At ACCESS US 2025, our live podcast The Future of Access features four experts exploring how to improve drug affordability and access while maintaining innovation. With rising drug costs, we ask: What bold models are emerging? We cover benefit design, PBMs, AI, evolving pharmacy models, and whether markets can act before regulation.

• Conference Overview
• Sarah Emond – ICER
• John O’Brien – National Pharmaceutical Council
• Annette Powers – Bristol Myers Squibb
• Ray Pressburger – Accenture

• Stuart Altman – Power, Politics and Universal Health Care
• PBMs
• 340B Program
• Copay Maximizers
• Net Price
• Lilly Direct
• Indolent Disease, PFS
• Concomitant Drug
• HIV & AZT
• Orphan Drugs
• Calquence vs Imbruvica
• Value-Based Contracts
• Outcome-Based Contracts
• Disruptive PBMs
• CostPlus Drugs
• Fair Access 2024
• Drug Rebates
• Drug Carve-Outs
• Dynamic Pricing
• Accelerated Approvals
• ICER Assessment

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Specialty drug benefit design isn't just one decision — it triggers a domino effect impacting employer and health plan costs, patient access, care delivery and patient cost-sharing. In this episode, we unpack PSG’s latest research on how employers and health plans are rethinking specialty strategies amid rising pressure: cost management as a top priority, movement toward rebate alternatives, shifting site of care models, and evolving approaches to affordability and utilization management. Our guests break down where the biggest shifts are happening, what’s still missing, and how smarter benefit design can create better outcomes across the healthcare system.

• PSG (Pharmaceutical Strategies Group)
• 2025 Trends in Specialty Drug Benefits Report
• Specialty Drugs
• Drug Utilization
• PBM (Pharmacy Benefit Manager)
• Copay Assistance (Maximizers & Accumulators)
• Drug Rebates
• Drug “Carve Outs”
• Value-Based Agreements
• Utilization Management
• Step Therapy
• Biosimilars
• Site-of-Care

Questions or comments?
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In this episode, we interview Brian Reid, the founder of Reid Strategic and the creator and editor of our favorite industry newsletter, the Cost Curve. Brian shares his journey to create the Cost Curve and how he navigates the onslaught of information to identify the most important issues of the day. We also get his take on what he calls the highest “importance-to-attention” healthcare stories, highlighting critical topics that are undercovered related to their significance. We also get the opportunity to understand his perspectives on the threats to innovation, the risks to patient affordability programs, and what all of us should be doing to be better healthcare consumers.

• Brian Reid- Reid Strategic
• Cost Curve Newsletter
• Martin Shkreli & Daraprim
• BioPharma Dive: Biotech and Pharma Industry News
• GLP-1s
• Net Price– “a drug’s net price equals the actual revenues that a manufacturer earns from a drug after rebates, discounts, and other reductions” Source: Drug Channels
• Armamentarium
• Pharmacy Benefit Managers (PBMs)
• Mark Cuban Pharmacy
• Psuedo-Generic Medication
• CVS Cordavis
• Quallent
• Nuvalia
• Biosimilars
• Lilly Direct
• Novo

• 340B Drug Pricing Program

• Copay maximizers
• AFPs

Questions or comments?
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In this episode, we explore the complex and often debated concept of value in prescription drugs. They discuss how different stakeholders—payers, manufacturers, providers, regulators, and patients—define value, and how methodologies like health technology assessments (HTA) and cost-effectiveness analyses shape drug pricing and access. With insights from leading experts, the conversation examines the controversies surrounding value-based pricing, including the role of real-world evidence, quality-adjusted life years (QALYs), and innovation incentives. Can we strike a balance between affordability, innovation, and patient access? And what does the future hold for value-based drug pricing in the U.S.? Tune in for a deep dive into one of the most critical issues in healthcare today.

• Daniel Ollendorf, Chief Scientific Officer and Director of HTA Methods and Engagement

• Lou Garrison, Professor Emeritus at University of Washington CHOICE

• Institute for Clinical and Economic Review (ICER)
• FDA
• GLP-1 Drugs
• Medicare
• Biosimilars
• Generics Versus Biosimilars
• PBMs (Pharmacy Benefit Managers)

• 340B Drug Pricing Program

Questions or comments?
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In this episode, we interview Sarah Emond, MPP, President and CEO of the Institute for Clinical and Economic Review (ICER). Sarah joined ICER over 15 years ago as Chief Operating Officer and was appointed to lead the organization following the retirement of Dr. Steven Pearson. Sarah outlines her vision for ICER and the priorities for strengthening the framework and collaboration to achieve their mission of evaluating the comparative effectiveness of new medicines. Sarah also discusses ICER’s efforts to expand patient engagement and the evaluation of payers to ensure fair access to medicine.

