Healthcare Matters

In this episode of Healthcare Matters, Dr. Robert Popovian and co-host Angela Degrassi discuss why uncertainty surrounding the CDC’s Advisory Committee on Immunization Practices, known as ACIP, matters far beyond Washington, DC. The conversation explains how ACIP recommendations are connected to the real-world systems that help patients get vaccinated, including pharmacist authority, state scope-of-practice laws, and Medicaid reimbursement. Dr. Popovian explains that adult vaccination is especially vulnerable to disruption because most adults receive vaccines at pharmacies, and in many states, pharmacists’ ability to administer vaccines is tied to ACIP recommendations. The episode also explores why seasonal vaccines, such as flu and COVID vaccines, are particularly exposed to uncertainty because they require updated authorization and recommendations each year. Robert and Angela discuss what happened when COVID vaccine guidance was delayed, how some states responded with temporary workarounds, and why not every state may be prepared to act quickly if similar uncertainty continues. The discussion also highlights GHLF’s new integration of Walgreens’ Vaccine Scheduler into GHLF’s vaccine hub, a tool designed to help adult patients better understand and access vaccines at local pharmacies. The key message: ACIP may sound like an advisory body, but its recommendations can directly affect whether patients can get vaccines, whether pharmacists can provide them, and whether Medicaid will pay for them. Contact Our Hosts Dr. Robert Popovian, Chief Science Policy Officer at GHLF: [email protected] Angela Degrassi, Senior Manager, Patient-Centered Research Operations & Engagement: [email protected] A podcast series produced by Amelia Violet Prouse. 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 is joined by new co-host Angela Degrassi for a conversation about access to oral antiviral treatments for COVID-19, especially for older adults and people living with chronic disease.Prompted by a new CDC report and supported by findings from a recent Global Healthy Living Foundation survey, the discussion explores a troubling pattern: awareness of COVID antiviral treatments may be high, but many high-risk patients still do not receive them when they test positive.Dr. Popovian explains why prescribing appears to rise when COVID is dominating headlines and then fall when public attention fades, even though patient risk has not changed. He and Angela discuss the real-world barriers that can stand in the way of timely treatment, including missed prescribing opportunities, delays in testing, out-of-pocket costs, and uncertainty about eligibility.This episode highlights a simple but important message: for high-risk patients, timely treatment should be part of the care plan, not an afterthought. It also offers practical guidance for patients and caregivers on what to do immediately after testing positive and why acting quickly can make all the difference. COVID-19 Antiviral Prescription Receipt Among Outpatients Aged ≥65 Years COVID-19 Oral Antiviral Treatments Among U.S. Patients with Chronic Conditions Contact Our Hosts Dr. Robert Popovian, Chief Science Policy Officer at GHLF: [email protected] Angela Degrassi|, Senior Manager, Patient-Centered Research Operations & Engagement: [email protected] A podcast series produced by Amelia Violet Prouse. 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 breaks down the 340B drug pricing program through the lens that matters most: what it means for patients. Prompted by Minnesota’s latest transparency report, he explains how a program originally created to support care for uninsured and underinsured patients has grown into one of the largest and least understood drug programs in the country.  Dr. Popovian unpacks how the program works, why contract pharmacies have become such a major part of it, and what the newest data suggest about who is benefiting most. He also raises a critical question: if hospitals and affiliated entities are receiving deep discounts on medicines, why are so many patients still facing high out-of-pocket costs?  This episode explores whether the 340B program is truly delivering on its original mission and why greater transparency, accountability, and patient benefit should be at the center of the conversation.  Minnesota 340B Covered Entity Report 2025 Minnesota 340B Covered Entity Report 2024 Contact Our Hosts Dr. Robert Popovian, Chief Science Policy Officer at GHLF: [email protected] A podcast series produced by Amelia Violet Prouse. 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.

Pharmacy Benefit Manager (PBM) reform has reached a turning point. In this episode of Healthcare Matters, Dr. Robert Popovian and Ben Blanc are joined by Bob Schenk, RPh, to break down the latest wave of federal and state reforms, including the FTC settlement with Express Scripts. From pharmacy-level claims transparency to rebate reform and vertical integration, the conversation explores what’s changed, what’s still missing, and how these shifts could affect employers, patients, and healthcare costs nationwide. As regulatory pressure builds, the big question remains: will transparency lead to true accountability, or simply new revenue strategies? 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 season premiere of Healthcare Matters, Dr. Robert Popovian and Ben Blanc are joined by Dr. Wayne Winegarden, Senior Fellow and Director of the Center for Medical Economics and Innovation at the Pacific Research Institute, to discuss a new economic study revealing the true cost of influenza in America.The study finds that influenza imposed a $29 billion economic burden during the 2023-24 season; $16 billion in direct medical costs and $13 billion in lost productivity. Using 14 seasons of CDC data, the research demonstrates that higher adult vaccination rates are significantly associated with lower hospitalizations and mortality, particularly among adults aged 50 and older.The conversation explores why adult vaccination rates have declined, what drives the real economic impact of flu season, and why employers, especially small businesses, should view vaccination as a critical workplace investment. Dr. Popovian and Dr. Winegarden break down the data and discuss actionable solutions for healthcare systems, employers, and policymakers to close the gap between what we know works and what's actually happening.To access the full study and white paper, click here.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, our hosts unpack the evolving conversation around drug pricing reform—focusing on a new proposal often referred to as “TrumpRx.” Drawing from Robert’s recent co-authored article The Promise of TrumpRx, they explore how direct-to-consumer purchasing, pricing transparency, and reforming the rebate-driven PBM system could reshape what patients actually pay at the pharmacy counter. Robert breaks down how PBMs influence list prices, why rebate contracting misaligns incentives, and how deductibles and co-insurance calculations leave many patients, especially those with chronic illnesses, paying more than they should. The conversation also outlines four key policy changes that would be necessary for any TrumpRx-style model to meaningfully benefit patients, including allowing cash prices to count toward deductibles and extending transparency to both employers and consumers. The conversation explores how upcoming policy shifts, including changes tied to the IRA, may influence drug affordability and how clearer pricing information could help patients make more informed decisions about their care. You can read Robert’s full article here: https://www.linkedin.com/pulse/promise-trumprx-robert-popovian-vskne/ To watch all the interviews we captured at ACR, visit: https://youtube.com/playlist?list=PLf0iG26PiXMtANSCb4wklzYdqPueqUNdx&si=5TK2MbGJNcyGv9GC  You can find all Informed Immunity episodes here: https://ghlf.org/informed-immunity/ 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 unpack key findings from the recent Global Healthy Living Foundation’s national survey on access to COVID-19 oral antivirals. As federal emergency support phases out, how are high-risk patients navigating access to these lifesaving treatments? Dr. Popovian highlights persistent knowledge gaps, reimbursement hurdles, and policy inconsistencies that continue to disrupt real-world uptake. From provider barriers to state-by-state disparities, he explores what’s standing in the way — and offers actionable solutions to help ensure these therapies reach the patients who need them most. To access and download the full report (PDF) click here. 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 breaks down the complex but critical connection between vaccine policy and access in the United States. Our hosts examine how guidance from the CDC’s Advisory Committee on Immunization Practices (ACIP) can affect not only where patients can get vaccinated but also whether healthcare providers are reimbursed for administering those vaccines. From immunization reimbursement to state scope-of-practice laws, Dr. Popovian outlines real-world barriers and provides practical solutions needed to ensure vaccines reach the people who need them most. 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 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.

