Latest / Making Medicine / Balancing Access and Affordability in the Future of Healthcare

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Balancing Access and Affordability in the Future of Healthcare · Making Medicine

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You're listening to Making Medicine Stories from the Early Stage Life Sciences Ecosystem, a
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podcast that explores the people and deals that have led to the medicines, devices,
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and technologies that keep us healthy. Let's get into the show. Welcome
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to another episode of Making Medicine Podcasts. This is John Stanford, your host,
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and we've got a pretty special episode here today. We're thrilled to have
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Mary Greeley, CEO of the Healthcare Leadership Council, or HLC as we know
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it, to talk about what HLC is up to, her career, her
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most recent out and if you haven't read it, you absolutely have to.
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And we're going to talk all things healthcare policy and what can make differences for
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patients today and tomorrow. So Mary, first, let me thank you for
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being here today. And maybe for those who don't know in our listenership,
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can you tell us a little bit about Healthcare Leadership Council. Well, the
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Healthcare Leadership Council is of rather unique trade association here in Washington, DC,
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and that we represent all the different sectors of healthcare. And you know it's
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unusual to have health plans, health systems, medical device, pharmaceutical manufacturers,
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data analytic firms, pharmacies all in the same room. But we really work
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together across these different sectors towards reaching a consensus on how we can make American
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healthcare better, how it can really transform the system to make it a better
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healthcare system. And I have to say innovation is really a key pillar for
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the Healthcare Leadership Council. Our members strongly believe that affordability, quality, accessibility,
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population, health, all of those things can be addressed best through private
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sector innovation. And that's what really brings this group together. Well, you
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know, we're on the heels of the COVID nineteen pandemic. I think if
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we needed any further proof that it's private sector innovation that can bring out better
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healthcare outcomes, we've certainly lived through a case study. I've got to say,
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you have an incredible job pulling all of the elements of one sixth horror
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economy under one banner and one roof. So I'm I'm sure your board meetings
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are filled with a lot of best and bright ideas from across the healthcare landscape,
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and you have the challenging job of manifesting that into an agenda. So
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I'm curious you know here we are are What are you working on today?
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What's keeping HLC busy on? Behalf of your unique membership? Well, I
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think you put your finger on it by talking about the pandemic. We have
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spent a lot of time working on disaster readiness and response. We've played a
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very pivotal role on addressing the pandemic, and as you mentioned, the strong
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role for the private sector, the partnership. I think we're all aware of
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the development of the vaccines in such a short time, being pushed by the
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private sector, but also getting laboratory tests, getting supplies, all of those
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things, to say nothing of the healthcare workforce providing services during the pandemic.
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Just again, strong role by the private sector, and I think more importantly,
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the different sectors collaborating with each other to really meet this crisis and just
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did a phenomenal job. So that is really a big issue that we've worked
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on and we continue to do that work to make sure that we're better prepared
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the next time we have such an incident. We're also doing a lot of
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work on data interoperability. We think that did analyte is going to play a
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phenomenal role in making our health system more accessible and more affordable. Doing a
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lot of work on health equity. We know this administration is looking at every
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issue through that health equity lens, and we are in lockstep with them on
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trying to address the disparities in healthcare delivery, and all of our members are
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very committed to working on that. So the whole host of issues following issues
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patient safety issues. But I would say that data interoperability is something that is
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consuming quite a bit of our time these days. Well I can maybe you
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can't turn around these days with chat, GPT or barred or these other products
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coming out lot. We seem to be living through an AI moment that we
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all kind of knew was coming, but it's here now and I'm excited.
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Maybe if you could speak a little bit more, because I think we know
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this is going to be an imperative business is and it could transform healthcare.
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But you mentioned that it could also help on the affordability side. I think
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that's a fascinating benefit that no one's talking about. Can you say anything more
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there? Oh? To me, the number one benefit of this will be
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reducing the cost of clinical trials. We know how expensive it is to bring
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a drug to market. And anything we can do to reduce that cost.
