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Healthcare Costs, PBMs & Why Manufacturers Oppose Drug Price Controls · Making Medicine

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  Speaker 1: At Making Medicine, we're reporting on the headlines, not making
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  Speaker 1: medical recommendations. For personal health questions, always ask your doctor.
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  Speaker 1: Nothing in this episode constitutes investment, financial, or legal advice.
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  Speaker 1: Consult your own advisors before making decisions.
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  Speaker 2: Ninety percent of prescriptions are generic drugs, So if you're
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  Speaker 2: going to impose price controls on branded innovative pharmaceuticals, you're
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  Speaker 2: not actually getting all that much in terms of reducing
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  Speaker 2: the cost of health care in the first place. What
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  Speaker 2: you are having an outsized impact on is the innovation
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  Speaker 2: ecosystem in the United States, and I think manufacturers understand
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  Speaker 2: that that's not a tradeoff that we.
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  Speaker 1: Want to make. Welcome back to the Making Medicine podcast,
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  Speaker 1: where science, policy and innovation meet. Today we're joined by
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  Speaker 1: a guest, Charles Crane. He's Vice president of Domestic Policy
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  Speaker 1: at the National Association of Manufacturers better known as NAM,
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  Speaker 1: the largest manufacturing trade association in the United States, and
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  Speaker 1: Charles is their lead on policy in the United States,
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  Speaker 1: meaning he's a great voice to talk to about all
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  Speaker 1: things policy. But what particularly caught our eye was that
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  Speaker 1: NAM has just released a new report, Prescription for a
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  Speaker 1: Healthy Workforce Manufacturer's Roadmap to lower healthcare costs. You might
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  Speaker 1: not immediately think of manufacturers when it comes to pricing
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  Speaker 1: policy or FDA stability, but this report lays out why
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  Speaker 1: you should. American companies large and small do care about
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  Speaker 1: new medicines coming to the market, and they also care
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  Speaker 1: about the maintaining of a healthy US workforce. We thought
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  Speaker 1: it'd be a great conversation to have Charles talk all
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  Speaker 1: things policy, and it was, so let's get into the show.
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  Speaker 2: Charles.
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  Speaker 1: Welcome to the show.
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  Speaker 2: Great to be here.
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  Speaker 1: John, Well, we certainly are aware of the great work
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  Speaker 1: that the Association does, but not every one of our
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  Speaker 1: listeners is a manufacturer and they may not know what
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  Speaker 1: NAM is. So can you talk a little bit about
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  Speaker 1: the association and what specifically you do.
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  Speaker 2: So the NAM, the National Association of Manufacturers, is the
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  Speaker 2: national trade group for the manufacturing sector, and that includes
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  Speaker 2: all segments of manufacturing, from traditional industrials to energy, to
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  Speaker 2: infrastructure to the biopharmaceutical and biomedical space. So we really
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  Speaker 2: have everybody we speak here in DC on behalf of
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  Speaker 2: the thirteen million men and women who make things in America.
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  Speaker 2: Our charge, and I'm our head of policy here, so
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  Speaker 2: I leave this charge I guess I could say is
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  Speaker 2: to effectuate positive policy outcomes on behalf of those thirteen
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  Speaker 2: million people who make things in America, and to ensure
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  Speaker 2: that the policy environment from Congress to the Administration to
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  Speaker 2: the federal agencies are set up to support manufacturing investment
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  Speaker 2: and job creation and growth here in the United States.
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  Speaker 1: Well, we probably should have had you on sooner, given that, yes,
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  Speaker 1: you're all of the manufacturing sector, but that does include
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  Speaker 1: the biopharma manufacturing sector, so we'll have to have you back.
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  Speaker 1: But what caught oor Iem wanted to have on the
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  Speaker 1: show is this great new report you put out around
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  Speaker 1: the impact of the cost of healthcare, And we're going
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  Speaker 1: to get into the report, will make the link, will
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  Speaker 1: be live for everybody so everybody can check it out,
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  Speaker 1: and it's it's got a lot of great stuff that
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  Speaker 1: we're going to pour through. You know, one stat that
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  Speaker 1: stood out to me was seventy percent of manufacturers said
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  Speaker 1: rising healthcare costs are the single biggest business concern. I
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  Speaker 1: guess that leads me to ask you, why did you
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  Speaker 1: do this report and what are some of your key
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  Speaker 1: takeaways from it.