In this episode of Healthcare Matters, join Dr. Robert Popovian and Ben Blanc as they dissect the critical role of Pharmacy Benefit Managers (PBMs) in the health care system, guided by recent findings from the Federal Trade Commission (FTC). The episode delves into how PBMs control a significant portion of the U.S. prescription market, discussing the implications of their dominance on drug prices, and the viability of independent pharmacies. Featuring a thorough examination of the FTC's recent report, Dr. Popovian explores the deep-seated issues of market concentration, anti-competitive practices, and the need for substantial regulatory reform. This episode aims to shed the light on the powerful influence PBMs have over drug access and affordability, proposing pathways for more equitable health care practices. Among the highlights in this episode: 01:45: Dr. Popovian delves into the FTC's report, revealing that three major PBMs control 80% of the retail prescription market in the U.S., highlighting issues of market concentration and limited competition 02:46: The conversation shifts to the impact of PBMs on drug prices and pharmacy operations, focusing on the FTC's concerns over anti-competitive practices  03:14: Dr. Popovian explains the effects of vertical and horizontal integration among PBMs, affecting drug access and pricing 06:35: Our hosts discuss the struggles faced by independent pharmacies due to PBM practices, as revealed in the FTC report 09:59: Dr. Popovian explores how PBMs use formulary design to manipulate which drugs patients can access and at what cost 11:59: Dr. Popovian criticizes the current rebate practices by PBMs, discussing their detrimental effects on the availability of generic and biosimilar drugs 14:25: Dr. Popovian calls for greater transparency and potential regulatory reforms to ensure fair drug pricing and maintain pharmacy viability 16:44: Dr. Popovian shares some final thoughts To read the full FTC report “Pharmacy Benefit Managers: The Powerful Middlemen Inflating Drug Costs and Squeezing Main Street Pharmacies,” go to: https://www.ftc.gov/reports/pharmacy-benefit-managers-report 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 our hosts as they explore the innovative world of gene therapy with guest Dr. Anne Sydor, Director of Research Development at GHLF. Together, they delve into the complexities of gene therapy treatments, the reasoning behind their high costs, and the challenges posed by current regulatory environments. They also discuss whether there is a need to reevaluate payment models to support the sustainable deployment of these life-altering therapies. This episode provides a deep dive into the future of gene therapy and the regulatory model for manufacturing processes. Among the highlights in this episode: 02:34: Dr. Popovian discusses the impressive number of gene therapy trials currently listed in the National Institutes of Health database, indicating significant research activity in this field 03:07: Dr. Popovian explains the impetus behind his collaborative paper on gene therapy value and pricing models, highlighting the need to understand pricing in the context of long-term health outcomes and societal benefits 04:43: Dr. Sydor provides a comprehensive overview of gene therapy, explaining its different types and methodologies, emphasizing their transformative impact on patient care 07:47: Dr. Popovian addresses why gene therapies are notably expensive, focusing on the high costs of research, development, and the significant value they bring to patients and society 09:28: Dr. Sydor highlights the societal and economic benefits of gene therapies, noting their potential to extend lives and improve quality of life for patients with rare diseases 11:15: Dr. Sydor elaborates on regulatory challenges impacting gene therapy accessibility and suggests potential improvements to ease these burdens 16:24: Dr. Popovian questions the adequacy of current payment models for gene therapies in the U.S. and suggests that a reevaluation might be necessary to accommodate the unique costs and benefits of these treatments 20:14: Dr. Sydor and Dr. Popovian discuss the broader implications of gene therapy pricing, emphasizing the need to balance upfront costs against long-term benefits in health care policy discussions 22:53: 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 bring you essential takeaways from the World Vaccine Congress. Joined by guests Abby Bownas, leader of the Adult Vaccine Access Coalition (AVAC) and the American Disease Prevention Coalition (ADPC), and Dr. Thomas Acciani, Director of U.S. Vaccine Policy at GSK, they delve into their significant roles within the vaccine landscape and discuss the overarching importance of the congress. Dr. Popovian highlights the latest advancements in vaccine research conducted by GHLF and their research partner IQVIA Human Data Sciences. This episode offers a comprehensive overview of the current state and future directions of vaccine development and deployment. Tune in to gain a deeper understanding of the challenges and opportunities that lie ahead in the field of vaccines. Among the highlights in this episode: 01:20: Dr. Popovian shares his recent participation to the World Vaccine Congress, including his roles as a presenter and panel moderator, offering insights into the significance of the event 02:43: Dr. Popovian and Abby Bownas discuss the importance of increasing adult vaccination rates and the federal and policy opportunities that can help achieve this goal  04:13: Abby explains the role of the American Disease Prevention Coalition (ADPC) in supporting pharmacists as vaccinators across different states, highlighting the variation in vaccination rules and authority levels 05:06: Dr. Popovian and Abby discuss the broad coalition of partners involved in ADPC, including pharmacists, vaccine makers, patient groups, and advocacy organizations. They emphasize the coalition's efforts to harmonize state laws on pharmacist vaccination authority before federal temporary provisions expire 06:53: Abby stresses the collaborative effort required among all providers to improve vaccine access and uptake, making the case for pharmacies and physicians to work together effectively 08:23: Dr. Acciani describes his role at GSK and the importance of addressing policy barriers to enhance patient access to vaccines, stressing the collaboration with public and private sectors to remove these obstacles 09:17: Dr. Popovian and Dr. Acciani discuss the need to eliminate unnecessary policy barriers to improve vaccination accessibility, advocating for a "no wrong door" policy where patients can receive vaccinations immediately upon request 11:20: Dr. Popovian presents findings from a study on Medicaid reimbursement and its correlation with vaccine uptake, emphasizing the impact of economic incentives on vaccination rates 13:50: Dr. Popovian discusses GHLF’s research on immunization access and its correlation with reimbursement strategies, particularly focusing on the disparities in vaccination rates among different socio-economic groups 15: 57: Dr. Popovian discusses the challenges faced by immunocompromised patients in accessing vaccines, discussing the significant barriers that persist despite insurance coverage 17:27: Dr. Popovian shares insights on future research directions for GHLF, including a study on vaccine uptake challenges among immunocompromised patients and the potential policy interventions to reduce barriers to vaccination 20:10: Dr. Popovian reflects on the broader implications of vaccine research beyond infectious diseases, pointing to exciting developments in oncology vaccines and their potential impact on public health 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, Dr. Robert Popovian and Ben Blanc are joined by Kate Hudson, Associate Vice President and Counsel for Government Relations and Public Policy at the Association of American Universities, to dissect the complex issue of march-in rights. They delve into how this regulation negatively influences the partnership between public research and private sector investment, which is crucial for supporting biopharmaceutical innovation from university labs to a patient’s bedside. The episode reveals march-in rights' potential risks and benefits, especially how the policy might impact innovation and patient access to future therapies. Among the highlights in this episode: 02:25: Researchers found that 75% of all Food and Drug Administration-approved drugs between January 2008 and December 2017 were funded and researched by private companies, with only 19% of the approved drugs having origins in publicly supported research and development, and 6% originating in companies that were spun from publicly supported research programs 03:48: Kate shares her professional journey and current role at the Association of American Universities 06:06: Kate explains the concept of march-in rights under the Bayh-Dole Act, detailing its purpose, application, and implications for intellectual property generated from federally funded research 09:52: Dr. Popovian describes his involvement with University Pharmco and its mission to promote research commercialization, emphasizing the potential impact of march-in rights on such initiatives 12:19: Kate addresses why the debate around march-in rights is crucial from a patient's perspective, particularly concerning the potential chilling effect on innovation and drug development 17:18: Kate provides her perspective on how march-in rights could influence private sector investment, potentially driving it outside the United States, and discusses the international adoption of similar legislative frameworks 19:54: 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.

