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

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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.