This week, ICER launched a new podcast series: “A Prescription for Fair Drug Pricing.”
In the series, neurologist Dr. Jason Crowell sits down with ICER’s President Dr. Steve Pearson to pry open the black box of US drug pricing and to wrestle with each of the financial and ethical tensions that undergird our current medical infrastructure. They will dive into why prescription drugs are so expensive in our country, uncover the tradeoffs that American patients face when they can’t afford drugs, explore how other countries use clinical data to ensure a drug’s price reflects how well it works, and recommend individual steps that all of us can take — from physicians to patients to policymakers — to achieve both fair pricing and fair access across the US health system.
In particular, this is a must-listen for physicians who are concerned that prescription drugs not only can have health side effects, but financial side effects, too.
We’ll be releasing a new episode each week for a limited time. Subscribe now on Apple, Google, Spotify, or wherever you typically get your podcasts. Or you can come back to this webpage each week and click on the latest episode.
- Trailer (10/29/2020): COMING SOON: A Prescription for Fair Drug Pricing
- Episode 1 (11/2/2020): Financial Toxicity
In the first episode of the series, we discuss the problem of skyrocketing drug prices and the harmful effects they have on our patients. Not only must patients decide what their medications are worth to them, but payers introduce barriers that limit patients’ access to care. More broadly, we also review the ways that drug prices affect all of our society, via rising insurance premiums and taxes.
- Episode 2 (11/9/2020): Tradeoffs
Whenever we choose to spend on one thing instead of another, we pay an opportunity cost. And, just like in life, healthcare is an either/or decision. Patients face decisions about how to spend their money on healthcare, just like insurance companies and governments must decide how to spend their finite dollars on healthcare.
- Episode 3 (11/16/2020): From Pharma to the Medicine Cabinet: Who Manages the Drugs?
Drugmakers, pharmacies, wholesale distributors, physicians, pharmacy benefit managers—the world of prescription drugs can seem extraordinarily complex. In episode 3, we disentangle this spider’s web and answer the question: who decides how much our patients pay at the pharmacy?
- Episode 4 (11/23/2020): What’s in it for Me? Incentives for Making New Drugs
What motivates a drug manufacturer to create a drug in the first place? How do firms stretch the limits of these incentives? In episode 4, we discuss how the “ecosystem” of drug development in the US has led to truly remarkable innovation but also runaway drug prices.
- Episode 5 (11/30/2020): Who Sets a Drug’s Price, and How Do We Know It’s Fair?
In episode 5, we review the variety of approaches one might take to settle on what the “fair” price of a drug should be. The most logical solution to this problem is to price the value—set a drug’s price commensurate with the clinical benefits it provides.
- Episode 6 (12/7/2020): Cost-Effectiveness 101
If a “fair” price rewards the benefit a drug provides, how do we quantify those benefits—both to the patient and, more broadly, to society? Cost-effectiveness analysis is the tool we can use to quantify a drug’s benefit in a way that can be compared across treatments.
- Episode 7 (12/14/2020): What else makes a drug “valuable”?
If we only look at the benefits that a drug provides to those patients who take it, we may underestimate its value by ignoring the benefits it provides to the broader healthcare system. In episode 7, we reveal some of the other reasons that can make a drug more valuable than first meets the eye.
- Episode 8 (12/21/2020): How doctors can be a part of the solution
What can physicians do in their hospitals and communities to advocate for fair drug prices? What questions should we ask our patients to assess for financial toxicity? In the final episode of the season, we discuss the steps doctors can be taking now to help solve the drug pricing problem.
Jason Crowell, MD, is a neurologist specializing in the evaluation and treatment of patients with Parkinson’s disease and other movement disorders. A native of Florence, Alabama, he received his undergraduate degree in mathematics from the University of Alabama and medical degree from the University of Alabama School of Medicine. He completed a neurology residency at the University of Virginia, where he served as chief resident, followed by fellowship training in movement disorders and deep brain stimulation at the University of Alabama at Birmingham. He is currently a neurologist at Beth Israel Deaconess Medical Center and a Jerome H. Grossman, MD, Graduate Fellow at Harvard Kennedy School where he is studying healthcare policy. He is also the Deputy Editor of the Neurology Minute Daily Briefing, a daily news update for neurologists produced by the American Academy of Neurology.
Steven D. Pearson, MD, MSc, is the Founder and President of the Institute for Clinical and Economic Review (ICER), an independent non-profit organization that evaluates the evidence on the value of medical tests, treatments, and delivery system innovations to encourage collaborative efforts to improve patient care and control costs. Dr. Pearson is also a Lecturer in the Department of Population Medicine at Harvard Medical School. He received his medical degree from UCSF, completed an internal medicine residency and research fellowship at Brigham and Women’s Hospital, and obtained a Master of Science Degree in Health Policy and Management at the Harvard School of Public Health. An internist, health services researcher, and ethicist, Dr. Pearson has served in many advisory and leadership roles in academia and government. In 2004 he was awarded an Atlantic Fellowship from the British Government and chose to serve as Senior Fellow at the National Institute for Healthand Clinical Excellence (NICE). Returning to the United States in 2005 he was asked to serve during the George W. Bush Administration as Special Advisor, Technology and Coverage Policy, at the Centers for Medicare and Medicaid Services, and also accepted an appointment as Visiting Scientist in the Department of Bioethics at the National Institutes of Health, a position he maintained from 2005-2019. In other roles, Dr. Pearson has also served as a Board Director of HTAi, the international society of health technology assessment agencies, and as the Vice Chair of the Medicare Evidence Development and Coverage Advisory Committee (MedCAC). Dr. Pearson’s ongoing academic and policy work combines efforts in comparative effectiveness research, health policy, and bioethics. His publications include over 150 peer-reviewed articles and commentaries on the role of evidence in the health care system, and the book No Margin, No Mission: Health Care Organizations and the Quest for Ethical Excellence, published by Oxford University Press.