Join Dr. Robert Popovian and Ben Blanc for a special live episode from the World Vaccine Congress in Washington, DC, where they delve into the latest developments in vaccine policy and economic research. This episode spotlights the congress's role as a vital hub for collaboration and innovation in the vaccine industry. Tune in to get an insider's view of the pivotal conversations shaping the future of vaccines. 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 take a deep dive into GHLF’s latest vaccine study with guests Dr. Wayne Winegarden, Senior Fellow in Business and Economics at the Pacific Research Institute (PRI) and Director of PRI's Center for Medical Economics and Innovation, and Esteban Rivera, Associate Director of Data Science and Economics at GHLF. Together, they delve into the study, which underscores the pivotal role pharmacists play in vaccination efforts and the urgent need for regulatory reform. They discuss how pharmacies enhance vaccine access and affordability, especially in marginalized communities, the challenges posed by regulatory barriers, and suggest ways to reform these barriers to improve vaccination rates. Tune in to explore how pharmacies can play a pivotal role in public health through streamlined vaccination processes. Among the highlights in this episode: 03:04: Dr. Popovian, Chief Science Policy Officer at GHLF, discusses a statistic by the Center for Disease Control that nearly 60% of all flu vaccines were administered in pharmacies in the latest flu season, emphasizing the significant role pharmacists play in combating preventable diseases 03:53: Dr. Popovian explains the reasons behind GHLF’s new report on pharmacy-administered vaccinations, including previous findings on access in low-income communities and the preference for pharmacy vaccinations post-pandemic 06:18: Dr. Winegarden discusses the study's groundbreaking findings, particularly the complex and burdensome state regulations around vaccinations and their health and economic implications 09:10: Esteban Rivera elaborates on the cost-effectiveness of vaccinating patients at pharmacies compared to physician offices and highlights the equitable benefits of increased vaccine accessibility at pharmacies 10:24: Dr. Winegarden provides an example of the RSV vaccine to illustrate specific cost savings and health impacts of pharmacy versus physician office vaccinations 13:27: Esteban Rivera discusses the complexity of regulatory pathways for vaccination, emphasizing the need for simplification to reduce costs and improve accessibility 14:26: Dr. Popovian gives examples of states that have either streamlined or erected barriers for pharmacist immunization, particularly highlighting the negative impact on underserved communities in New York 16:16: Dr. Popovian advocates for state-level regulatory reform to grant pharmacists the same authority to immunize as physicians, stressing the importance of accessibility and convenience for patients  18:24: Dr. Popovian shares some final thoughts To access the full report, go to: https://ghlf.org/removing_barriers_to_pharmacy_vaccination/ 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, our hosts dive into the impact of pharmacy reimbursement on vaccination rates with guest Vibhu Tewary, researcher and Project Director at IQVIA Institute for Human Data Science. Through discussing a recent study, they reveal how a modest increase in reimbursement can lead to higher flu vaccination rates among Medicaid-covered adults. The episode also touches on the role of pharmacies in public health, the need for policy reform to enhance vaccine accessibility, and the potential for future research to further improve public health outcomes. Among the highlights in this episode: 01:50: Vibhu shares his background in public health and policy, emphasizing his commitment to impactful research for patient access and health care improvements  04:21: Vibhu discusses the key findings from a 2023 paper that highlighted pharmacies as major vaccination sites, with over 90% of COVID-19 vaccinations for adults provided through pharmacies in 2021 and 2022 06:24: Dr. Popovian, Chief Science Policy Officer at GHLF, discusses the need to harmonize state laws to allow pharmacists to immunize more adults, addressing the disparities in pharmacy access and emphasizing the cost effectiveness of pharmacy-administered vaccinations 08:36: Dr. Popovian and Vibhu delve into the recent report co-authored by GHLF and IQVIA Institute for Human Data Science that establishes a direct link between increased pharmacy reimbursement rates and higher flu vaccination rates among Medicaid-covered adults  You can find the full report at https://www.iqvia.com/insights/the-iqvia-institute/reports-and-publications/reports/trends-in-adult-vaccination-in-the-us 10:24: Vibhu outlines the methodology and key findings of the study, demonstrating that a $13 increase in reimbursement could lead to a six-percentage point increase in vaccination rates, consistent across gender and race 13:50: Dr. Popovian suggests aligning Medicaid reimbursement rates for vaccinations with those of Medicare to address disparities in vaccination access among underserved populations 15:28: Dr. Popovian and Vibhu discuss potential areas for future research, including the role of pharmacists in vaccine distribution, patient awareness, and addressing health equity in adult vaccination 18:17: 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.

Dr. Robert Popovian and Conner Mertens dive into the problematic practices of Pharmacy Benefit Managers (PBMs) that prioritize profits over patient access to affordable medications. Focusing on the case of a generic asthma medication offered at a discount yet overlooked by PBMs, the hosts explore the deep-seated issues of misaligned incentives in health care. They also discuss innovative solutions to bypass the traditional pharmaceutical distribution system, aiming to enhance patient access and affordability. Join our hosts as they explore the complexities of health care economics and the path towards a more equitable system. Among the highlights in this episode: 02:21: Our hosts discuss the problematic practices of PBMs, such as refusing to cover cheaper, generic medications for profit motives 03:08: Dr. Popovian explains how rebate systems influence PBMs to prefer higher-priced brand-name drugs over generics, leading to misaligned incentives that do not favor cost savings for patients or employers 04:36: Our hosts touch upon how PBMs exclude drugs from formularies, not for efficacy reasons but for profit, impacting patient access and savings negatively 05:49: Dr. Popovian speaks on the potential benefits of pharmaceutical companies selling directly to consumers, bypassing PBMs and insurers, and how it could save patients money and increase access 10:01: Our hosts discuss how direct-to-consumer sales, and other models like direct sales to health providers or employers, could challenge the current pharmaceutical distribution system dominated by PBMs 13:09: Dr. Popovian and Conner discuss the importance of seeking ways to make health care more accessible and affordable 14:27: Conner shares his thanks and reflections as he says goodbye to the series 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] A podcast episode produced by Ben Blanc, Associate Director, Digital Production and Engagement at GHLF. 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.

Join our hosts as they explore the substantial impact of COVID-19 vaccines. They discuss a groundbreaking study by the Progressive Policy Institute (PPI) revealing how rapid vaccine development and distribution saved millions of lives and prevented hospitalizations, leading to a significant $500 billion economic saving. The episode delves into vaccine efficacy, the importance of boosters, and strategies to combat vaccine hesitancy. Tune in for a concise yet comprehensive analysis of how COVID-19 vaccines have reshaped public health and the economy. Among the highlights in this episode: 00:50: Dr. Popovian, Chief Science Policy Officer at GHLF, shares his involvement in a research paper with the Progressive Policy Institute, discussing the impact of vaccine development and distribution. You can read the full publication at: https://www.progressivepolicy.org/publication/quantifying-the-economic-and-health-benefits-from-rapid-development-covid-19-vaccines-and-boosters/ 02:36: Dr. Popovian summarizes the paper's findings, highlighting that 2.9 fatalities and 12.5 million hospitalizations were avoided, saving the U.S. economy $500 billion in hospitalization costs, and he also discusses the importance of boosters in reducing fatality rates 04:43: Dr. Popovian emphasizes that elderly and immunocompromised individuals benefit most from immunization, both in terms of health outcomes and economic savings 05:47: Dr. Popovian addresses the topic of herd immunity, noting its relative efficacy but stressing the risks associated with acquiring natural immunity through illness 07:39: Dr. Popovian talks about recent studies showing that individuals who are fully vaccinated and boosted have a lower incidence of long COVID 08:58: Conner Mertens, Patient Advocate and Community Outreach Manager at GHLF, and Dr. Popovian discuss the challenges of vaccine hesitancy and the importance of returning to basics in advocating for vaccination, especially among older adults 10:29: Conner Mertens highlights the cost-effectiveness of vaccines in preventing expensive hospital treatments 10:52: Dr. Popovian suggests the need for better preparation and funding for future outbreaks, beyond just COVID-19 12:20: Dr. Popovian shares some 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] A podcast episode produced by Ben Blanc, Associate Director, Digital Production and Engagement at GHLF. 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.