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  Speaker 2: It's a great question that stat that you cited has
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  Speaker 2: been rising for years, manufacturers are increasingly struggling with the
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  Speaker 2: rising cost of healthcare. Taking a step back, ninety five
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  Speaker 2: percent of manufacturing workers are eligible for a workplace healthcare plan.
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  Speaker 2: So this is a deep commitment that the industry has
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  Speaker 2: to provide these competitive benefits to their workers. It's important
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  Speaker 2: to attract and retain quality talent, and frankly, it's the
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  Speaker 2: right thing to do. That's especially true to time when
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  Speaker 2: our sector actually has four hundred thousand open jobs across
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  Speaker 2: the industry. So we need to do everything we can
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  Speaker 2: to bring skilled workers into the modern manufacturing sector to
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  Speaker 2: drive growth and investment for the long term. But it's
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  Speaker 2: hard to do that if you're facing this top business
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  Speaker 2: challenges you just outlined of rising healthcare costs and the
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  Speaker 2: degree to which that has continued to be the case.
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  Speaker 2: And it is especially true for our small and medium
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  Speaker 2: sized members. If you look at the survey that you cited,
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  Speaker 2: they are disproportionately likely to say that rising health care
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  Speaker 2: costs are impacting them, and so we want to ensure
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  Speaker 2: that they can continue offering these competitive benefits. It's good
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  Speaker 2: for them as employers, and it's really good for manufacturing
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  Speaker 2: employees and their families. To ensure that we have the
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  Speaker 2: policy prescriptions in place, and that's what this report is about,
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  Speaker 2: to help them reduce the cost of health care. But
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  Speaker 2: it's critically important that we do so in a way
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  Speaker 2: that doesn't impact the US's lead in innovation and bio
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  Speaker 2: pharmaceutical research and our ability as a country to bring
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  Speaker 2: these innovative life saving treatments to market. So easy to
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  Speaker 2: target to buy a pharma space. If you're looking to
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  Speaker 2: reduce health care costs, that's really wrong headed. Is your
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  Speaker 2: listeners already known? We can talk about why, and so
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  Speaker 2: we want to offer real, practical, useful policy solutions to
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  Speaker 2: help manufactures where they really need it, which is bringing
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  Speaker 2: down healthcare cost in the aggregate.
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  Speaker 1: That balance, that tension is super interesting. Of that's stat
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  Speaker 1: ninety five percent of workers in the manufacturing space have
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  Speaker 1: access to health benefits, which means you must be one
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  Speaker 1: of the biggest groups of providers of health insurance. So yeah,
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  Speaker 1: i'd say you have some investment in seeing health care
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  Speaker 1: costs come down, while simultaneously, so many of your members
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  Speaker 1: are innovative, and a manufacturer almost by definition, is either
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  Speaker 1: innovating a product or innovating a process. So that's an
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  Speaker 1: interesting tension. Give me the give me some of the
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  Speaker 1: top lines of what you wave your magic wand of
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  Speaker 1: policy prescriptions. What would you be doing to drive down
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  Speaker 1: health care costs not just for manufacturing employees, but for
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  Speaker 1: all Americans.
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  Speaker 2: You know, the point is really well taken about the
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  Speaker 2: innovative nature of the sector. Manufacturers performed fifty three percent
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  Speaker 2: of all private sector R and D in the country,
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  Speaker 2: So we sort of intuitively get this right, the importance
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  Speaker 2: of R and D and innovation. So if I'm waving
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  Speaker 2: a magic wand, I can tell you the things I'm
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  Speaker 2: not doing right, which is not price controls, not cutting
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  Speaker 2: investment in innovation. You know, I want to grant regulatory
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  Speaker 2: certainty to those innovators right to ensure that we have
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  Speaker 2: that innovation ecosystem across the country all the way from
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  Speaker 2: early stage research to tech transfer, all the way up
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  Speaker 2: through you know, late stage critical trials and ultimately manufacturing
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  Speaker 2: and distribution of life saving treatments. So that's the kind
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  Speaker 2: of biopharma space, and I know we're going to talk
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  Speaker 2: about that more in the sort of true healthcare traditional
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  Speaker 2: healthcare ARISA healthcare. To use a DC term, which is
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  Speaker 2: the Statute of course that governs how we offer these
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  Speaker 2: healthcare benefits. You know, we want increased access to flexible coverage,
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  Speaker 2: we want fair tax treatment to continue to provide these benefits.
