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VT's Grumpies and Lady Discuss the U.S. Biotech Policy Landscape

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Read our MFN preprint: https://vitaltransformation.com/2026/02/preprint-new-research-the-impact-of-mfn-on-oncology-and-hematology-treatments/

In this episode of the Vital Health Podcast, host Duane Schulthess speaks with two Vital Transformation colleagues on biopharma pricing policy, market access, and innovation risk:

They discuss what our new MFN pricing modeling suggests about drug viability, how IRA incentives appear to be reshaping oncology and orphan drug development, why Medicare Advantage and commercial coverage can create administrative friction and delays compared with traditional Medicare, how 340B opacity and consolidation affect the value chain, and what these pressures could mean for insurance premiums, investment, and future innovation.

Key Topics:

  • MFN Modeling: Net present value analysis, benchmark-country pricing, launch viability, and market uncertainty.
  • Effects of IRA on Trials: Oncology pullback, small-molecule exposure, orphan drug pressure, and suspended trials.
  • Coverage Friction: Medicare Advantage burden, prior authorization delays, formulary shifts, and referral slowdowns.
  • 340B Transparency: Vertical integration, hospital consolidation, opaque pricing flows, and revenue pressure.
  • Innovation Outlook: Premium increases, global competition, intellectual property risk, and future access concerns.

Opinions expressed are those of the speakers.

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Vital Health Podcast

Duane Schulthess, Managing Director of Vital Tran…
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