• Sarah Emond, MPP, President and CEO, Institute for Clinical Economic Review (ICER)

• Dr. Steven Pearson, Founder, President, Institute for Clinical and Economic Review (ICER)

• Barriers to Fair Access Report

• Gross-to-Net Bubble

• Pharmacy Benefit Managers (PBMs)

• Humira biosimilars

• Institute for Clinical and Economic Review (ICER)

• 340B Drug Pricing Program

Questions or comments?
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In this episode, we sit down with Stacie Dusetzina, Ph.D., a leading health economist from Vanderbilt University Medical Center to discuss the critical healthcare and policy trends shaping 2025. From shifts in federal leadership to the evolving impact of the Inflation Reduction Act, our guest provides expert insights on what to expect in drug pricing, health insurance, and patient access in the coming year. We explore how the public and private sectors are addressing affordability challenges and highlight innovative approaches to improve access to essential medications. With a focus on the future, this conversation offers a thoughtful outlook on the policies and market dynamics set to redefine healthcare in 2025.

Stacie Dusetzina, Ph.D., Vanderbilt University

Vanderbilt University Medical Center

A primer on copay accumulators, copay maximizers, and alternative funding programs

IRA

Medicare Part D

Pharmacy Benefit Managers (PBMs)

Medicaid

CMMI’s Medicaid group negotiation

COVID-19

Statins

PCSK9 inhibitors

Imatinib

340B Drug Pricing Program

Questions or comments?
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In our second of three episodes in conjunction with members of ACCESS Forum, we engage with leading experts to uncover the multifaceted challenges of access and affordability in cell and gene therapies. Our conversation investigates how these treatments' innovative yet complex landscape leads to challenging regulatory pathways, pricing models, and reimbursement strategies.

Alicia Silver, MPP, Head of Cell and Gene Therapy, ADVI Health
Eric Faulkner, President, Passage Health Associates
ADVI Health
Alliance for Regenerative Medicine
ARPA-H
Bespoke Gene Therapy Consortium
Blue Bird Bio
Blue Cross Blue Shield
Medicare DRG Rates
NICE (National Institute for Health and Care Excellence)
Novartis
Passage Health Associates
REMS Program
Single Case Agreements
Spark Therapeutics

Medical terminology referenced in this episode:

• Alzheimer's
• Aspheresis
• CAR T therapy
• Hemophilia
• Hepatitus C
• Luxturna
• Metachromatic leukodystrophy
• Myeloablative Conditioning
• Sickle Cell Disease
• SMA treatment
• Spinraza
• Vaso Occlusive Crises
• Zolgensma

In this episode, we sit down with leading Market Access experts and members of ACCESS Forum to compare and contrast the drug pricing and access systems worldwide and the US. Our discussion delves into the distinct approaches taken by government vs. private markets, examining how regulatory environments, pricing controls, and reimbursement processes impact patient access to innovative therapies. We explore the challenges each approach faces, from cost pressures to affordability and access, and how they balance the interests of patients, governments, and pharmaceutical companies. Join us for a deep dive into how the global healthcare landscape is evolving and what lessons can be learned.

Nikos Maniadakis, Ph.D., Professor, Health Management & Policy, University of West Attica
Kimberly Baldwin, Senior Vice President, Value & Access, Ipsen Biopharmaceuticals
Fauzea Hussain, Vice President, Public Policy, McKesson
CMS (Centers for Medicare & Medicaid Services)
European Medicines Agency
Health technology assessments (HTAs)
IRA (Inflation Reduction Act)
Medicaid
Medicare
National Institute of Clinical Excellence (NICE)
NCCN guidelines
P&T committee (Pharmacy and Therapeutics Committee)
PAP (Patient Assistance Program)
Part B (Medicare)
Part D (Medicare)
Pharmacy Benefit Managers (PBMs)
Quality-Adjusted Life Years
Tricare
Veterans Administration
Medical terminology referenced in this episode:

• Cell and gene therapies (CGT)
• Insulin
• Orphan drugs

Questions or comments?
Email us at comments@prescriptionforbetteraccess.com.