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So we think artificial intelligence data analytics will play an important role there, and
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I think more importantly it's helping create more diversity in clinical trials. So we're
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already seeing our members use those tools to expand the reach of their clinical trials
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and to do it in a much more efficient way. Well, that also
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gets to your health equity goal. So that's say you can get a few
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birds with one stone there, and I'll certainly say from the life science investor
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perspective, would love nothing more and seeing those costs of clinical trials come down
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because we could leverage our capital into more and more risky IT efforts that all
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ultimately will benefit patients for platforms, we can't even let me just add on
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health equity that you mentioned the use of data and analytics there. Our members
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have consistently been looking and have been looking at data that resides in their electronic
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health records and detecting what we call unconscious bias, so disparities and treatment of
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patients, racial inequities that really were not apparent until they looked at that data,
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analyzed it, and we're able to have conversations about all right, how
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to reroduce those inequities and disparities, so very powerful tool. Absolutely while in
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your uniquely position where you've sit. We often have on the show, maybe
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someone from a major manufacturer, someone from a patient group, someone from the
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tech community. But you get to have all these facets funneling up in HLC.
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And you know a one question we always get from our listeners. We
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have some pretty incredible speakers like you come and join us, and everyone's always
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interested in sort of what their path has been. Now you've been at HLC
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for some time, how how did you find yourself in this incredible role and
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what are some of the some of the lessons learned over your time leading the
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organization for a good while. Well, in my first life, I was
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actually a speech pathologist and did that for five years, really enjoyed it,
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but decided that I want a little more flexibility and decided to go to law
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school. And at the time that I went to law school, there was
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no specialty in healthcare law. I planned to be either a tax lawyer or
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a labor lawyer, but I happened to do an internship on Capitol Hill for
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the Chairman of the Ways. It means sub Committee on how At that time
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it was Dan Rostenkowski, and it was a great experience. I wound up
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working for Commerce from Rostenkowski for the three years that I was in law school
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during those summers, and then after I graduated from law school, I went
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to the Federation of American Hospitals and they're the investor own hospital industry and worked
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there for gosh, almost fifteen years before becoming the Washington council for the large
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umbrella organization, the American Hospital Association. And then I interviewed for the job
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at the Healthcare Leadership Council, and I have to tell you I was very
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honest and saying I did not understand how this could possibly work, because I
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was not used to having or seeing payers, manufacturers, health systems in the
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same room collaborating and not just having the food fight. But it has been
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a wonderful experience seeing this group that understands the importance of the private sector having
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a strong role in healthcare and that the best way to do that is to
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collaborate with each other. So they check their weapons at the door, come
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to the into our room, into our table, and really tackle those big
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broad healthcare issues. How do we get to a patient centered, value based
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healthcare system where we have broader access, more affordability. But I think most
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importantly of all, better outcomes for everyone. Yeah, I think that that
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drive for outcomes comes through and you and you're speaking and you're writing, and
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uh, you know recently, I know that you end a great piece on
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investment in cancer at a sense, and we'll make sure that that's up on
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the Incubate website so that our listeners see it. What what compelled you to
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write about cancer and medicine. Well, we've been very concerned about aspects of
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the Inflation Reduction Act from the very beginning. And I have to say,
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on both the professional as well as the personal level, I have a sister
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in law that was diagnosed with stage four breast cancer and as a result of
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new innovative medicines being available, her oncologist told her three years ago there would
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be nothing I could do for you. Now I'm excited to get patients like
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you because I do have medicines that could address your condition, and she is
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now hems her free. So, as I said, it struck me both
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on a professional level representing my members, but also on a very personal level
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as well, so we've seen the Medicare party prescription program. That benefit has
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been extraordinarily successful. We worked hard for its passage, but it is me
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prescription drugs excess to a much broader population to Medicure beneficiaries and add very affordable
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premiums. The premiums have been virtually flat over several years, so we felt
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looking at the Inflation Reduction Act that they're really potential downsides that are big and
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having the government involved in pricing where we have seen the private sector has been
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functioning very well in what I would call a much more market based approach to
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drug pricing as opposed to government price controls. So when you dive deeper into
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this legislation, one of the things that really concerned us was this disparate treatment
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between different categories of pharmaceuticals and how that could really affect future innovation. And
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I just wanted to make sure that we called attention to that problem well.
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And it's certainly one that's on the mind of Incubate as the early stage funders.
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What we've termed the small molecule penalty, UH, this idea that small
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molecule drugs will get far less of a reward uh than their biologic brethren.
