Tradeoffs

We follow Maryland's 52-day rush to convince the Trump administration to give the state new funding to transform rural health care.

Guests:

• Bonita Baer, Maryland resident
• Mark Boucot, president and CEO of Garrett Regional Medical Center and Potomac Valley Hospital 
• Elizabeth Kromm, assistant secretary for population health and strategic initiatives, Maryland Department of Health
• Levi Lantz, ALL Produce & Greenhouse
• Ken Ulman, former executive, Howard County, Maryland; president of Margrave Strategies

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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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Rural health experts dig into the Trump administration’s effort to transform rural health care.

Guests:

• Kevin Bennett, Director Center for Rural & Primary Healthcare; Professor, Family and Preventative Medicine, School of Medicine Columbia, University of South Carolina
• Paula Chatterjee, Director of Health Equity Research, Penn LDI; Assistant Professor, Medicine, Perelman School of Medicine
• Sarah Jane Tribble, Chief Rural Correspondent, KFF Health News
• Rachel Werner, Executive Director, Leonard Davis Institute of Health Economics; Professor of Medicine, Perelman School of Medicine, University of Pennsylvania

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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

Learn more and read a full transcript on our website.

Al Engelberg’s recently published memoir, “Breaking the Medicine Monopolies”, digs into the history of generic drugs. 

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Black Americans report higher levels of mistrust in the health care system than white Americans and suffer worse outcomes in everything from maternal mortality to life expectancy. What if improving health literacy and demystifying health information could be the part of the solution?

This week, one doctor’s crusade to help more people understand their own health care and why insurers are starting to buy in.

Guests:

Lisa Fitzpatrick, MD, MPH, MPA, Founder and CEO, Grapevine Health

Keith Maccannon, Director of Marketing, Outreach and Community Relations, AmeriHealth Caritas District of Columbia

Yvonne Smith, Grapevine Client

Karen Dale, RN, MSN, Market President, AmeriHealth Caritas District of Columbia

Learn more and read a full transcript on our website.

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A Chicago violence prevention program is pairing cognitive behavioral therapy with intensive mentoring and wraparound support to help high-risk teens avoid incarceration.

Guests:

Nour Abdul-Razzak, Research Associate, University of Chicago Harris School of Public Policy; Research Director, University of Chicago Inclusive Economy Lab

Charles Branas, Professor and Chair, Department of Epidemiology, Columbia University Mailman School of Public Health

Toni Copeland, Director of Student Supports and Violence Prevention Programs, Chicago Public Schools

Jennifer Doleac, Executive Vice President of Criminal Justice, Arnold Ventures

Jasper Guilbault, Therapist, Brightpoint

Gary Ivory, President and CEO, Youth Advocate Programs

Julie Noobler, Director of Mental Health and Wellness, Brightpoint

T-Man

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A leading addiction expert explains how he’s driven by the memory of a friend who died, and why he believes giving data on the drug supply to people on the street is more important than using it to inform national drug policy.

Guest:

Nabarun Dasgupta, Epidemiologist, University of North Carolina Street Drug Analysis Lab and Opioid Data Lab

Learn more and read a full transcript on our website.

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A group of nurses in Baltimore wants to bring basic care to every person in a neighborhood regardless of age, health, income or insurance.

Can this idea from abroad take root in the United States?

Guests:

Dawn Alley, PhD, Head of Scale, IMPaCT Care

Asaf Bitton, MD, MPH, Executive Director, Ariadne Labs

Regina Hammond, Founder, Rebuild Johnston Square Neighborhood Organization

Chris Koller, President, Milbank Memorial Fund

Terry Lindsay, Community Health Worker, Sisters Together and Reaching, Inc. (STAR)

Sarah Szanton, PhD, RN, FAAN, Dean, Johns Hopkins School of Nursing; Founder, Neighborhood Nursing

Learn more and read a full transcript on our website.

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Economist Amy Finkelstein has studied America’s patchwork of health insurance policies for more than 20 years. In a forthcoming book she concludes it’s time tear the whole system down.

This week, Dan talks with Amy about how she came to that conclusion and what a better system could look like. 

Guest:

Amy Finkelstein, PhD, Professor of Economics, MIT

Learn more and read a full transcript on our website.

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