In this episode of Healthcare Matters, Dr. Robert Popovian and Ben Blanc sit down with Dr. Alison Bailey, Chief of Cardiology for Centennial Heart at Parkridge in Chattanooga, Tennessee and a Physician Director of Cardiovascular Disease for HCA Healthcare, to explore how policy decisions can help—or hinder—innovation in cardiovascular care.

They discuss the hidden consequences of the Inflation Reduction Act (IRA) for small molecule drug development, the promise of gene-targeted therapies like siRNA, and why medical research funding remains vital for turning new science into life-saving treatments.

Tune in to learn why smarter incentives and stable funding are key to tackling America’s growing cardiovascular crisis.

Among the highlights in this episode:

03:28: Dr. Bailey shares her passion for cardiovascular prevention, emphasizing how patient education and access shape outcomes

04:12: Dr. Bailey discusses the concerning rise in cardiovascular death rates in the U.S. despite advances in treatment, pointing to lifestyle factors and health inequities

05:35: Ben asks about the impact of small molecule therapies in cardiology and how the Inflation Reduction Act may affect future drug development

06:04: Dr. Popovian explains how the IRA’s Maximum Fair Price (MFP) policy shortens market exclusivity for small molecules, reducing incentives for new cardiovascular treatments

08:40: Dr. Bailey expands on how genetically targeted small molecules, like siRNA therapies, are game-changers for cholesterol and rare cardiac conditions, but policy must support their development

10:50: Ben asks about the consequences for patients if companies shift focus away from small molecules. Dr. Bailey warns that fewer innovations could limit treatment options and worsen health disparities

12:15: Dr. Popovian explains how small molecules remain essential for oral medications that improve adherence, affordability, and widespread access—especially in chronic conditions like heart disease

13:00: Ben brings up the bipartisan MINI Act, which aims to align protections for certain targeted small molecule therapies with biologics to maintain incentives for innovation

14:45: Dr. Bailey supports the MINI Act as a practical fix that would encourage more investment in next-generation therapies and benefit cardiovascular patients

16:20: Dr. Popovian highlights the risk of medical research funding cuts, stressing that NIH funding drives discoveries that pharma can’t tackle alone

18:05: Dr. Bailey gives real-world examples of now-standard heart medications that came from decades of NIH and industry collaboration, underscoring the need for stable funding

19:00: Dr. Popovian adds that even widely used generic drugs like beta blockers for heart failure exist today because of federally funded research

20:40: Dr. Popovian and Dr. Bailey agree that more clinician voices are needed to help policymakers see the real impact of drug policy on patient care

22:00: Dr. Bailey closes by stressing that these therapies are not hypothetical—they are real and available now but require supportive policy to reach all patients who need them

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: rpopovian@ghlf.org

Ben Blanc, Director, Digital Production and Engagement at GHLF: bblanc@ghlf.org

A podcast series produced by Ben Blanc.

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to podcasts@ghlf.org

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.

In this episode of Healthcare Matters, Dr. Robert Popovian and Ben Blanc dive into a recent paper published in the Journal of Health Economics and Outcomes Research that explores the unintended consequences of drug price-setting under the Inflation Reduction Act. Using real-world modeling focused on Eliquis and Xarelto—two widely used anticoagulants—Dr. Popovian discusses how Pharmacy Benefit Managers (PBMs) may shift costs onto patients in response to federal pricing reforms, potentially increasing the risk of treatment abandonment, hospitalization, and death.

Tune in as our hosts break down how pricing policy, rebates, and transparency intersect—and why policymakers must act now to protect patient access.

Among the highlights in this episode:

00:45: Ben introduces the topic of the episode: how new drug pricing rules that aim to lower costs could unintentionally increase out-of-pocket expenses and reduce access for patients

01:12: Robert discusses GHLF’s recent paper, which he co-authored and that was published in the Journal of Health Economics and Outcomes Research, on the potential risks of the IRA’s Maximum Fair Price (MFP) policy

To access he full paper, visit: https://jheor.org/article/125251-could-the-inflation-reduction-act-maximum-fair-price-hurt-patients

02:16: Robert explains how the MFP allows the federal government to set prices for high-spend Medicare drugs and how this disrupts the current rebate model used by PBMs