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  Speaker 2: We want different types of plans to be available to
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  Speaker 2: manufacturers and manufacturing workers. We want increased preventative care and
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  Speaker 2: access to telehealth for instance, to keep healthcare costs low
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  Speaker 2: on the front end so they don't balloon when you
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  Speaker 2: think about you know, chronic disease and the real impacts
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  Speaker 2: that I can have on a worker, their family, and
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  Speaker 2: the workforce for at large. So there's a lot of
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  Speaker 2: kind of in the weed specifics, but the thematic takeaway is,
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  Speaker 2: don't limit innovation, actually target the cost centers that really
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  Speaker 2: exist for manufacturers and help them provide the benefits they
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  Speaker 2: want to provide to their workers.
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  Speaker 1: Yeah, I thought the part of the report and some
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  Speaker 1: of your ongoing comments there of like, let's meet these
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  Speaker 1: employers where they are, whether it's ecros and cuseras, and
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  Speaker 1: of just let's have flexibility about accessing health insurance. But
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  Speaker 1: let's stay with this idea of like let's avoid bad
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  Speaker 1: ideas because you know, some people might say, well, you've
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  Speaker 1: got all these employees, so surely you want to see
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  Speaker 1: the cost of medicines come down via price controls because
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  Speaker 1: you've got all these covered lives, And yet your membership
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  Speaker 1: seems to get, no, we don't. We don't want to
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  Speaker 1: choke off the innovation. You know. Do you feel from
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  Speaker 1: your membership that like these things like Most favor One
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  Speaker 1: of the struggles with Most Favor Nation is it sounds
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  Speaker 1: great on paper. Who doesn't want to have the best pricing?
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  Speaker 1: But it seems like your members, maybe more so than
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  Speaker 1: the average trade association, get why that's cutting our nose
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  Speaker 1: to spite our face. Does that come through when you
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  Speaker 1: talk to them.
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  Speaker 2: It really does. Some of it goes back to the
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  Speaker 2: kind of innovation first dynamic that that I mentioned earlier,
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  Speaker 2: but more broadly than that, I think that manufacturers understand
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  Speaker 2: and have really experienced through the pandemic and elsewise, the
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  Speaker 2: importance of having healthy workers on the shop floor. And
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  Speaker 2: if you're limiting innovation preventing access to life saving drugs
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  Speaker 2: or to drugs that prevent devastating conditions or that prevents
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  Speaker 2: symptoms from those conditions, then yes, there's a real human
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  Speaker 2: cost to that. If folks don't have access to treatments
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  Speaker 2: that has an impact on them and their families, But
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  Speaker 2: there's an economic and a societal cost as well. And
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  Speaker 2: I think the manufacturers feel that we have struggled with attrition,
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  Speaker 2: with absenteeism, with presenteeism driven by chronic disease, and I
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  Speaker 2: think folks intuitively get that if you're limiting access to
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  Speaker 2: these treatments, you're ultimately, as you said, cutting off your
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  Speaker 2: nose to spite your face. The other thing I would
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  Speaker 2: add is sort of taking a step back from the
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  Speaker 2: quote unquote problem. This larger dynamic of health care cost
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  Speaker 2: retail prescription drugs, which is sort of what people think
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  Speaker 2: about when they think about health care, like I've got
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  Speaker 2: to go to the pharmacy and pay out a pocket
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  Speaker 2: to get a prescription filled. Retail prescription drug costs only
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  Speaker 2: account for nine percent nine percent of all health care
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  Speaker 2: costs in the US, And on top of that, ninety
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  Speaker 2: percent of prescriptions are generic drugs. So if you're going
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  Speaker 2: to impose price controls on branded innovative pharmaceuticals, you're not
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  Speaker 2: actually getting all that much in terms of reducing the
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  Speaker 2: cost of health care in the first place. What you
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  Speaker 2: are having an outsized impact on is the innovation ecosystem
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  Speaker 2: in the United States. So you're getting a negligible benefit
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  Speaker 2: for a really outsized cost on our ability to live
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  Speaker 2: disease tree lives, and I think manufacturers understand that that's
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  Speaker 2: not a trade off that we want to make.