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And I think in cancer that's particularly pervasive, where we know that some of
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the benefits for the acology community are gonna are gonna come there. How to
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use the small molecule penalty impacting that that answer community and for me to even
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make it more understandable and in something that people can really grasp, I call
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it the small pill. I call it the pill penalty because you know,
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in particularly in cancer, and I find it very confounding that I think one
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of the really important initiatives that this administration has taken on. President Briden did
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this as Vice president as well, and that is a cancer moon Shot program.
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And the goal here is to reduce cancer mortality by fifty percent over the
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next twenty five years. An extraordinary and laudable goal. But if you're going
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to be able to do that, then you need to invest in the tools
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that are necessary to achieve that goal of reducing mortality. And so much of
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the great cancer innovation that we've seen in the last few years has been that
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development of oral medications in the form of pills that patients can take conveniently in
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their own homes. They don't have to leave their home. They don't have
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to go to outpatient hospital department, they don't have to go to their physician's
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office. This is oral medication that they can take at home. So we're
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concerned that these provisions are going to really discourage the development of the small molecule
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drugs and really discourage innovation in this area. So, you know, really,
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in essence, the administration is undermining their own cancer Moonshot initiative by including
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this provision in the legislation. Yeah, well, I'm glad that you said
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that. I thought your piece spoke to this this. Well, there is
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a disconnect there. Off, we're going to conquer cancer with this moon shot,
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but at the same time we're going to move the market away for drugs.
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It's one of the most frustrating things that we see out of the law.
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You know, any I know you're a solutions oriented person. You must
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be your members in line. How do you see a fix? What would
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you do if you had a magic wand in order to get rid of that
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kill penalty? Well, if I had a magic wand, yes, I
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would see an Act of Congress that says we're not going to have this disparate
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treatment between these small molecule medications and biologics. So I think the most important
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thing I would ask Congress not to do is what we saw in the President's
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proposed budget and in some congressional legislation that's pending, that there are proposals that
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would cut that grace period before price controls kick in for both small molecule and
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for biologics to just five years. So one, we want to make sure
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that doesn't happen. But then what we want to do is to reduce that
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disparity so that both biologics and small molecules have thirteen years before they have to
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enter into the price setting. I won't call them negotiations because it really isn't
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a negotiation. There is a limit on what the Secretary is allowed to pay
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for drugs, so we want to make sure we're able to postpone that.
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Well. I think here you're absolutely right, and that is intubates number one
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two at three Policy priority love the branding of the penalty, and so small
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molecule penalty equals bill penalty. Make sure to put that on the website.
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But I also just recently saw a study out of our friends and vital transformation.
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We're beginning to look at the economic development costs of this law. I
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see more than two hundred, two hundred and thirty step ins, fewer medicines,
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and one hundred and thirty thousand plus jobs that would be deleted from our
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economy if this plays out as written. Not successful in ending this law,
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What what does the life sciences community look like in five to ten years from
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your well, I think we're at a very critical juncture almost our cross words
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here. And as you point out, we know that the life science industry
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say and extends lives, and that it also creates very good paying jobs,
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that it fuels economic growth in communities. What we also know is that we
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have countries like China and India that want what we have. They're actively working
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to build their own medical technology sectors, and they certainly would like to entice
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companies to set up their operations there. So I think we have to decide
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if we want to continue to be the global leader in medical innovation or do
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we want to see that role to other nations. I think it's a real
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challenge, a real concern, and a real threat that we have to address.
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So I am hoping that we're able to convince our leaders in government that
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long term growth and innovation should not take a back seat to what I view
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as short term political concerns. It's a real challenge, but I think we
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have to confront it. I mean pretty serious table stakes you laid out.
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This is about whether or not I think we take for granted that we are
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the home of so much of the world's medical innovation. Fresh off a trip
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back from Japan where the government invited us there saying how do we do that?