Dr. Robert Popovian and Conner Mertens, along with guest Catherine Hicks, a patient diagnosed with juvenile idiopathic arthritis as a child, dive into the complex world of formulary exclusions. They discuss how these exclusions impact patient care and the hidden consequences they bring, including how Catherine was personally impacted. Dr. Popovian also shares learnings from GHLF’s research work, shedding light on the clinical and economic implications of these exclusions. Tune in for a deep dive into the realities of navigating health care policy and the pressing need for patient advocacy. Among the highlights in this episode: 01:50: Conner asks Dr. Popovian to explain formulary exclusions 02:30: Our guest, Catherine Hicks, shares her struggle with juvenile idiopathic arthritis and epilepsy, detailing how formulary exclusions led to severe health complications and long-term spinal damage  03:50: Catherine emphasizes the human impact of formulary exclusion decisions, highlighting how these affect not just individuals but large groups of patients 05:48: Dr. Popovian describes the research conducted by GHLF, revealing that a significant percentage of drug exclusions are neither clinically nor economically beneficial 09:06: Catherine stresses the importance of patient self-advocacy in navigating health care and insurance systems, based on her personal experiences  10:55: Conner asks Dr. Popovian about alternatives to formulary exclusions and how to combat their negative effects 11:12: Dr. Popovian discusses the lack of active legislation addressing formulary exclusions and the need for collective policy efforts to prohibit such practices 12:42: Conner summarizes the episode, highlighting the harm caused by formulary exclusions to patients like Catherine  13:12: Dr. Popovian shares some final thoughts You can watch the "Impact of Formulary Exclusions on Individual Patients" webinar at: https://youtu.be/jK0xaXGtUvk You can access both Analysis of Formulary Exclusions papers via the links below: Analysis of Drug Formulary Exclusions from the Patient's Perspective: 2023 Update https://bit.ly/ExclusionsUpdate  Modeling the Effects of Formulary Exclusions: How Many Patients Could Be Affected by a Specific Exclusion? https://bit.ly/SpecificExclusion  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] A podcast episode produced by Ben Blanc, Associate Director, Digital Production and Engagement at GHLF. 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.

Our hosts delve into the complex and concerning rise in drug shortages affecting patients in the U.S. and around the world. They explore the intricate economics driving the scarcity of essential medicines, from the impacts of the Inflation Reduction Act to the raw material supply disruptions tied to over-reliance on China.  Listen as they discuss the severe repercussions on patient care, including delayed treatments and compromised health outcomes, and present thought-provoking solutions that challenge current pricing policies and distribution practices. Among the highlights in this episode: 01:43: Dr. Popovian lists the three recuring topics he has been hearing about while attending conferences: the Inflation Reduction Act's impact on drug pricing, health care affordability concerns, and drug shortages 02:58: Dr. Popovian explains the perennial nature of drug shortages, highlighting manufacturing issues and the Senate's interest  03:50: Our hosts cover the range of drugs affected by shortages, from sterile injectables to high-demand medications like Ozempic, and distribution issues for chemotherapy drugs 04:46: Dr. Popovian dives into the economic factors behind drug shortages, including low profitability leading manufacturers to exit the market 07:02: Dr. Popovian shares a personal anecdote about a drug shortage which affected his daughter, emphasizing the consequences for patient care 08:15: Dr. Popovian reminisces about the history of drug shortages, focusing on a significant event a dozen years ago involving pediatric cancer medications 09:17: Conner and Dr. Popovian discuss possible solutions, including rethinking pricing policies to prevent manufacturers from exiting the market, diversifying raw material sourcing away from China, and regulatory safeguards to prevent shortages 12:14: Dr. Popovian shares some 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.

In this episode of Healthcare Matters, join our hosts as they dive into the intricacies of the Inflation Reduction Act (IRA). While the act has brought about significant benefits like the annual cap on out-of-pocket costs, zeroing out costs for vaccines, and the insulin cap, it's not without its challenges.  Join Dr. Popovian and Conner Mertens as they explore the benefits and risks associated with the IRA, offering valuable insights into how it affects patients, particularly in terms of prescription drug costs. Among the highlights in this episode: 02:12: Dr. Popovian outlines the benefits of the IRA, such as the $2,000 annual cap on out-of-pocket costs, zero out-of-pocket costs for vaccines, and the insulin cap of $35, as well as the negative implications such as the reluctance of pharma companies to release drugs for smaller populations, possibly impacting patients with rare diseases 05:14: Conner brings up the unintended consequences of the IRA, especially its impact on research and development 05:30: Dr. Popovian foresees more step therapy, prior authorization, and potential removal of drugs from formularies as a result of the limitations the IRA imposes on insurance companies and pharmacy benefit management companies 07:21: Dr. Popovian comments on the recent list of drugs to be negotiated by CMS* and points out surprises, such as the inclusion of drugs that will lose their patent before the implementation of set prices *CMS is the federal agency that provides health coverage through Medicare, Medicaid, the Children's Health Insurance Program, and the Health Insurance Marketplace 09:40: Dr. Popovian expresses frustration about the lack of rebates and concessions being passed to patients at the pharmacy counter 12:05: Dr. Popovian shares some 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.

In this week’s episode of Healthcare Matters, co-hosts Dr. Robert Popovian and Conner Mertens are joined by special guest, Dr. Shilpa Venkatachalam, Director of Patient-Centered Research Operations and Ethical Oversight at GHLF. Dr. Venkatachalam’s personal story sheds light on the systemic barriers that hinder patients from accessing crucial vaccines, even when recommended by their health care providers. In this episode, we’ll dig into issues such as state-level regulations, the critical need to expand pharmacist abilities to administer vaccines, difficulties in transferring patient data/information, and the importance of advocating for oneself in the health care system. Among the highlights in this episode: 02:16: Dr. Venkatachalam delves into the intricacies of her journey with trying to get the Shingrix vaccine as a patient with rheumatoid arthritis, highlighting the system-level barriers patients face, even when vaccines are available 06:30: Dr. Venkatachalam explains the frustration and disbelief of having both the vaccine vial and professionals available but still being unable to get vaccinated, shedding light on the myriad bureaucratic hurdles in the U.S. health system 08:39: Conner empathizes with Dr. Venkatachalam’s story, pointing out how the health care system often makes it more challenging for patients to acquire necessary vaccines, especially in critical situations like Dr. Venkatachalam’s 09:01: Dr. Venkatachalam expands on the emotional and physical toll of not being able to access the vaccine quickly 11:10: Conner and Dr. Popovian discuss potential solutions to ensure patients don’t face the challenges Dr. Venkatachalam went through in accessing preventative care 11:38: Dr. Popovian highlights the broader issue of how state regulations and fragmented patient information contribute to the obstacles faced by patients 15:45: Dr. Popovian highlights the resistance from state medical societies against expanding pharmacists' ability to administer vaccines and how it contrasts with public sentiments about accessibility 19:41: Dr. Popovian emphasizes the importance of data ownership by patients and the challenges posed by data hoarding institutions 20:10: Dr. Venkatachalam offers advice and encouragement, urging listeners not to give up, to advocate loudly, and to reach out to organizations like GHLF for support 22:20: Dr. Popovian shares some 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.