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  Speaker 1: Gosh, I want every association to have your membership because
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  Speaker 1: that's incredibly informed. And do you feel like sometimes when
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  Speaker 1: you're talking health care policy with your membership, they're like, Hey,
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  Speaker 1: why is Washington fixated on the drug side? We look
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  Speaker 1: at p and ls all day and the p and
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  Speaker 1: L on the healthcare spend. You know, you're looking at
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  Speaker 1: a tiny fraction of the spend. Why aren't we talking
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  Speaker 1: about hospitals, which I think the report did touch on
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  Speaker 1: one hospital hospital program that, for lack of a better word,
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  Speaker 1: drives up some of the cost of medicines. What was
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  Speaker 1: the recommendation around some types of hospital hospitals and how
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  Speaker 1: they might be sort of gaming this system there?
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  Speaker 2: Yeah, so this is the three forty B section of
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  Speaker 2: the report. I hesitate to sort of guess the average
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  Speaker 2: Americans knowledge of these sort of in the main and
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  Speaker 2: soup exactly, we love an acronym here in DC three
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  Speaker 2: forty B. It's a program that supposed to allow hospitals
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  Speaker 2: and health centers and underserved and under resource communities get
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  Speaker 2: access to reduce cost prescription drugs and specifically to take
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  Speaker 2: those savings and then reinvest them in other health services
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  Speaker 2: for those underserved and underresourced communities. Noble program, important program
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  Speaker 2: program that the industry supports, both the manufacturing industry at
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  Speaker 2: large and the biopharmaceutical sector specifically. The problem has really
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  Speaker 2: been scope creep and hospitals, to your point, kind of
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  Speaker 2: taking advantage and getting into the three forty B program
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  Speaker 2: when those really aren't the communities that they're serving. Just
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  Speaker 2: as as an example, twenty seven hundred hospitals across the
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  Speaker 2: country participate in three forty B. That's half of the
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  Speaker 2: hospitals in the US. I'm not a sort of statistician.
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  Speaker 2: I don't know how many underserved and underresourced community there
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  Speaker 2: are in the country. It's probably not half of every hospital.
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  Speaker 2: Is actually the intent of this program right Three forty
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  Speaker 2: is growing at a faster rate than any other federal
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  Speaker 2: healthcare program. And I know that your listeners read the
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  Speaker 2: news about the growth and Medicaid costs and Medicare cost
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  Speaker 2: and everything else. Over the course of time, three fort
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  Speaker 2: is actually growing at a faster rate. It's a smaller
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  Speaker 2: piece of the pie, but it's growing more quickly than
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  Speaker 2: all of those other programs. And so you have these
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  Speaker 2: discounts going to these hospitals that ultimately are keeping those discounts,
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  Speaker 2: and so the discounts aren't flowing to the employer community
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  Speaker 2: into employees across the country, and so it drives up
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  Speaker 2: healthcare cost for the folks that we're really trying to
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  Speaker 2: represent in favor of keeping them at those hospitals who
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  Speaker 2: aren't even so to be part of the program in
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  Speaker 2: the first place.
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  Speaker 1: It sounds, first of all, you can come in and
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  Speaker 1: do our explanations on these different healthcare terms anytime. Because
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  Speaker 1: I think that was don't tend me with the good time.
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  Speaker 1: That was a terrific one. It feels like three forty
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  Speaker 1: B to some extent, is the flip side of another
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  Speaker 1: recommendation you called out around middlemen and PBMs in maybe
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  Speaker 1: continuing Congress's progress on addressing then. But I don't want
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  Speaker 1: to put words in your mouth. Do you see PBMs
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  Speaker 1: as another example of like, look, we got the drug,
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  Speaker 1: we got the doctor, but there's stuff in the middle,
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  Speaker 1: and it's just driving up cost.
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  Speaker 2: Yeah, I actually really like the way that you frame that,
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  Speaker 2: because healthcare costs is this huge term that has one
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  Speaker 2: hundred different meanings, right, and so what you see when
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  Speaker 2: you dig under the hood is that there are a
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  Speaker 2: number of drivers of increased health care costs. As we
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  Speaker 2: said earlier, cost spent on branded prescriptions, where all this
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  Speaker 2: political energy is to put price controls on them, are
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  Speaker 2: not where the actual drivers of health care costs are.