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How do we build? What we add? And as we'd walk out
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of these meetings, they'd also say, why, why, by the way,
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are you gutting your own sort of very successful industry is in a globally
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competitive marketplace. There are options to go elsewhere. And I think back to
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to your distriant haunt, I think that's such a I think more and more
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Americans are having these stories where medicine does make We are making a lot of
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gains. We shouldn't use track of that. Well. Our country very much
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doesn't know drug lack or drug loss like they do in the European Union or
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around the world. We think if someone invents it, it's going to be
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available to us. Here there's a medicine out there that can make me or
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a loved one better. And I think that's the other table stake here is
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we're talking about as fully implemented, not being first in line for some of
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these medicines anymore. And rear position is HLC at HLC, Yeah, can
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we can we rectify that? Did you see a world where Americans will be
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okay with this idea that we have to wait for medicine that could be available
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around the risk? I do not think we are known as a country who
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is willing to wait in line for their healthcare, probably not for any consumer
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good, but definitely not for healthcare. And I think that the biggest concern
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I have is that, you know, here we are in an era of
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where we're not just developing treatments for cancer, we're developing shores for cancer,
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and certainly we want to have those really available. And let me point out
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that this provision also will affect diseases like Alzheimer's diabetes, and we can't lose
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sight of that as well. So I don't think we will tolerate it.
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What worries me is people won't know right away what they didn't get, what
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drugs weren't developed, but they will be well aware that if people in other
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countries are getting treatments before we are in this country, that is just unacceptable.
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We've always been the leaders, We've always had this access, and we'll
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want to continue to do that kind of voices. When you think of your
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disparate membership, what is going to get through to Congress here that we are
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wandering off in a direction we really don't want to go. What would you
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to our listeners, whether it's policymakers and their staff, or advocates, or
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patients or others you know who. What messages is HLC seeing successfully get through
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the policymakers, your advocacy well, and I see this down about every issue
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we work on when talking with my staff, if we cannot make the case
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why what we want, what our position is is good for patients and consumers,
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number one, then we shouldn't be taking that position. For probably more
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importantly, you're never going to win an issue unless you can make the case
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as to why members of Congress should vote your way because it affects their constituents.
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We have to put the patient space on this issue, and we have
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to convey that to Congress because I think we can get lost in the economics
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of it and try to explain it. But at the end of the day,
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and I think you said it well, it means that people will not
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get life saving drugs or they will have to wait a long time to get
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them. I think there is nervousness on Capitol Hill that they're not quite sure
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what the ramifications of the you know, Inflation Reduction Act and these price setting
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proposals are going to be. So I think we have time because we're just
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in this period of beginning the implementation. We have time to contact members of
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Congress and make the case to them. But it really is going to take
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their constituents, that patient voice, that consumer voice, to make the case
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to them, and I feel we have a responsibility to facilitate that as best
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we can. Well you can certainly count on us as partners in those efforts.
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And I like your optimists, you know, we look at these major
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pieces of legislation. They do get improved over time, and the chapter we're
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at the end of the beginning, not the beginning of the end as far
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as price controls on medicine this country, and we have a lot of opportunity
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shape how drastically. It's got to impact count. We always like to end
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on a positive note, people away from tough mcgloom and so maybe you know,
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maybe a final question for you is you have insight into the entire healthcare
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space. Again, one sticks to our economy, everything from the incredible power
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of AI and the internet, to drug innovators and developers, to the brick
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and mortar stores and clinics where we get our healthcare, if we get it
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right, if we put the right policies place, if we stop the food,
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where do you see the potential for patients in the decades. Well.
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I frequently go out and visit our member companies and visit with their employees,
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and I am always amazed, thrilled at the dedication and commitment that I see
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from these professionals on the work that they're doing to make the system better.
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We used to be able to take Congression staff out to visit these locations.
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Ethics rules won't let us do it anymore. But I can't tell you how
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powerful it was for them to hear from these enthusiastic employees that felt they were
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playing a pivotal role in making our healthcare system better, and that optimism and
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dedication continues. And I think that's the real story, that we have a
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lot of power in the private sector and now we just need to make sure
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that we don't have the public sector or the government putting barriers in the way
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of that dedication to innovation and really improving healthcare for everyone. I love that
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we don't we forget the people behind the large names of these iconic brands and
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companies healthcare. So I'm so glad that you pulled them to the fore.
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To close out, she's Mary Greeley. She's the CEO of the Healthcare Leadership
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Council or HLC, one of the pre eminent groups in the country advancing the
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healthcare conversation. Thank you so much for joining us today, thanks to our
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audience for listening and always giving us ideas for future episodes. You can get
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more from Incubate, including Mary's outstanding op ed at www dot incubate Coalition dot
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org. Special thanks to Ashton Roberts Auster and a podcast as always, keeping
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