In this episode of "Healthcare Matters," join hosts Dr. Robert Popovian and Conner Mertens as they unravel the shady practice known as “copay accumulator adjustors.” Joined by JP Summers, a patient advocate and chronic disease patient herself, they’ll shed light on this practice employed by pharmacy benefit management companies and insurers. You’ll learn how these policies adversely affect patients by preventing patient assistance from applying towards deductibles, leading to financial and emotional burdens. The hosts debunk myths about rising premiums when legislation prohibiting maximizer and accumulator practices is passed, using credible research and data to create an online free interactive tool. Tune in for insightful discussions and personal stories that underscore the urgency of reforming copay accumulator policies. Among the highlights in this episode: 02:16: Dr. Popovian lays out what a ‘copay accumulator adjustor’ is, and how pharmacy benefit managers and insurers can keep patients from reaching their deductibles using these shady practices. He also explains how they impact patients' out-of-pocket costs. 03:38: Conner provides an anecdote about how these policies look in practice, and how they can impact a patient’s deductible. 04:44: JP shares her personal experience as a patient affected by copay accumulator policies and how it impacted her ability to afford necessary medications. She continues on to show how these practices also negatively impacted her health, her family’s health, and their lives overall. “Never in my life, did I think I would have to choose a loved-one’s health over mine.” 07:11: JP describes the different advocacy efforts she’s undertaken to raise awareness about copay accumulator policies and the impact of her storytelling on creating change. Sharing our stories can be difficult, but ultimately rewarding when it can be used to influence policies that make patient’s lives easier. 08:46: Conner begins exploring the myth that copay accumulator bans will lead to rising insurance premiums. He introduces the GHLF research and data that directly refute those claims. Dr. Popovian explains what the data all means: “What we found…is that there was no statistical differences between states that had passed the bans, and states that hadn’t passed the bans.” He goes on to emphasize that on the state and federal level, there is strong bipartisan support for these bans. 11:15: We hear from Anne Sydor (GHLF Director of Research, Development, and Communications) about where the data was collected from and the transparent methods of analysis for the research presented within the free GHLF tool. She also outlines how patients can know if they are being impacted by a copay accumulator adjustor program. 13:29: Esteban Rivera (GHLF Data Scientist) further explains what the data shows: “…There’s no significant statistical relationship between the passing of legislation, on an increase in premium pricing.” 14:52: Conner shares his closing thoughts on the myth of rising premium costs as a result to passing copay accumulator bans.  15:31: Dr. Popovian gets the last word on the importance of protecting patients from predatory practices. 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.

Join our hosts as they tackle the critical issue of hospital price transparency in the U.S. health care system. Their guest, David Balat, founder of the Healthcare Finance Specialists and an expert in health care finance, sheds light on the impact of hidden costs and the benefits of empowering patients through transparent pricing. Discover how consumerism in health care can lead to lower costs and better outcomes, and learn why price transparency is crucial for improving access to affordable, high-quality health care. Among the highlights in this episode: 0:57: Dr. Popovian, Chief Science Policy Officer at GHLF, addresses the fact that 41% of U.S. citizens carry some sort of medical debt, with 24% considering bankruptcy to solve the issue 2:20: David Balat outlines his extensive experience in the health care industry, both in hospital administration and policy work 4:35: David discusses the Trump and Biden administrations’ support of the Hospital Price Transparency Rule 5:23: “The hospital industry, the American Hospital Association, fought this rule [the Hospital Price Transparency Rule] tooth and nail, sued it to the highest court and they lost at every level, which we were very, very pleased with. One of the main arguments was people don't really care—people won't use price transparency. And you know, honestly, that may be the case, but it's just been so hard to access that it hasn't been used,” says David 5:43: Dr. Popovian asks David about employers' roles in health care transparency 7:55: David discusses the misconceptions around hospital pricing transparency, emphasizing that a large portion of health care services are elective and can benefit from transparency 8:26: Dr. Popovian and David discuss the potential patient benefits of true hospital price transparency 11:40: David explains how consumerism in health care would benefit patients by giving them control over their care and addressing their financial fears 14:34: Dr. Popovian, Chief Science Policy Officer at GHLF, shares some 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.

At the Global Healthy Living Foundation, we know the value of grassroots advocacy. Tune in to this week's episode to hear how trained patient-advocates proactively connect with local, state, and federal health policy stakeholders to share their perspectives and influence change. This week features guests, Corey Greenblatt, Associate Director of Policy and Advocacy, and Patient Advocate and Community Outreach Manager, JP Summers. Alongside co-hosts Conner and Robert, they recount a summer advocacy road trip that spanned more than eight states and dozens of patient-led meetings with lawmakers and stakeholders. Among the highlights in this episode: 1:31: Corey discusses the reasons for initiating a states tour, the experience of doing so during a post-pandemic period, and the response they received from the policymakers they visited 3:07: “The response from policymakers was overwhelmingly positive. One of the things that we realized through these trips was that patients walk into a door of a legislator’s office… with a net positive rating before they say a word. That's because policymakers and staffers understand the toll that it takes for patients to be there and speak to them and share their stories,” says Corey 3:58: Conner highlights the importance of coalition building 6:18: JP shares her experience with the positive reception from legislators and the empowering feeling of advocacy work 7:53: Corey discusses key policy issues routinely addressed during the tours, with particular emphasis on copay accumulator adjuster laws and pharmacy benefit manager (PBM) transparency laws 10:35: JP elaborates on her personal advocacy experiences in Wisconsin and Texas 12:39: Conner brings up additional key issues such as high healthcare costs, expensive medications, and non-medical costs (such as transportation and caregiver expenses) that affect patients 14:04: Conner shares a key takeaway from the tours, emphasizing the importance and impact of bringing patients' voices directly to lawmakers 15:32: Corey emphasizes the growing awareness of Pharmacy Benefit Managers (PBMs) as influential actors in the healthcare industry, allowing for more focused discussions on specific healthcare issues 16:48: Dr. Popovian, Chief Science Policy Officer at GHLF, shares some 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.

We may be on the verge of an enormous shift in how drug prices are set. It’s been led by a dramatic decline in insulin prices, but it’s spreading to other brand drugs as well. Join our hosts for the first episode of our 4th season as they dive head-first into this important topic. They’ll discuss how this new paradigm is the unintended but welcome result of legislative, regulatory, and market pressures exerted on the biopharmaceutical industry. Among the highlights in this episode: 1:14: Dr. Popovian, Chief Science Policy Officer at GHLF, tells us about an 85% discount on the HUMIRA biosimilar that has entered the marketplace 1:55: There have been major shifts in the drug pricing paradigm 2:25: Manufacturers of insulin in the U.S. significantly dropped their prices, which will be capped at $35, representing almost an 80% reduction in price 3:10: These pricing shifts aren’t just limited to insulin as we have seen other brand drugs selling directly to consumers at discounted prices in response to significant marketplace pressure 4:00: 4 factors are contributing to drug manufacturers rethinking of pricing models: 1) Litigation and legislative pressure regarding insulin at the state and federal levels 2) The Inflation Reduction Act has wide-ranging implications on drug pricing 3) The removal of the cap for average manufacturer price for Medicaid rebates 4) FTC and Congressional investigations into pricing practices 6:54: PBMs (Pharmacy Benefit Managers) favor rebate contracting, which leads to higher drug prices by increasing kickbacks and despite passing on some of the benefits to employers or plan sponsors, PBMs keep a significant portion of the rebates and fees, causing higher prices to primarily benefit them 9:02: It’s not limited to insulin – other brand products are being sold directly to consumers with success 9:33: The retail biosimilar market is rapidly evolving, especially with the introduction of biosimilars competing against Humira. For example, the biopharma company Coherus recently set a price ceiling for its Humira biosimilar by selling it directly at an 85% discount through a cost-plus pharmacy 11:27: The biggest losers from lower list prices are PBMs, as they will no longer receive significant rebates. Patients are the biggest winners, as they will experience substantial savings when paying deductibles or coinsurance based on the lower retail prices of medications 12:52: Conner Mertens, Patient Advocate and Community Outreach Manager at GHLF, discusses how legislative, regulatory, and market pressures are shaking up the way drugs are priced in the United States 13:23: Dr. Popovian shares some final thoughts “Are we on the cusp of a new drug pricing paradigm?” - Full article available via the link below: https://progressivepolicyinstitute.medium.com/are-we-on-the-cusp-of-a-new-drug-pricing-paradigm-fdf611c009b3 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.