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  Speaker 2: It's rather they're in these middlemen, like the three forty
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  Speaker 2: B hospitals who were taking their cut, and like the
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  Speaker 2: pharmacy benefit managers, which is who you're referring to in
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  Speaker 2: this question. PBMs are these underregulated or frankly unregulated middlemen
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  Speaker 2: who sit at that intersection between the pharmacies and the
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  Speaker 2: drug makers and the employer plan sponsors, and they are
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  Speaker 2: theoretically designed with excuse me, they're theoretically charged with designing
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  Speaker 2: your pharmacy benefit. As an employer, that's a good thing.
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  Speaker 2: You don't want to have to do that yourself. You
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  Speaker 2: want to have a services writer do that. But of
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  Speaker 2: course they're doing in a way that increases their own
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  Speaker 2: profits at the expense of savings for workers. And their employees,
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  Speaker 2: and that has this broader impact on the cost of
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  Speaker 2: health care. And they aren't passing discounts onto workers. They
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  Speaker 2: don't have transparency about how they're having these prices negotiated
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  Speaker 2: and what gets on the formula area and what doesn't.
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  Speaker 2: It's incredibly complicated, incredibly quickly, and so it creates this
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  Speaker 2: sort of mirage of complication for employers who are just
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  Speaker 2: trying to do the right thing and provide benefits for
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  Speaker 2: their workers, but they can't actually get to the bottom
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  Speaker 2: of what's driving those costs, and in a lot of
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  Speaker 2: cases it's the PBMs practices themselves.
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  Speaker 1: Yeah, and you've got such an employer force in your membership.
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  Speaker 1: I don't know if you're the right person to answer
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  Speaker 1: this question, but I'm we ask anyway, can you talk
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  Speaker 1: about the power because sometimes I get up to Capitol
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  Speaker 1: were we think PBF and reform over at incubator is
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  Speaker 1: a good thing. We like where Congress went, We want
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  Speaker 1: them to keep going. It makes sense, the perverse incentives
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  Speaker 1: for high list prices all that, But sometimes I get
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  Speaker 1: pushback of like, well, really, how powerful is this PBM.
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  Speaker 1: It's Pfizer's product, or it's Merks product. Or it's BMS's product,
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  Speaker 1: they get to set the price. And so I'm just
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  Speaker 1: going to put this to you of how much power
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  Speaker 1: do these PBMs have Because your employers can't even see
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  Speaker 1: that they're not getting the savings they should be. Seeing
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  Speaker 1: you have some exposure of the manufacturer community, I don't
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  Speaker 1: think people would assume that the employer, who's kind of
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  Speaker 1: the end customer for all these plans or the manufacturer
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  Speaker 1: has all this power. How powerful are these PBMs that
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  Speaker 1: they can insist on I'm going to take you off
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  Speaker 1: the formula. You either play my game or you don't.
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  Speaker 1: Do you have any thoughts on that I do?
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  Speaker 2: And you're exactly right. They have quite a lot of power.
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  Speaker 2: They have all the leverage because the drugmakers obviously need
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  Speaker 2: their treatments to be on the formulary, the employer wants
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  Speaker 2: access to these treatments for their workers relatively affordable cost.
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  Speaker 2: And the PBM is the intersection between those two plus
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  Speaker 2: the pharmacies themselves. Obviously, although I'm sure your listeners well
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  Speaker 2: I don't know if they know or not, as I'm
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  Speaker 2: sure you know, they're increasingly vertically integrated with the pharmacies
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  Speaker 2: and the PBMs, which creates an additional conflict of interest
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  Speaker 2: and a lack of oversight and transparency. But PBMs are
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  Speaker 2: at the middle of this equation and the types of
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  Speaker 2: reform that we're asking for or really straightforward and simple.
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  Speaker 2: You mentioned the bill that Congress passed earlier this year.
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  Speaker 2: Increases transparency so employers know what they're paying for, they
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  Speaker 2: know what they're getting. Requires rebate pass through. If the
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  Speaker 2: PBM gets a rebate from the drug manufacturer, they have
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  Speaker 2: to pass that on to the employer and ultimately the
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  Speaker 2: employees in the form of reduced costs. These are simple
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  Speaker 2: reforms and something that we are really thrilled that Congress
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  Speaker 2: is able to do. We champion these for years and
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  Speaker 2: we want to continue to see momentum in that direction.
