Prescription for Better Access

Hosted by Mark Hansan and Dr. Scott Howell

Technology Health Fitness ScienceInterviews guests

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Episodes

Latest episode

Jul 2026

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EN-US

About the show

With pharmaceutical and biotech manufacturers launching more high-cost specialty drugs and the insurance industry increasing the use of more restrictive barriers to access, those who need these medicines—the patients themselves—are caught in the middle, not only shouldering the cost of higher copays and deductibles, but for many, rationing or even abandoning treatment altogether. While manufacturers invest in programs to help navigate the challenges impeding access and affordability, the entire healthcare industry can agree -- the status quo is unsustainable. There has to be a better way. And two industry veterans have joined forces to co-host a new interview-focused podcast to help shape the future of patient access and affordability.

Listen to episodes

39 recent

July 15, 202637 min

An Interview with Kathryn Carey, President, Optum Rx Pharmacy Benefit Manager

In this episode, we sit down with Kathryn Carey, President, Optum Rx Pharmacy Benefit Manager , to discuss one of the most significant shifts underway in the pharmacy benefit management industry. We explore their new transparent, fixed-fee model, what is driving it, and what it actually means for patients, providers, pharmacies, and manufacturers. We also examine Optum Rx’s digital tools and how they are reshaping the prescribing experience, and the broader effort to reduce friction in patient access. At its core, this is a conversation about whether these changes are early stages of a new model for how medicines are accessed and paid for in the United States. Optum Rx New PMPM Model PBMs Explained PreCheck Prior Authorization PreCheck MyScript Shop MyScript Price Edge Price Wise Savings IQ Critical Drug Affordability Program Questions or comments? Email us at comments@prescriptionforbetteraccess.com . Find us on social media! Follow us on X , LinkedIn , YouTube and Threads .

May 20, 202644 min

Inside PhRMA: An Interview with Stephen Ubl, President and CEO, PhRMA

In this episode, we interview Stephen Ubl, President and CEO of PhRMA, to discuss what is happening across the industry at a time of significant change. We talk about biopharma’s continued commitment to innovation, what member companies are doing to help patients access medicines more directly, and how new tools from the organization are supporting patient affordability. We also cover the impact of policies like the IRA and MFN, along with the growing focus on PBM reform and other structural challenges in the system. It is a wide-ranging conversation about where the industry is headed and what it will take to ensure the country continues to lead the world in bringing new treatments to patients in need. Steve Ubl, CEO of PhRMA PhRMA PhRMA Leadership Transition PhRMA 3 Announcements Medicine Assistance Tool (MAT) America’s Medicines Jim Collins, Building Companies to Last FTC Settlement with Express Scripts IQVIA Data: Prior Authorization and Associated Delays and Denials of Branded Medication Dispensation Most Favored Nation Drug Pricing 340B Drug Pricing Program New York Times: How a Hospital Chain Used a Poor Neighborhood to Turn Huge Profits Hatch-Waxman Act Questions or comments? Email us at comments@prescriptionforbetteraccess.com . Find us on social media! Follow us on X , LinkedIn , YouTube and Threads .

March 30, 202638 min

Spotlight on Rare Disease: A Conversation with Alexander Hardy, President and CEO, BioMarin

In this episode, we sit down with Alexander Hardy, President and CEO of BioMarin, to talk about his path to leading one of the world's premier rare disease companies. Alexander reflects on his experience across small molecules, biologics, oncology, and rare diseases, and how his work in access and patient services has shaped his thinking about leadership. We discuss the policy environment coming out of Washington — including the IRA and other pricing reforms — and how those factors influence long-term innovation and investment decisions. We also explore the real-world challenges facing rare disease patients, employer concerns about high-cost therapies, and what needs to change over the next five years to improve access and affordability. Alexander Hardy PathoGenesis Eli Lilly | GSK | Novartis Genentech — Access Solutions BioMarin — Rare Connections AUTHrd Act of 2026 (part of the EPIC Act, HR 1492/S832 ) — pending before Congress Health Technology Assessments in Rare Diseases Questions or comments? Email comments@prescriptionforbetteraccess.com . Find us on X , LinkedIn , YouTube , and Threads .

March 10, 202641 min

A Legal Perspective on PBM Reform and FTC Enforcement

In this episode of Prescription for Better Access , we’re joined by William (Bill) Sarraille, a legal expert on drug access and reimbursement. He discusses two developments shaping the pharmacy benefit landscape: the FTC’s enforcement action involving Express Scripts and PBM reforms in the Consolidated Appropriations Act of 2026. Bill explains what these policy changes could mean for benefit design, drug coverage, employer-sponsored plans, and transparency in the PBM market. We also explore potential impacts on formularies, utilization management, contracting practices, and patient out-of-pocket costs, along with possible unintended consequences for employers, manufacturers, and patients seeking timely and affordable access to medicines. William (Bill) Sarraille, University of Maryland School of Law LinkedIn Pharmacy Benefit Managers (PBMs) FTC Settlement 2024 Administrative Complaint Cigna Healthcare Fair Market Value in Healthcare Consolidated Appropriations Act of 2026 Part D Plan PBMs No Longer Profit From Rebates But Plans Benefit – Pink Sheet TPA (Third Party Administrators) DOL Proposal Copay Accumulators and Maximizers Amicus Brief, HIV and Hepatitis Institute Questions or comments? Email us at comments@prescriptionforbetteraccess.com . Follow us on X , LinkedIn , YouTube , and Threads .