03:38: Robert describes how PBMs and insurers may respond to lower drug prices by shifting medications to higher formulary tiers or increasing patient cost-sharing to make up for lost rebate revenue

05:10: Ben transitions to the study’s real-world modeling and asks why Eliquis and Xarelto were chosen as the focus

05:42: Robert explains that these two anticoagulants were selected because they are widely used among older adults and come with serious risks if treatment is abandoned

06:55: Ben highlights the human cost of non-adherence and prompts Robert to detail the real-world health outcomes if patients stop taking these drugs

07:23: Robert cites published data showing that increased out-of-pocket costs lead to medication abandonment—and in the case of Eliquis and Xarelto, that can mean higher risks of stroke, heart attack, and death

09:16: Ben asks about transparency in drug pricing and how the current system makes it difficult to understand what patients actually pay

09:38: Robert explains how PBMs deliberately obscure drug pricing, rebates, and patient costs, calling it a “black box” that benefits from secrecy and ultimately harms patients

12:07: Robert calls on Centers for Medicare and Medicaid Services (CMS) to monitor both formulary coverage and out-of-pocket costs for MFP drugs, ensuring that price controls don’t backfire by limiting access or shifting costs to patients

13:20: Robert references a real-time tracking tool from the Pioneer Institute that supports the findings of his study and shows actual increases in out-of-pocket costs for MFP drugs

You can access the Pioneer Institute’s tool here: https://pioneerinstitute.org/the-inflation-reduction-act-ira-overview/

14:59: Robert reinforces that the IRA’s price-setting goals are noble—but without oversight of PBM behavior, patients could be harmed by unintended policy consequences

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: rpopovian@ghlf.org

Ben Blanc, Director, Digital Production and Engagement at GHLF: bblanc@ghlf.org

A podcast series produced by Ben Blanc.

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to podcasts@ghlf.org

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.

In this episode of Healthcare Matters, hosts Dr. Robert Popovian and Ben Blanc are joined by Peter Pitts, former FDA Associate Commissioner and President of the Center for Medicine in the Public Interest. Together, they unpack the sweeping personnel cuts at HHS, ongoing instability at the FDA, and how it all may threaten the future of drug innovation in the U.S. With delays in leadership appointments, policy misalignment across agencies, and increased uncertainty from pricing reforms like the Inflation Reduction Act, pharmaceutical companies may hit pause—and patients may pay the price.

Tune in for a timely discussion on how chaos in science policy reverberates through clinical innovation and patient access.

Among the highlights in this episode:

03:09: Peter Pitts shares his FDA background and warns against viewing staff consolidation through a purely numerical lens—emphasizing the nuance of function and legal responsibility

04:07: Peter breaks down FDA’s structure, clarifying that the majority of its 18,000 staff are non-political, career public health officials—not industry influenced

06:33: Peter explains that gutting senior leadership slows down innovation and drug approvals, as regulatory coordination is weakened

07:42: Peter details ongoing leadership instability across FDA’s key centers (drugs, biologics, devices), and notes the loss of progressive voices like Dr. Peter Marks and Dr. Patrizia Cavazzoni

08:32: Dr. Popovian adds that short- and long-term uncertainty in biopharma is significant, especially in oncology—a therapeutic area critical to innovation and patient survival

09:53: Peter warns that chaos and unpredictability undercut investor confidence, which could delay development in oncology, gene therapy, and rare diseases

11:10: Dr. Popovian reinforces that cancer care is now chronic care, and disruptions in FDA operations could rob patients of critical time and treatment options

11:42: Peter highlights misalignment between FDA and CMS, especially when CMS questions the validity of FDA-approved data—jeopardizing reimbursement

12:43: Dr. Popovian and Peter urge alignment between FDA and CDC guidance, citing conflicting vaccine messaging as a source of confusion for patients and providers

13:37: Peter underscores the need for improved communication and coordination between public health agencies to rebuild trust

15:06: Dr. Popovian raises concerns that instability and underappreciation will deter top scientists from public service roles at agencies like the FDA

17:21: Dr. Popovian explains that pharmaceutical companies are delaying R&D and trial investments due to regulatory uncertainty

18:35: Peter adds that companies may also pause research into new uses for existing drugs—despite their public health value—due to unclear FDA pathways

19:21: Dr. Popovian discusses how the Inflation Reduction Act (IRA) further complicates investment decisions, creating a “perfect storm” with FDA uncertainty

23:19: Ben emphasizes that policy uncertainty delays hope for patients awaiting new treatments—and that public accountability is more important than ever

24:03: Dr. Popovian shares some final thoughts

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: rpopovian@ghlf.org

Ben Blanc, Director, Digital Production and Engagement at GHLF: bblanc@ghlf.org

A podcast series produced by Ben Blanc.