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  Speaker 1: You mentioned a little bit earlier regulatory certainty, and that
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  Speaker 1: is certainly a topic that we have spent some time
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  Speaker 1: on this show and the soap opera at times that
• 17:34
  Speaker 1: we've seen and the changing cast of characters as it
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  Speaker 1: relates to regulators. But interesting that you bring I mean,
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  Speaker 1: it makes sense that we bring it. We're biotech investors.
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  Speaker 1: When the FDA is giving us murky signals, it makes sense.
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  Speaker 1: It's obvious to us, Hey, this isn't sustainable. I was
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  Speaker 1: intrigued that it's become so obvious for someone a massive
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  Speaker 1: trade organization. So many million of Americans are your constituency,
• 18:03
  Speaker 1: you know, how did that one end up on your radar?
• 18:05
  Speaker 2: So a couple of thoughts here, and this sort of
• 18:07
  Speaker 2: goes back to where we started, which is that the
• 18:09
  Speaker 2: experiences of manufacturers writ large are really mirrored in the
• 18:13
  Speaker 2: experiences of the biopharma manufacturing space specifically. So we've worked
• 18:18
  Speaker 2: on the costs and the burden of federal regulations and
• 18:21
  Speaker 2: what works and what doesn't for years and years and years.
• 18:23
  Speaker 2: This is a key part of our kind of policy
• 18:25
  Speaker 2: portfolio on behalf of our members. We commission to study
• 18:28
  Speaker 2: in twenty twenty two to twenty three on the aggregate
• 18:31
  Speaker 2: cost of federal regulations to the US economy on manufacturers,
• 18:35
  Speaker 2: not just on biofarmer companies. It's about three hundred and
• 18:38
  Speaker 2: fifty billion dollars every year that the industry spends on
• 18:40
  Speaker 2: compliance with federal rules and regulations, which disproportionately fall on
• 18:44
  Speaker 2: small manufacturers because they don't have the you know, economies
• 18:47
  Speaker 2: of scale to really streamline compliance with those types of rules,
• 18:51
  Speaker 2: and so the lessons learned from that are, you know,
• 18:54
  Speaker 2: the importance of right sized work or regulations, and the
• 18:56
  Speaker 2: importance of reliable rules of the road so that manufacturing,
• 19:00
  Speaker 2: which is a long term capital intints of ministry, can
• 19:03
  Speaker 2: plan for the future. You know what else is a
• 19:06
  Speaker 2: long term capital intensive ministry biotech R and D and
• 19:09
  Speaker 2: clinical trials and the creation of life saving treatments for
• 19:12
  Speaker 2: the American people. And so when we look at the
• 19:15
  Speaker 2: regulatory environment for the biopharmaceutical space specifically, really those lessons
• 19:20
  Speaker 2: carried through. We need workal regulations, We need regulators who
• 19:23
  Speaker 2: understand the sector and are working with the same science
• 19:27
  Speaker 2: and facts, and the true innovative nature of these companies
• 19:30
  Speaker 2: needs to be reflected in the regulatory environment. And we
• 19:33
  Speaker 2: need the certainty that comes with reliable rules of the road,
• 19:37
  Speaker 2: knowing what your targets are, knowing what your processes are,
• 19:40
  Speaker 2: knowing what your timelines are. Because if you're a biotech company,
• 19:43
  Speaker 2: especially an early stags biotech company, and you're committing yourself
• 19:46
  Speaker 2: to what ten, twelve, fifteen years of hundreds of millions
• 19:51
  Speaker 2: of dollars of spend, and when you get to the
• 19:54
  Speaker 2: end of that process, you're going to hope that you
• 19:56
  Speaker 2: get an FDA approval, you really need to know the
• 19:58
  Speaker 2: rules of the road for the entirety of those fifteen years.
• 20:01
  Speaker 2: Otherwise you're not going to spend the first dollar on
• 20:04
  Speaker 2: the research because you have no certainty that it's going
• 20:06
  Speaker 2: to turn out in your favor. Now, you can't guarantee
• 20:08
  Speaker 2: that the research will work. Of course, that's the nature
• 20:11
  Speaker 2: of innovation and of science, but you should be able
• 20:14
  Speaker 2: to guarantee that if the innovation does work, that the
• 20:17
  Speaker 2: regulatory environment will be there waiting for you. And when
• 20:20
  Speaker 2: we have that uncertainty, it limits your ability to have
• 20:25
  Speaker 2: to commission that type of research.
