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: rpopovian@ghlf.org

Conner Mertens, Patient Advocate and Community Outreach Manager at GHLF: cmertens@ghlf.org

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to healthcarematters@ghlf.org

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

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: <a href="mailto:rpopovian@ghlf.org">rpopovian@ghlf.org</a>
Conner Mertens, Patient Advocate and Community Outreach Manager at GHLF: <a href="mailto:cmertens@ghlf.org">cmertens@ghlf.org</a>
We want to hear what you think. Send your comments, or a video or audio clip of yourself, to <a href="mailto:healthcarematters@ghlf.org">healthcarematters@ghlf.org</a>
Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

Welcome to Healthcare Matters! In this podcast, we talk about 'matters' in healthcare and why it matters to you! 

Our host Ben Blanc will speak with our talented Chief Science Officer Robert Popovian. And together, we will take on some pretty complex topics and distil them, so everyone can understand what is happening in the world of healthcare. 

The show is brought to you by the Global Healthy Living Foundation. 

www.ghlf.org

Welcome to Healthcare Matters! In this podcast, we talk about 'matters' in healthcare and why it matters to you! 
Our host Ben Blanc will speak with our talented Chief Science Officer Robert Popovian. And together, we will take on some pretty complex topics and distil them, so everyone can understand what is happening in the world of healthcare. 
The show is brought to you by the Global Healthy Living Foundation. 
www.ghlf.org

Healthcare Matters

A podcast that pulls back the curtain to help you make sense of complex healthcare economics and policy issues. Our goal is to help simplify the complexities in healthcare economics and policy issues for you.

The podcast is part of the Global Healthy Living Foundation Podcast Network and hosted by Dr. Robert Popovian, Chief Science Policy Officer at GHLF and Ben Blanc, Associate Director, Digital Production and Engagement at GHLF.

A podcast that pulls back the curtain to help you make sense of complex healthcare economics and policy issues. Our goal is to help simplify the complexities in healthcare economics and policy issues for you.
The podcast is part of the Global Healthy Living Foundation Podcast Network and hosted by Dr. Robert Popovian, Chief Science Policy Officer at GHLF and Ben Blanc, Associate Director, Digital Production and Engagement at GHLF.

S3, Ep 2- A Failed Promise: Why Are Patients Overpaying for Generic Medications?

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: rpopovian@ghlf.org

Ben Blanc, Associate Director, Digital Production and Engagement at GHLF: bblanc@ghlf.org

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 podcasts@ghlf.org

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

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: <a href="mailto:rpopovian@ghlf.org">rpopovian@ghlf.org</a>
Ben Blanc, Associate Director, Digital Production and Engagement at GHLF: <a href="mailto:bblanc@ghlf.org">bblanc@ghlf.org</a>
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 <a href="mailto:podcasts@ghlf.org">podcasts@ghlf.org</a>
Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

S5, Ep 10- Decoding the Advisory Committee on Immunization Practices' Vaccine Guidelines: What Patients and Providers Need to Know

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: rpopovian@ghlf.org

Ben Blanc, Associate Director, Digital Production and Engagement at GHLF: bblanc@ghlf.org

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 podcasts@ghlf.org

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

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:
-       <a href="https://www.linkedin.com/feed/update/urn:li:activity:7246621458792165376/">https://www.linkedin.com/feed/update/urn:li:activity:7246621458792165376/</a>
-       <a href="https://www.linkedin.com/feed/update/urn:li:activity:7245454053596422144/">https://www.linkedin.com/feed/update/urn:li:activity:7245454053596422144/</a>
To read the full article from The Wall Street Journal, visit: <a href="https://www.wsj.com/opinion/federal-trade-commission-pharmacy-benefit-managers-insulin-43b0a974?mod=opinion_lead_pos1">https://www.wsj.com/opinion/federal-trade-commission-pharmacy-benefit-managers-insulin-43b0a974?mod=opinion_lead_pos1</a> 
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: <a href="mailto:rpopovian@ghlf.org">rpopovian@ghlf.org</a>
Ben Blanc, Associate Director, Digital Production and Engagement at GHLF: <a href="mailto:bblanc@ghlf.org">bblanc@ghlf.org</a>
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 <a href="mailto:podcasts@ghlf.org">podcasts@ghlf.org</a>
Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

S5, Ep 9- Policy & Politics: Decoding the Political Landscape of Health Care

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: rpopovian@ghlf.org

Ben Blanc, Associate Director, Digital Production and Engagement at GHLF: bblanc@ghlf.org

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 podcasts@ghlf.org

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

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: <a href="https://ghlf.org/copay-assistance-protection/">https://ghlf.org/copay-assistance-protection/</a>
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: <a href="https://oversight.house.gov/release/chairman-comer-calls-on-pbm-executives-to-correct-hearing-testimony/">https://oversight.house.gov/release/chairman-comer-calls-on-pbm-executives-to-correct-hearing-testimony/</a>
Contact Our Hosts
Dr. Robert Popovian, Chief Science Policy Officer at GHLF: <a href="mailto:rpopovian@ghlf.org">rpopovian@ghlf.org</a>
Ben Blanc, Associate Director, Digital Production and Engagement at GHLF: <a href="mailto:bblanc@ghlf.org">bblanc@ghlf.org</a>
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 <a href="mailto:podcasts@ghlf.org">podcasts@ghlf.org</a>
Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

S3, Ep 2- A Failed Promise: Why Are Patients Overpaying for Generic Medications?

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