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Theresa Carnegie of Mintz shares her perspective at the Axios roundtable. Photo: Hector Emanuel for Axios

This Tuesday, Axios' health care business reporter Bob Herman and Co-founder Mike Allen hosted an Expert Voices Live discussion on drug pricing and demystifying the pharmaceutical supply chain.

A broken system

While the discussion proved to be a lively debate, there was one area of agreement among attendees — the current health care system and its approach to drug pricing and coverage — is broken.

Sean Dickson and Marcie McClintic Coates look on as Robert DuBois speaks. Photo: Hector Emanuel for Axios
  • Robert DuBois, Chief Science Officer and Executive Vice President and the National Pharmaceutical Council, shared his opinion on high out of pocket costs: "Insurance is supposed to be the healthy subsidizing the sick, but with high out of pocket for drugs, it's the sick subsidizing the healthy."
  • Sean Dickson, Director of Health Policy at West Health, on the system: "The complexity of the system that we built well over a decade ago is contributing to the difficulty of reforming it."
Possible fixes

Herman asked the group if they saw relatively easy fixes to the current health care bills that would allow for widespread support.

  • Jennifer Bryant, Executive Vice President of Policy and Research at PhRMA, highlighted a topic of agreement among the table, "There are distorted incentives that are leading to less uptake of biosimilars and generics than we might otherwise see. One of the reasons is the incentive to put higher list-price products on formulary, and that penalizes patients the most."
  • Marcie McClintic Coates, Head of Global Policy at Mylan, stressed the importance of fixing the formulary tiers, "The formulary tiers still look like 2003, we've not kept a formulary tier for any speciality generics or biosimilars, we have a one-size-fits-all bucket."
  • Jack Hoadley, Researcher at Georgetown's Health Policy Institute, suggested solutions to encourage biosimilar penetration, "Some of it is just acceptance and education among the public and providers that biosimilars are a substitute, the other is figuring out — at several levels, including at the FDA — how to get biosimilars into the market."
Bob Herman and John Rother connect after the event. Photo: Hector Emanuel for Axios
More time, please

As the conversation came to a close, Bob Herman listed the topics he had hoped to cover with the group — the Institute for Clinical and Economic Review's reports, rebates, and an alternative system for drug pricing — if they had more time. The discussion concluded with the following key insights:

  • Matt Kazan, Principal at Avalere, spoke about his time on the hill and the three things needed to get bills like H.R.3 get passed, "Members of Congress can explain the provision at home, it's bipartisan, and the Congressional Budget Office says it saves money."
Michael Budros of Healthsperien at the Axios roundtable. Photo: Hector Emanuel for Axios
  • Michael Budros, Policy Director at Healthsperien, mentioned one topic left out of the conversation, "We haven't talked about how drugs and prices connect to the value to patients...It's something to think about in future iterations of price and cost reform."

Thank you, Mylan for sponsoring this event.

Go deeper

Updated 2 hours ago - World

Over 70 dead in worst bombardments between Israel and Hamas for years

Palestinian Muslims exchange wishes for Eid al-Fitr, marking the end of the fasting month of Ramadan, near a razed building in the northern Gaza Strip town of Beit Lahia, on May 13. Israeli forces said they had killed a senior Hamas commander in May 12 airstrikes. Gaza's health ministry said children died in the strikes. Photo: Majdi Fathi/NurPhoto via Getty Images

At least 67 Palestinians and seven Israelis have been killed in fighting between Israel's military and Hamas since Monday, per Reuters.

The big picture: The worst aerial exchanges of fire between Israel and Hamas since 2014 continued into early Thursday. It comes days after escalating violence in Jerusalem that injured hundreds of Palestinians and several Israeli police officers during protests over the planned evictions of Palestinian families from their homes.

Biden admin grants Colonial waiver to ease fuel shortages

Fuel tanks at Colonial Pipeline Baltimore Delivery in Baltimore, Maryland on Monday. Photo: Jim Watson/AFP via Getty Images

The Biden administration approved a temporary waiver of shipping requirements late Wednesday to help Colonial Pipeline transport fuel, as service resumes across the U.S. following last week's ransomware attack that that took it offline.

Why it matters: The century-old Jones Act requires ships to be built in the U.S. and crewed by American workers, but the waiver means foreign companies can transport gasoline and diesel to areas where there are fuel shortages.

Updated 5 hours ago - Politics & Policy

Don McGahn agrees to closed-door interview with House panel on Russia report

Former White House counsel Don McGahn during a discussion at the NYU Global Academic Center in Washington, D.C., in 2019. Photo by Alex Wong/Getty Images

Former White House counsel Don McGahn agreed Wednesday to speak with the House Judiciary Committee about former President Trump's alleged attempts to obstruct the Russia investigation — with certain conditions, per a court filing.

Why it matters: The agreement ends a two-year standoff after McGahn, a key player in former special counsel Robert Mueller's investigation, repeatedly refused to agree to a subpoena for testimony — resulting in the matter being taken to court.