• 20:27
  Speaker 1: Well, amen on that. I mean, I think that is
• 20:30
  Speaker 1: a drumbeat we've been trying to hit. So it was
• 20:33
  Speaker 1: great to see it alongside those other ones. I want
• 20:36
  Speaker 1: to shift gears a little bit. That was the what
• 20:38
  Speaker 1: of this great report, and I think it is a
• 20:40
  Speaker 1: really good prescription, as you call it, for how we
• 20:43
  Speaker 1: can deal with rising healthcare costs for manufacturers and frankly
• 20:49
  Speaker 1: for everybody. Let's talk about the how, because something that
• 20:52
  Speaker 1: Nam has done over the last many administrations, as long
• 20:57
  Speaker 1: as I've been in DC, has cultivated bipartisan support, deep relationships.
• 21:03
  Speaker 1: It seems that doesn't really matter which way the wind
• 21:06
  Speaker 1: is blowing. NAM has a seat at the table to
• 21:09
  Speaker 1: talk about these big, thorny economic issues. You're in charge
• 21:13
  Speaker 1: of that. How do you cultivate that? And so how
• 21:17
  Speaker 1: are you going? And the sister question that is how
• 21:20
  Speaker 1: did you cultivate that? And then how are you going
• 21:21
  Speaker 1: to take advantage of that to move some of these
• 21:23
  Speaker 1: ideas forward.
• 21:25
  Speaker 2: Well, first of all, thank you for saying that. I mean,
• 21:27
  Speaker 2: that is exactly what we view as our role here
• 21:30
  Speaker 2: in DC. Everybody I think as a policymaker here in DC,
• 21:34
  Speaker 2: all five hundred and thirty five of them on Capitol Hill,
• 21:36
  Speaker 2: regardless of party or sort of political and policy leanings,
• 21:40
  Speaker 2: understand the value of manufacturing to the American economy. We
• 21:44
  Speaker 2: have members in every state, in every congressional district. Certainly there,
• 21:47
  Speaker 2: as I said, thirteen million people who make things in
• 21:49
  Speaker 2: America that are spread out across the sector, that are
• 21:53
  Speaker 2: across the country, and that people really understand the needs
• 21:57
  Speaker 2: of those workers and those voters, and so our job
• 22:00
  Speaker 2: up here in dcs to build those bipartisan relationships. These
• 22:03
  Speaker 2: are not partisan issues. There are occasionally individual policies that
• 22:07
  Speaker 2: have greater support among Democrats or greater support among Republicans,
• 22:11
  Speaker 2: but the ultimate goal that we're shooting towards, which is
• 22:14
  Speaker 2: an environment that allows for manufacturing investment, in job creation
• 22:17
  Speaker 2: and growth, and support of the American dream for the
• 22:21
  Speaker 2: American people. That's not a partisan issue, and so we're
• 22:24
  Speaker 2: able to take that as a starting point and have
• 22:26
  Speaker 2: real deep conversations about what the policy prescription is. In
• 22:31
  Speaker 2: this case, we're talking about health care policies, but that
• 22:33
  Speaker 2: applies to tax policy, to transportation and infrastructure, to science
• 22:38
  Speaker 2: and innovation, to chemicals. Everything impacts manufacturers. And so today
• 22:43
  Speaker 2: we're talking about ways that we can remove healthcare costs
• 22:46
  Speaker 2: as a roadblock to manufacturing investment and growth. And so
• 22:51
  Speaker 2: I'm optimistic that we're going to be able to continue
• 22:54
  Speaker 2: that conversation. As we just said earlier, we had this
• 22:56
  Speaker 2: tremendous win in the form of PBM reform just earlier
• 22:59
  Speaker 2: this year, and I think there's real bipartisan interest and
• 23:02
  Speaker 2: continuing to address this healthcare affordability topics. We just have
• 23:06
  Speaker 2: to make sure, and I know that your listeners care
• 23:08
  Speaker 2: about this as well, that positive makers don't take the
• 23:11
  Speaker 2: easy way out and don't impose these price controls on
• 23:14
  Speaker 2: innovators in a way that one won't actually make them
• 23:17
  Speaker 2: much of a difference on healthcare costs, but could have
• 23:19
  Speaker 2: real damaging impacts on the American innovation ecosystem rather than
• 23:23
  Speaker 2: actually solving the problem.
