Understanding the Relationship Between Government Policies, Patient Access: John M. O'Brien, PharmD, MPH

John Michael O'Brien, PharmD, MPH, president and CEO of the National Pharmaceutical Council (NPC), discussed how continued communication across sectors is vital in helping to understand the relationship between patient access to treatment and government policy.

This transcript has been lightly edited for clarity; captions were auto-generated.

Transcript

How can the relationships between pharmaceutical makers, insurers, health systems, and patients be improved?

This question reminds me of Don Berwick quoting Paul Batalden in saying that “every system is perfectly designed to get the results it gets,” which means that we have some real work to do if we want a system that ensures that scientific advancement is accessible to patients, valued by society, and sustainably reimbursed by payers to ensure continued advancement. We can’t lose our world-leading ability to generate the next scientific breakthrough. We can’t lose our ability to turn a death sentence into a chronic, manageable condition, or generate a new cure that provides benefits that endure across a patient’s lifetime.

When AJMC^® first launched 30 years ago, I was a pharmacy student making my first trip to Washington, DC, to better understand the role of health policy in patient care. Over those past 3 decades, I’ve relied on that experience to work across the government, to work in the managed care industry at a health plan, to work at a pharmaceutical company, and, most importantly, to care for my own parents as they’ve aged. It’s those experiences that inform my role today in leading the NPC. But the one thread that ties all of those experiences together is a never-ending belief that prescription medicines are something that help people get well, stay healthy, avoid more costly care settings, and live their best life the way that they define it.

But all too often, the way that we pay for medicines is about extracting margin today as opposed to generating value tomorrow. That’s true whether we’re talking about helping patients with enduring treatments across their lifespan or helping managed care plans achieve population health that lowers costs for years to come. We can’t pay for today’s treatments and tomorrow’s cures with the same reimbursement system that we used to pay for blood pressure medicines and cholesterol drugs decades ago. We need as much innovation in managed care reimbursement as we have in scientific innovation in the pharmaceutical labs. So here at NPC, we want to have an honest, evidence-driven conversation that helps decision makers, wherever they are, understand the value of scientific advancement, so that everyone understands how private-sector or government policies affect patient access to today’s treatments and tomorrow’s cures.

Congratulations on 30 years! We look forward to working with you over the next 30 as well.