A mother asks: How could her son pass through so many institutions and none are able to stop his decline?

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The Inflation Reduction Act gave Medicare historic new power to directly negotiate the prices of some of the costliest prescription drugs. Now the federal agency must grapple with a difficult question: What makes a drug price fair?

This week, we revisit our 2023 episode explaining how this negotiation process works and the impact it could have.

Guests:

Anton Avanceña, PhD, Assistant Professor of Health Outcomes, University of Texas 

Darius Lakdawalla, PhD, Professor of Pharmaceutical Economics and Public Policy, University of Southern California 

Lauren Neves, JD, Deputy Vice President, PhRMA

Steve Pearson, MD, MSc, Founder and President, Institute for Clinical and Economic Review (ICER)

Ben Rome, MD, MPH, physician and researcher, Harvard Medical School

Meena Seshamani, MD, PhD, Deputy Administrator, Centers for Medicare and Medicaid Services

Leslie Walker, Senior Producer/Reporter, Tradeoffs

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