Join our hosts in this special compilation episode as they revisit some of the most informative and engaging segments from past episodes. They'll discuss drug formulary exclusions and their impact on patients, cash pharmacy models disrupting the industry, and the safety of biosimilars. Tune in to hear valuable insights and advice to help you better understand the ever-changing landscape of health care economics and policy. Among the highlights in this episode: 1:16: Dr. Popovian, Chief Science Policy Officer at GHLF, explains what drug formulary exclusions are 3:50: When patients are stable on a medication, formulary changes can force them to switch to a different treatment, and while the burden of these changes falls on the patients and their health care providers, Pharmacy Benefit Management Companies (PBMs) and insurers bear none of the risks 6:01: Dr. Popovian states that very little has been done to address drug formulary exclusions on the federal level and suggests that there should be some action taken to hold PBMs and insurers accountable for the consequences of their policies 7:07: Conner Mertens, Patient Advocate and Community Outreach Manager at GHLF, and Dr. Popovian discuss cash pharmacies and how their model can help patients save money on prescription drugs 10:47: “Biosimilars are absolutely safe and absolutely as effective as the brand biologics. FDA has approved these medicines; they go through rigorous research and development process[es]. It takes several years, several 100 millions of dollars to be able to bring these drugs to the market. There is a lot of science that goes behind it, there’s a lot of regulation, there’s a lot of scrutiny, there’s nothing to be worried about [concerning] these drugs” says Dr. Popovian 11:57: Conner explains the importance of looking for verified and peer-reviewed health information as well as trusting scientists and finding the right patient community 13:39: Conner shares information on the importance of advocacy and how to get involved with GHLF’s 50-State Network: “Sign up, tell us your story, and work with us to elevate the stories. We'll give you a megaphone,” he says. More information here: www.50statenetwork.org 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.

We are developing policy solutions based on innuendos, gossip, and erroneous modeling assumptions instead of actual data. To help patients with out-of-pocket costs, we need our policymakers to step up, do the brave thing, and improve drug affordability by implementing policies based on accurate data. In this episode, our hosts dive deeper into the important discussion surrounding transparency in drug pricing and discuss an article published in National Review and co-authored by Dr. Robert Popovian, Chief Science Policy Officer at GHLF. “The reason I authored the paper is because frankly, if you don't have transparency in the marketplace, and you don't have accurate collection of information and data, you're going to make poor policy decisions,” says Dr. Popovian. Among the highlights in this episode: 2:23: Why transparency is essential in the effort to collect accurate data 3:38: Dr. Popovian explains the complexity of determining how much pharmaceutical spending in the United States falls back into the pockets of pharmacy benefits managers (PBMs) 5:15: Why collecting accurate and precise data is essential to current Congressional efforts on improving and reforming the healthcare system 8:24: Dr. Popovian discusses the opposition that lawmakers and advocates are facing in their efforts on transparency 10:22: “Their arguments [PBMs’ arguments] fall flat because the data doesn't support it. If somebody is paying less for something, then why do you need to increase premiums?” says Dr. Popovian 11:52: Dr. Popovian shares his vision on what policymakers could do to bolster the transparency effort 14:18: Dr. Popovian shares some 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.

Over the last 20 years, the United States has made good progress in expanding access to care, yet millions of patients are still struggling to pay for their health care. In this episode, our hosts discuss current legislation advancements that help protect patient assistance programs concerning their out-of-pocket costs and how patients are being taken advantage of through insurer-initiated programs such as accumulators and maximizers. Our guest, JP Summers, Patient Advocate and Community Outreach Manager at the Global Healthy Living Foundation (GHLF), brings her patient perspective to the discussion having recently met with policymakers in Wisconsin. Among the highlights in this episode: 1:45: To date, 16 states have passed legislation protecting patient assistance programs 2:28: What are patient assistance programs? 3:25 “On average, out-of-pocket costs for the average patient have been going down in the United States for pharmaceuticals. They [patients] spend less in out-of-pocket costs for drugs today than let's say 10 or 20 years ago. But that's an average. And you have to be careful with averages because what happens is that there is a group of patients who are clearly being harmed by the current policies,” says Dr. Robert Popovian, Chief Science Policy Officer at GHLF 4:22: Dr. Popovian discusses why there is a group of patients who are struggling more than average with health care costs 5:46: The impact of accumulators and maximizers 7:23: Dr. Popovian details some of the legislative advancements made at the state level to better limit health care costs for patients 8:35: GHLF has built an interactive tool to evaluate whether state laws protecting patient assistance programs impact health care premiums: https://ghlf.org/copay-assistance-protection/ 9:29: Dr. Popovian explains the pushback from insurers and PBMs (pharmacy benefit managers) against reforms aimed at protecting patient assistance programs 11:02: JP Summers, a patient herself, explains the importance of being a patient advocate 11:44: JP Summers discusses her experience in getting patient assistance from the biopharmaceutical industry 12:23: “I feel that there was a lot of positive things being said [at a meeting JP attended with lawmakers in Wisconsin]. There were several patients besides myself there to advocate to share their personal stories. But what really caught my attention was the press. They were very involved. They were asking questions, and that tells me that they're invested in what we're looking to do in Wisconsin,” says JP 15:03: Dr. Popovian shares some 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.

2023 will be marked by the introduction of several biosimilars for Humira (adalimumab) on the U.S. market. While biosimilars can generate savings for the health system, many questions remain with decisions to be made by Pharmacy Benefit Managers (PBMs), and health insurers, all of which will impact patients themselves. In this episode, our hosts discuss the many implications of introducing competition to the marketplace. “Are we going to see lower prices? Are we going to see lower costs for patients? Those are… the questions that we're going to have to face in the next 12 months,” says Dr. Robert Popovian, Chief Science Policy Officer at GHLF. Our guest, Zoe Rothblatt, Associate Director of Community Outreach at GHLF, and person living with spondyloarthritis and Crohn's disease, joins the conversation to bring her patient perspective. Among the highlights in this episode: 1:35: “According to Amgen’s most recent Biosimilar Trends Report, biosimilars have saved the U.S. healthcare system roughly $21 billion over the past six years,” says Dr. Popovian 3:13: “Every time a biosimilar has been introduced into the market, the prices of the originator biosimilar drop… but also the [price of the] competitors, the biosimilars themselves,” says Dr. Popovian 4:54: The complexity of determining patient benefits from biosimilar introductions on the U.S. marketplace 7:08: The PBMs will benefit the most from biosimilar introductions to the market although the exact amounts are difficult to estimate due to the lack of transparency with pharmacy benefit design 9:18: “I'm hoping that we will see that some biopharmaceutical company that is developing biosimilars is brave enough to come out and slash its average wholesale price, or retail price significantly, and draw attention from policymakers, patient advocacy groups, patients, and providers, and for us to put pressure on the PBMs to do the right thing,” says Dr. Popovian 11:40: In the U.S., a biosimilar with an “interchangeable” designation can be substituted for its reference product at the pharmacy, without additional approvals from the prescribing physician, state law permitting 12:34: “If you are substituted for a biosimilar and you're currently on a brand name drug, by law pharmacists are required to inform you upfront about the substitution,” says Dr. Popovian 14:34: “Knowledge is so much power when you live with a chronic condition that often… it feels like [your disease is] controlling you and I always feel like a way to take some of that power back is through knowledge, and just learning more about my condition,” Zoe Rothblatt, Associate Director of Community Outreach at GHLF 14:48: Zoe discusses the prospect of drug switching from a patient’s perspective 16:58: Will biosimilars have similar support programs as biologics do, and how can patients look into them? 18:51: Dr. Popovian shares some final thoughts ****** For more information on the recent developments on biosimilars: You can find the full report by Patients Rising on the significant developments in the biosimilar space and the impacts on patient access, affordability, and quality of care here: https://accessandaffordability.org/wp-content/uploads/2023/01/2023-BioSimilars-Report-FINAL-01242023.pdf “AbbVie's Humira Gets a U.S. Rival, but Costs Could Stay High” - Jan 31, 2023 (Reuters) https://www.reuters.com/business/healthcare-pharmaceuticals/abbvies-humira-gets-us-rival-costs-could-stay-high-2023-01-31/ 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.

