In this episode of Healthcare Matters, hosts Dr. Robert Popovian and Ben Blanc are joined by Peter Pitts, former FDA Associate Commissioner and President of the Center for Medicine in the Public Interest. Together, they unpack the sweeping personnel cuts at HHS, ongoing instability at the FDA, and how it all may threaten the future of drug innovation in the U.S. With delays in leadership appointments, policy misalignment across agencies, and increased uncertainty from pricing reforms like the Inflation Reduction Act, pharmaceutical companies may hit pause—and patients may pay the price.

Tune in for a timely discussion on how chaos in science policy reverberates through clinical innovation and patient access.

Among the highlights in this episode:

03:09: Peter Pitts shares his FDA background and warns against viewing staff consolidation through a purely numerical lens—emphasizing the nuance of function and legal responsibility

04:07: Peter breaks down FDA’s structure, clarifying that the majority of its 18,000 staff are non-political, career public health officials—not industry influenced

06:33: Peter explains that gutting senior leadership slows down innovation and drug approvals, as regulatory coordination is weakened

07:42: Peter details ongoing leadership instability across FDA’s key centers (drugs, biologics, devices), and notes the loss of progressive voices like Dr. Peter Marks and Dr. Patrizia Cavazzoni

08:32: Dr. Popovian adds that short- and long-term uncertainty in biopharma is significant, especially in oncology—a therapeutic area critical to innovation and patient survival

09:53: Peter warns that chaos and unpredictability undercut investor confidence, which could delay development in oncology, gene therapy, and rare diseases

11:10: Dr. Popovian reinforces that cancer care is now chronic care, and disruptions in FDA operations could rob patients of critical time and treatment options

11:42: Peter highlights misalignment between FDA and CMS, especially when CMS questions the validity of FDA-approved data—jeopardizing reimbursement

12:43: Dr. Popovian and Peter urge alignment between FDA and CDC guidance, citing conflicting vaccine messaging as a source of confusion for patients and providers

13:37: Peter underscores the need for improved communication and coordination between public health agencies to rebuild trust

15:06: Dr. Popovian raises concerns that instability and underappreciation will deter top scientists from public service roles at agencies like the FDA

17:21: Dr. Popovian explains that pharmaceutical companies are delaying R&D and trial investments due to regulatory uncertainty

18:35: Peter adds that companies may also pause research into new uses for existing drugs—despite their public health value—due to unclear FDA pathways

19:21: Dr. Popovian discusses how the Inflation Reduction Act (IRA) further complicates investment decisions, creating a “perfect storm” with FDA uncertainty

23:19: Ben emphasizes that policy uncertainty delays hope for patients awaiting new treatments—and that public accountability is more important than ever

24:03: Dr. Popovian shares some final thoughts

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: rpopovian@ghlf.org

Ben Blanc, 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.

See omnystudio.com/listener for privacy information.

Are well-intentioned vaccine policies making access harder instead of easier? In this episode of Healthcare Matters, hosts Dr. Robert Popovian and Ben Blanc unpack a new report from the Global Healthy Living Foundation (GHLF) on how Shared Clinical Decision Making (SCDM) and risk-based recommendations may unintentionally reduce adult vaccination rates—particularly in underserved communities. From real-world data showing a 10 percent drop in pneumococcal vaccine uptake to sharp disparities in meningitis coverage, the findings are hard to ignore.

Tune in as we explore how these policies may create confusion, widen health inequities, and hinder access—and what can be done to fix it.

Among the highlights in this episode:

03:00: Dr. Popovian explains what Shared Clinical Decision Making (SCDM) is and the role of Advisory Committee on Immunization Practices (ACIP), noting the challenges of expecting time-strapped physicians to hold complex conversations with patients

06:00: Dr. Popovian expresses concern that SCDM can lead to decreased immunization rates due to misaligned expectations and informational imbalance

07:15: Dr. Popovian cites a 10 percent drop in pneumococcal vaccine uptake after its recommendation changed from “routine” to SCDM, and notes a striking difference in coverage between the quadrivalent meningococcal vaccine (60.8%) and MenB (11.9%) meningitis vaccines, the latter being subject to SCDM

10:03: Dr. Popovian explains that pharmacists and clinic-based providers often lack access to patients’ full medical records—making risk-based decisions difficult in practice

13:47: Dr. Popovian explains that patients in underserved areas often rely on pharmacies or federally qualified health clinics, where continuity of care is lacking and risk assessments are harder to verify—exacerbating health inequities

15:59: Dr. Popovian predicts the administration will double down on SCDM and patient-led decisions—likely leading to lower vaccination rates and reduced herd immunity

17:58: Dr. Popovian warns that some states (like Louisiana) are banning public health messaging about vaccines, making the role of advocacy organizations even more critical in providing accurate information

19:00: Ben emphasizes the importance of education, outreach, and advocacy to bridge the gap between policy and real-world vaccination practices

19:00: Dr. Popovian calls for aligning ACIP recommendations with FDA labels and tracking the public health consequences of recent policy changes

20:02: Dr. Popovian shares some final thoughts

For more information about “Enhancing Adult Vaccine Uptake: Challenges in Shared Clinical Decision Making and Risk-Based Recommendations,” and to access the full report, visit: https://ghlf.org/issues/vaccines/enhancing_adult_vaccine_uptake/

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: rpopovian@ghlf.org

Ben Blanc, 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.