• 23:25
  Speaker 1: You've been incredibly generous with your time, but I'm going
• 23:27
  Speaker 1: to cheat and fit one more in because it just
• 23:31
  Speaker 1: seems you can't have a conversation with anybody about anything
• 23:34
  Speaker 1: and not talk about China. And so I think it
• 23:36
  Speaker 1: would be a mistake to have you on leading voice
• 23:40
  Speaker 1: at a leading national trade How do you beyond just healthcare?
• 23:46
  Speaker 1: How does nam think about China? We're dealing in our
• 23:50
  Speaker 1: own industry with the complexities of investment there and out
• 23:53
  Speaker 1: licensing and frenemies and intellectual property and all these things?
• 23:58
  Speaker 1: How do you think about that? And I should I
• 24:01
  Speaker 1: will be fair to the listeners. Charles's job is domestic policy.
• 24:04
  Speaker 1: He writes the ship for manufacturers inside the United States.
• 24:07
  Speaker 1: But he's a big mind. So I put the tough
• 24:10
  Speaker 1: question to you about how do you all think about China.
• 24:12
  Speaker 2: It's a great question. It's one we think about a lot.
• 24:14
  Speaker 2: It's one that applies to the whole raft of policy
• 24:18
  Speaker 2: issues that we work on. On a day to day basis,
• 24:20
  Speaker 2: How can we make the United States the best place
• 24:23
  Speaker 2: to invest, the best place to manufacture things. That's true
• 24:27
  Speaker 2: for our biopharmaceutical members, and it's true for all of
• 24:29
  Speaker 2: our members really large. We need reliable intellectual property protections
• 24:34
  Speaker 2: if you're going to invest and innovate here. We need
• 24:36
  Speaker 2: reduce healthcare costs, which you just talked about for a
• 24:38
  Speaker 2: half hour. We need competitive tax policies, we need competitive
• 24:42
  Speaker 2: regulatory policies, which we've touched on today. Anything that we
• 24:45
  Speaker 2: can do to ensure that the US has the most
• 24:49
  Speaker 2: fruitful environment for investment, innovation, job creation, and that we
• 24:53
  Speaker 2: can have supply chains here as well. We saw this
• 24:56
  Speaker 2: certainly in the biopharma space during COVID. The supply chain
• 25:00
  Speaker 2: and vulnerabilities were very much exposed, and so to the
• 25:03
  Speaker 2: extent we can on shore, near shore, friendshore those supply
• 25:06
  Speaker 2: chains in addition to actual investment in manufacturing here in
• 25:10
  Speaker 2: the US. That drives all of the work that we're doing.
• 25:14
  Speaker 2: And that's going to continue to be the case as
• 25:15
  Speaker 2: we continue to navigate the tricky China dynamic. That you
• 25:18
  Speaker 2: laid out thoughtful stuff.
• 25:20
  Speaker 1: I mean, I love your takeaway that the way The
• 25:22
  Speaker 1: single best policy agenda for China Hawks to look at
• 25:26
  Speaker 1: is making this the most competitive innovative environment here at home.
• 25:31
  Speaker 1: I think that's a terrific spot to leave it. The
• 25:33
  Speaker 1: report on healthcare and the cost and what to do
• 25:36
  Speaker 1: about it is really compelling. The pieces about our segment
• 25:39
  Speaker 1: of the industry, pushing back against bad ideas and really
• 25:44
  Speaker 1: tackling the things that not everyone are talking about. That's
• 25:48
  Speaker 1: the right thing. We'll be promoting the report. We'll make
• 25:51
  Speaker 1: sure folks see it. Charles, I'm so grateful that you
• 25:54
  Speaker 1: took time to be with us today.
• 25:56
  Speaker 2: John, thank you so much for having me appreciate it.
• 25:58
  Speaker 1: That wraps up this episode the Making Medicine Podcast. Another
• 26:02
  Speaker 1: huge thank you to Charles and Nam for joining us
• 26:04
  Speaker 1: on today's show. Be sure to subscribe on YouTube and
• 26:07
  Speaker 1: follow us on our other channels so you don't miss
• 26:09
  Speaker 1: upcoming conversations. Do you have thoughts on anything we discussed
• 26:13
  Speaker 1: today and how it might impact your portfolio or your company.
• 26:16
  Speaker 1: Let us know and we might feature your comment in
• 26:18
  Speaker 1: next week's episode. Thanks for listening, and as always, keep innovating.