The COVID-19 pandemic led to an increased role of pharmacies in the overall immunization process, as they served as key sites of administration for COVID-19 vaccines. The IQVIA Institute for Human Data Science and the Global Healthy Living Foundation (GHLF) released a report today to better understand the trends in vaccine administration in the United States. “[The report is] built into the evidence of how we can address equity, where patients want to get their care, and what are the policy solutions that are important for us to pursue to make our healthcare system more equitable among everyone,” says Dr. Robert Popovian, Chief Science Policy Officer at GHLF. In this episode, Dr. Popovian discusses the key findings of the report, from the enhanced role of pharmacies in the overall immunization process in the U.S. to the differences in vaccine administration site by gender, income, or race. Among the highlights in this episode: 1:56: “90% of the U.S. population lives within a five-mile radius of a retail pharmacy,” says Dr. Popovian 3:23: What led to the partnership between IQVIA and GHLF in developing the report 4:28: A deeper look at the key factors and changes in vaccine administration that were analyzed 5:19: “What the trends tell us is that overwhelmingly adult patients received their [COVID] vaccines in a pharmacy after the pandemic took place… But we also saw some trends where there was an increased flu vaccination in the pharmacies in the last two flu cycles,” says Dr. Popovian 6:42: The trends in pediatric vaccine administration 7:31: Dr. Popovian discusses differences in vaccination trends as they pertain to race and ethnicity 8:20: “Minorities, whether they're racial minorities, or ethnic minorities, have a very limited access to health care compared to white Americans… So if we want to maintain access for patients who are minorities, we need to ensure that pharmacies, pharmacists, and pharmacy technicians at some point are able to administer all vaccines that a physician, for example, or a provider can administer in their office. That is critical,” says Dr. Popovian   9:58: Dr. Popovian elaborates on the policy recommendations that GHLF and IQVIA put forward in response to this report’s findings 12:45: Dr. Popovian shares some final thoughts 14:17: Please find below the two reports mentioned by Dr. Popovian Accessibility of adult immunizations in pharmacies compared to physician offices in low-income communities (Published on March 30, 2022) - Journal of the American Pharmacists Association (JAPhA)/GHLF: https://www.japha.org/article/S1544-3191(22)00094-2/fulltext Trends in Vaccine Administration in the United States (Published on January 18, 2023) - IQVIA Institute for Human Data Science/GHLF: https://www.iqvia.com/insights/the-iqvia-institute/reports/trends-in-vaccine-administration-in-the-united-states 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.

This week, our hosts sit down for a special ‘mailbag episode’ to answer questions from our listeners. They are joined by the podcast’s producer, Ben Blanc, Manager of Programs and Special Projects at GHLF, who moderates the discussion. Our hosts cover a wide variety of topics, including everything from patient spendings to vaccines. Our hosts also share more about their advocacy work and the importance of providing a platform for patients to be heard. “What we're trying to do is convey information to the everyday patient who's looking for answers… And that's what we take very seriously,” says Dr. Robert Popovian, Chief Science Policy Officer at GHLF. “Tell us your story and work with us to elevate the stories. We'll give you a megaphone. We'll make sure that legislators and folks that are at the tables of power… are going to hear your experience and hear you out for how their decisions impact your life, your care, and your health,” says Conner Mertens, Patient Advocate and Community Outreach Manager at GHLF. Among the highlights in this episode: 2:44: Dr. Popovian explains what the Mark Cuban Cost Plus pharmacies are and how patients can sometimes save money by paying for their pharmaceutical needs in cash instead of using their insurance cards 4:19: Dr. Popovian shares information on other similar pharmacies that are cash-based 5:23: Ali asks: “I hear that PBMs use the rebates to lower premiums. Is that true? Is that the reason why they don't want to share their rebates with patients?” 7:20: One major area of improvement when it comes to PBMs is transparency 8:24: Albert asks: “I have heard from health care professionals that natural immunity is far better than vaccination. Is that true?” 8:50: “The question is whether or not you should risk getting really sick or perhaps dying. And by taking the vaccine, you're avoiding that journey as a patient,” says Dr. Popovian 10:26: Dr. Popovian explains why the COVID vaccine is ineffective for some immunocompromised patients and why that should be a factor people in general should consider when debating on whether to get their COVID shot 11:48: Co-host Conner Mertens explains the importance of looking for verified and peer-reviewed health information as well as trusting scientists and finding the right patient community 13:32: Conner shares information on the importance of advocacy and how to get involved with GHLF’s 50-State Network: “Sign up, tell us your story, and work with us to elevate the stories. We'll give you a megaphone,” he says. More information here: www.50statenetwork.org 14:48: Dr. Popovian answers this recurring question asked by patients: Are biosimilars safe? 17:03: Dr. Popovian shares some 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 of the recording of this episode, control of the U.S. Senate and the U.S. House of Representatives has not yet been determined, which means that like many other issues the future of health care policy for the coming years remains unknown. Could a change in the balance of power mean changes to existing programs? What will be the focus of Congress in the coming years regarding health care? “At the end of the day, whether it's a Republican Congress, or a Democratic Congress or Senate or a governorship doesn't matter, because the patient issues of trying to get healthier, to be kept healthy, and to be able to access medicines and physicians and hospitals is the same. And both parties have a responsibility to patients to be able to get them better, quicker and faster,” says Dr. Robert Popovian. Among the highlights in this episode: 1:04: In our next episode, the hosts will be taking questions from our audience: to participate, send your questions or audio clips to [email protected] 2:11: Oklahoma, Georgia, Illinois, and Washington have all passed accumulator or maximiser bans 3:23: One of the main health care issues that should remain a priority in 2023 is out-of-pocket spending for patients 4:00: Dr. Popovian explains how PBMs (Pharmacy Benefit Managers) along with insurers are pocketing rebates that should instead benefit patients 5:17: The importance of transparency in health care policies, especially when it comes to PBMs and money and rebate circulation between health care stakeholders 6:36: According to Dr. Popovian, one of the best ways to address transparency and pharmaceutical company pricing is, “to create an environment whereby [the] pharmaceutical industry has a stake also in the outcomes of these drugs… So instead of just setting a price and getting paid for it, they need to make sure that these drugs work in the patients.” 7:51: What can the next Congress do to maintain and ensure innovation in the medical fields while also ensuring patients are going to benefit better and more? 8:51: Dr. Popovian reviews which health care priorities should be the focus at the state level 11:31: Co-host Conner Mertens describes what patients are paying attention to in the new era of governorships at both the state level and the federal level 12:20: “Health care is bipartisan. Access to health care is a bipartisan issue,” says Dr. Popovian 13:31: Dr. Popovian shares some 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 HealthcareSee omnystudio.com/listener for privacy information.

As the third winter of the coronavirus pandemic looms, more waves of COVID-19 are expected with few masking or social distancing restrictions in place. However, death and hospitalization rates are expected to be less severe compared to past pandemic winters largely due to vaccination drives, natural immunity, and the increasing availability of effective COVID-19 treatments. In this episode, Dr. Robert Popovian, Chief Science Policy Officer at the Global Healthy Living Foundation, provides an update on where we stand with protection and treatment against the virus and how patients, vaccinated or not, can work with health care professionals on getting themselves better care. “So it's not just about the vaccines, but how do we move forward as a community, as researchers, as patient advocates, as health care professionals,” says Dr. Robert Popovian. Among the highlights in this episode: 1:16: 2,566 Americans passed away from COVID in the last seven days 1:47: What we need to know about where we are in the pandemic right now 2:46: Vaccine limitations, and options and treatments available for patients whose condition doesn’t allow for vaccination 4:01: The limits of natural immunity antibodies, and the potential of antibody treatments 5:27: What are some of the biggest hurdles to bring successful new treatments for COVID-19 to the market? 7:20: Dr. Popovian provides an update on BCG vaccine studies and the potential ties to COVID-19 protection 9:33: With so much time, money, research and development put forward to find the best protection against COVID-19, what are some of the medical advancements that have been generated by the pandemic? 11:08: Where do we stand with nasal vaccination? 12:32: Dr. Popovian shares some 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.