See omnystudio.com/listener for privacy information.

Did you know that millions of adults may have missed crucial vaccines due to restrictive state policies on pharmacist vaccination authority? In this episode of Healthcare Matters, hosts Dr. Robert Popovian and Ben Blanc sit down with Vibhu Tewary and Conrad Bhamani from the IQVIA Institute for Human Data Science to discuss new research conducted by the IQVIA Institute and GHLF on how these restrictions impact vaccination rates. They break down key findings from the report, revealing that states with tighter regulations see significantly lower vaccine uptake — by as much as 14% for RSV vaccines.

Tune in as they explore real-world consequences for underserved communities, why pharmacists are essential to public health, and what policy changes could help expand vaccine access.

Among the highlights in this episode:

01:17: Ben introduces the key topic of the episode: how state restrictions on pharmacists’ vaccination authority may be preventing millions of adults from accessing crucial vaccines

02:56: Dr. Popovian explains that pharmacists are the most accessible health care professionals, particularly in underserved communities, and cites data showing that many patients prefer to receive vaccines at pharmacies

05:27: Conrad highlights key statistics from the report, including that states requiring a physician’s prescription for RSV vaccines see a 14% lower vaccination rate, while states requiring a physician protocol see a 9% lower rate

07:41: Vibhu explains how pharmacy access is critical for people in low-income and minority communities, who often face additional barriers to seeing a physician during regular office hours

09:56: Dr. Popovian outlines policy recommendations, including eliminating physician prescription requirements and protocol restrictions, to make vaccinations more accessible

12:39: Dr. Popovian emphasizes the importance of collaboration between pharmacists and physicians and urges pharmacists to advocate for policy changes

14:10: Vibhu discusses how states that grant pharmacists independent vaccination authority tend to have higher immunization rates and how data should drive policy decisions

16:14: Dr. Popovian shares some final thoughts

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: rpopovian@ghlf.org

Ben Blanc, 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.

See omnystudio.com/listener for privacy information.

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.

See omnystudio.com/listener for privacy information.

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.

See omnystudio.com/listener for privacy information.

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.

See omnystudio.com/listener for privacy information.

In this episode of Healthcare Matters, join Dr. Robert Popovian and Ben Blanc as they dissect the critical role of Pharmacy Benefit Managers (PBMs) in the health care system, guided by recent findings from the Federal Trade Commission (FTC). The episode delves into how PBMs control a significant portion of the U.S. prescription market, discussing the implications of their dominance on drug prices, and the viability of independent pharmacies. Featuring a thorough examination of the FTC's recent report, Dr. Popovian explores the deep-seated issues of market concentration, anti-competitive practices, and the need for substantial regulatory reform.

This episode aims to shed the light on the powerful influence PBMs have over drug access and affordability, proposing pathways for more equitable health care practices.

Among the highlights in this episode:

01:45: Dr. Popovian delves into the FTC's report, revealing that three major PBMs control 80% of the retail prescription market in the U.S., highlighting issues of market concentration and limited competition

02:46: The conversation shifts to the impact of PBMs on drug prices and pharmacy operations, focusing on the FTC's concerns over anti-competitive practices

03:14: Dr. Popovian explains the effects of vertical and horizontal integration among PBMs, affecting drug access and pricing

06:35: Our hosts discuss the struggles faced by independent pharmacies due to PBM practices, as revealed in the FTC report

09:59: Dr. Popovian explores how PBMs use formulary design to manipulate which drugs patients can access and at what cost

11:59: Dr. Popovian criticizes the current rebate practices by PBMs, discussing their detrimental effects on the availability of generic and biosimilar drugs

14:25: Dr. Popovian calls for greater transparency and potential regulatory reforms to ensure fair drug pricing and maintain pharmacy viability

16:44: Dr. Popovian shares some final thoughts

To read the full FTC report “Pharmacy Benefit Managers: The Powerful Middlemen Inflating Drug Costs and Squeezing Main Street Pharmacies,” go to: https://www.ftc.gov/reports/pharmacy-benefit-managers-report

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.

See omnystudio.com/listener for privacy information.