January 9, 202639 min

From Policy to the Employer Front Lines: A Conversation with Dan Mendelson of Morgan Health

Employers sit at the center of the U.S. health system as the primary funders of coverage for more than 150 million Americans, yet they struggle with rising costs, fragmented vendors, and uneven outcomes. In this episode, we talk with Dan Mendelson, MPP, CEO of Morgan Health at JPMorgan Chase & Co. and Founder and former CEO of Avalere Health. We explore his journey from health policy to now leading Morgan Health’s efforts to improve the quality, affordability and equity of employer-sponsored healthcare. We’ll learn how Morgan Health evaluates the employer market, where they’re placing investment bets, and how they are testing new care models inside JPMorgan’s own benefit. We then turn to Washington: Dan shares his take on the policy currents that matter most for employers and innovators over the next few years. Dan Mendelson, CEO, Morgan Health LinkedIn Forbes Contributions Avalere Health Balanced Budget Act of 1997 Jamie Dimon , Chairman and CEO of JPMorgan Chase & Co. Continuation of Health Coverage (COBRA) Vera Whole Health, Central Ohio Primary Care Centivo Embold Health Cigna Healthcare Quantum Health Thyme Care 60 Minutes, “$2 million gene therapy could save her baby’s life. But insurance wouldn’t pay” PBM Alternatives Pharmacy Benefit Managers (PBMs) Individual Coverage Healthcare Reimbursement Accounts (ICHRA) Questions or comments? Email us at comments@prescriptionforbetteraccess.com . Find us on social media! Follow us on X , LinkedIn , YouTube and Threads .

November 25, 2025

Understanding the Impact of the Accelerated Approvals Program

The FDA’s Accelerated Approval Program (AAP) aims to bring promising, potentially life-saving medicines to patients sooner by allowing approvals based on surrogate endpoints while requiring timely confirmatory evidence. In this episode, we speak with Bridget Doherty, MPH, MS (Johnson & Johnson Innovative Medicine), and Jeff Allen, PhD (Friends of Cancer Research). Bridget discusses her team’s review of the AAP’s real-world impact, showing that hundreds of thousands of meaningful life-years have been gained for patients. Jeff shares findings from work strengthening biomarkers as reliable surrogate endpoints—helping define when increased speed can still preserve scientific rigor. We also explore the core access challenge: how payer coverage and utilization management help or hinder patients the AAP is designed to serve. We close with practical policy steps to ensure that earlier regulatory access truly leads to better outcomes for people who need treatments most. Bridget Doherty, MPH, MS , Johnson & Johnson Jeff Allen , Friends of Cancer Research J&J Center for U.S. Healthcare Policy Research Friends of Cancer Research Accelerated Approvals in Oncology Tracker Drug Development Dashboards 30 Years of Accelerated Approval: Data-Driven Insights Analysis of FDA Biomarker Qualification Program Original JNCCN Study How Gleevec Transformed Leukemia Treatment Immunotherapy Surrogate Endpoints Confirmatory Trials Years Gained from the FDA Accelerated Approval Program (2024) Circulating Tumor DNA (ctDNA) ctMoniTR Project Questions or comments? Email us at comments@prescriptionforbetteraccess.com . Find us on social media: X , LinkedIn , YouTube , and Threads .

October 17, 2025Episode 32

Charting a Path Forward for More Patient-Centered Value Assessment Methods

In this episode, we talk with Richard Xie , Senior Health Economist at RA Capital, and Gunnar Esiason , Senior Director of Patient Engagement at Raven (RA Capital Ventures), about value frameworks in pharma. We unpack how Generalized Cost-Effectiveness Analysis (GCEA) builds on traditional Cost-Effectiveness Analysis (CEA) and differs from ICER ’s model. The conversation explores what these approaches mean for pricing, access, and patient voice—especially in rare and high-innovation settings. Through the Cidara CD388 flu drug case, we discuss how assumptions shape value and trade-offs from manufacturer and patient perspectives. The episode highlights how evidence, incentives, and outcomes align—or conflict—in today’s system, and what reforms could better connect value frameworks to affordability and equitable access. Richard Xie, Senior Health Economist, RA Capital Management Gunnar Esiason, MBA, MPH, Senior Director, Head of Patient Engagement and Patient-Centered Innovation, Raven (RA Capital Ventures) Patient-Centered Value Assessment Models Episode 26: Sarah Emond, ICER Peter Kolchinski, The Great American Drug Deal NICE (UK) CDA (Canada) Australia CHAP Trikafta ICER Report on Cystic Fibrosis No Patient Left Behind GCEA Calculator Boomer Esiason Foundation Aurora Biosciences Most-Favored-Nation Drug Pricing Order Questions or comments? Email comments@prescriptionforbetteraccess.com . Follow us on X , LinkedIn , YouTube , and Threads .

September 18, 2025Episode 31

IRA, Part D Redesign & the Future of Drug Access: A Conversation with Jon Blum, Former CMS Principal Deputy Administrator and COO

In this episode, former CMS official Jon Blum reflects on the evolution and impact of the IRA’s drug provisions—from foundational drivers and political trade-offs to how 2026 Part D redesign and the M3P cost-smoothing program are reshaping access. We explore why M3P adoption remains limited, how CMS is monitoring plan behavior around negotiated pricing, and what shrinking standalone Part D options may mean for patients, especially in rural areas. Jon also challenges the “blame game” in Washington—emphasizing the systemic incentives behind each actor—and shares his own prescription for equitably balancing drug affordability, innovation, and policy integrity, including thoughts on MFN and future reform paths.

July 17, 2025Episode 30

The Future of Access, a Live Podcast Recording from the ACCESS US 2025 Conference

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 Questions? Email comments@prescriptionforbetteraccess.com . Follow us on X , LinkedIn , YouTube , and Threads .

May 21, 2025Episode 2950 min

The Domino Effect: 2025 Trends in Specialty Drug Benefits Report

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? Email us at comments@prescriptionforbetteraccess.com . Find us on social media! Follow us on X , LinkedIn , YouTube and Threads .