Since its creation in 1992, the federal 340B Drug Pricing Program allows qualifying health care providers who treat low-income and uninsured individuals to buy discounted prescription drugs. The program has grown significantly - due to an increase in the number of eligible health care providers and the higher volume of drugs purchased through the program. However, as the program has grown beyond its original intent, there has been a series of legal challenges between drug manufacturers, providers, and federal policymakers. “In the U.S. we have at most about 80,000 pharmacies… that serve patients. 38,000 to 39,000, almost, are eligible for this 340B discount, which is primarily meant for uninsured patients. There is no way in the U.S. that… we have 50 percent of our population which is uninsured, nor is it a possibility that 50 percent of our population is low income,” says Dr. Robert Popovian, Chief Science Policy Officer at the Global Healthy Living Foundation. Among the highlights in this episode: 1:31: There are 38,000 contract pharmacies eligible for the 340B program in the U.S. 2:25: Why was this program created by the federal government and who does it serve? 4:15: How the 340B program drifted away from its original intent 6:58: “Currently, there are no criteria for these institutions that receive these 340B discounts to reinvest and provide, for example, charity care,” says Dr. Robert Popovian 8:01: What the shortcomings of the program mean for patients 9:09: The New York Times released an article demonstrating how some health care providers use the 340B program to turn a substantial profit at the expense of underserved communities Link: https://www.nytimes.com/2022/09/24/health/bon-secours-mercy-health-profit-poor-neighborhood.html 10:27: Is the program salvageable and how? 12:53: Dr. Popovian shares some 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.

In the United States, nine out of 10 prescriptions issued are for generic, instead of brand-name medications. While Pharmacy Benefit Managers negotiate drug prices on behalf of Americans, an increasing number of patients are choosing to bypass these intermediaries – as well as their insurance – altogether and pay for prescription drugs in cash instead. “Generics are supposed to be very low-cost alternatives to brand-name medicines, but you'd be surprised to hear what's going on here,” says Dr. Robert Popovian, Chief Science Policy Officer at the Global Healthy Living Foundation. “We need to become better consumers of health care. We are patients, but we need to also become consumers just like the way we consume anything. We need to become better at it,” says Dr. Popovian. Among the highlights in this episode: 1:36: 92% of all prescriptions dispensed in the U.S. are for generic medicines as opposed to only 8% of prescriptions for brand-name medicines 2:45: Patients bypassing their insurance to buy their prescription medicines: the role of cash pharmacies 4:13: What is ‘spread pricing’? 5:18: A study published by The Schaeffer Center at University of Southern California found that patients overpay for their prescription about 25% of the time 6:58: What are Pharmacy Benefit Managers (PBM) and what is their role in the health care system? 8:54: Dr. Popovian gives a personal anecdote of how it can be cheaper to pay in cash for a medical exam rather than paying via an insurance plan 10:10: A few tips on things patients should consider in order to pay less for their medications and other medical expenses 11:25: The Federal Trade Commission is conducting an inquiry into the competitive impact of contracting and other business practices of PBMs 13:04: Dr. Popovian shares some 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.

The Inflation Reduction Act (IRA), a sweeping climate, health care and tax bill was signed into law this summer. While the IRA undeniably brings some great wins for patients, there are some significant complexities to consider regarding the health care financing and delivery system in the U.S. and the many ways in which this bill will impact patients. Dr. Robert Popovian, Chief Science Policy Officer at the Global Healthy Living Foundation, delivers his analysis on the wins and misses of a bill as it relates to patients in the U.S. “What I wish the bill did… is one: address the issue of formulary exclusions, and number 2: to have the patients benefit from the negotiated prices at the pharmacy. This is unbelievably unfair for patients! And this happens both with Medicare and with commercial plans,” says Dr. Robert Popovian. Among the highlights in this episode: 1:09: Listener comment 1:58: The IRA sets a $2,000 annual cap for beneficiaries' Part D spending 3:32: Starting next year, seniors will not pay out-of-pocket costs for any of the vaccines covered under their Medicare Part D program and reasons why that’s important for them 5:01: How the federal government missed an opportunity to address the issue of patients paying their co-insurance or deductible based on the retail price of the medicine rather than prices negotiated by PBMs on their behalf 5:45: Another issue that is not addressed in the bill is the growing number of formulary exclusions 6:49: Is there any clinical or economic justification for excluding certain medications from national PBM formularies or is it just about profitability? 8:25: An analysis on the bill’s negative impacts regarding drug innovation 9:12: Which classes of medicines and disease areas might be negatively impacted by the bill 10:02: Further discussion of the main issues that the IRA could have addressed and the impact on patients 12:20: The IRA also brings some great wins for patients 13:22: Dr. Popovian shares some 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.

We are a nation of working, playing, and yes, even getting sick and injured at all hours of the day and night. That’s why it is so vital to have access to quality health care beyond the weekday, 9-to-5 paradigm that our system is set up for. In this episode, we explore a new study that points to the need for pharmacies and pharmacists to play a greater role in expanding access to health care. “Patients in low-income communities, especially seniors living in low-income communities, deserve better access to health care,” says Dr. Robert Popovian, Chief Science Policy Officer at Global Healthy Living Foundation. Among the highlights in this episode: 1:38: Listeners’ comment 2:12: A deep dive into a study Robert was part of 2:22: The bottom line: pharmacies can play a valuable role in expanding immunization access and other access to health care 3:01: How low-income patients have a disadvantage in accessing quality health care 3:43: Conner describes trips to the ER as a child during off-hours 3:57: Robert recalls having to take his daughters to the ER for earaches on weekends 4:46: How to improve access to health care 5:50: The fallacy that if you have health insurance, your health care automatically improves 7:42: “Pharmacists, physicians and nurses need to work collaboratively,” says Robert 8:38: We must maximize the health care professional’s skill sets 8:48: Surprise findings in Robert’s study 10:05: Policies need to be implemented to expand pharmacies or pharmacist’s ability to provide more health care services Read to the GHLF study, funded by the American Disease Prevention Coalition, discussed in this episode 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.

Biosimilars are equally as safe and effective as brand biologic medicines. Plus, they are less expensive, which means they save patients money. So why are there still hurdles for the U.S. health care system to adopt them? “Patients are saving money and the system is saving money. So what we need to do is introduce policies in the marketplace that really enhance the adoption of biosimilars,” says Dr. Robert Popovian, Chief Science Policy Officer at Global Healthy Living Foundation. Among the highlights in this episode: 1:19: Listeners’ comment 2:33: What is a biosimilar? 3:15: How a biologic drug is created 3:44: One benefit of biosimilars is lower priced for patients 4:26: Why biosimilars are used more in Europe than the U.S. 5:27: States have different laws overseeing the substitution of biosimilars 5:40: The FDA has approved biosimilars and has found them to be of equal safety, efficacy, and purity 6:05: Pharmacists have the power to substitute biosimilars 6:36: Patients must be informed when a biosimilar is being used 6:53: Why are biosimilars cheaper? 7:50: How patients benefit from biosimilars 8:30: Barriers to biosimilar adoption in the U.S. market 9:27: The “regulatory malaise” of the FDA 10:35: The future of biosimilars 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.

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.