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to podcasts@ghlf.org

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.

Are well-intentioned vaccine policies making access harder instead of easier? In this episode of Healthcare Matters, hosts Dr. Robert Popovian and Ben Blanc unpack a new report from the Global Healthy Living Foundation (GHLF) on how Shared Clinical Decision Making (SCDM) and risk-based recommendations may unintentionally reduce adult vaccination rates—particularly in underserved communities. From real-world data showing a 10 percent drop in pneumococcal vaccine uptake to sharp disparities in meningitis coverage, the findings are hard to ignore.

Tune in as we explore how these policies may create confusion, widen health inequities, and hinder access—and what can be done to fix it.

Among the highlights in this episode:

03:00: Dr. Popovian explains what Shared Clinical Decision Making (SCDM) is and the role of Advisory Committee on Immunization Practices (ACIP), noting the challenges of expecting time-strapped physicians to hold complex conversations with patients

06:00: Dr. Popovian expresses concern that SCDM can lead to decreased immunization rates due to misaligned expectations and informational imbalance

07:15: Dr. Popovian cites a 10 percent drop in pneumococcal vaccine uptake after its recommendation changed from “routine” to SCDM, and notes a striking difference in coverage between the quadrivalent meningococcal vaccine (60.8%) and MenB (11.9%) meningitis vaccines, the latter being subject to SCDM

10:03: Dr. Popovian explains that pharmacists and clinic-based providers often lack access to patients’ full medical records—making risk-based decisions difficult in practice

13:47: Dr. Popovian explains that patients in underserved areas often rely on pharmacies or federally qualified health clinics, where continuity of care is lacking and risk assessments are harder to verify—exacerbating health inequities

15:59: Dr. Popovian predicts the administration will double down on SCDM and patient-led decisions—likely leading to lower vaccination rates and reduced herd immunity

17:58: Dr. Popovian warns that some states (like Louisiana) are banning public health messaging about vaccines, making the role of advocacy organizations even more critical in providing accurate information

19:00: Ben emphasizes the importance of education, outreach, and advocacy to bridge the gap between policy and real-world vaccination practices

19:00: Dr. Popovian calls for aligning ACIP recommendations with FDA labels and tracking the public health consequences of recent policy changes

20:02: Dr. Popovian shares some final thoughts

For more information about “Enhancing Adult Vaccine Uptake: Challenges in Shared Clinical Decision Making and Risk-Based Recommendations,” and to access the full report, visit: https://ghlf.org/issues/vaccines/enhancing_adult_vaccine_uptake/

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: rpopovian@ghlf.org

Ben Blanc, Director, Digital Production and Engagement at GHLF: bblanc@ghlf.org

A podcast series produced by Ben Blanc.

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to podcasts@ghlf.org

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.

Did you know that millions of adults may have missed crucial vaccines due to restrictive state policies on pharmacist vaccination authority? In this episode of Healthcare Matters, hosts Dr. Robert Popovian and Ben Blanc sit down with Vibhu Tewary and Conrad Bhamani from the IQVIA Institute for Human Data Science to discuss new research conducted by the IQVIA Institute and GHLF on how these restrictions impact vaccination rates. They break down key findings from the report, revealing that states with tighter regulations see significantly lower vaccine uptake — by as much as 14% for RSV vaccines.

Tune in as they explore real-world consequences for underserved communities, why pharmacists are essential to public health, and what policy changes could help expand vaccine access.

Among the highlights in this episode:

01:17: Ben introduces the key topic of the episode: how state restrictions on pharmacists’ vaccination authority may be preventing millions of adults from accessing crucial vaccines

02:56: Dr. Popovian explains that pharmacists are the most accessible health care professionals, particularly in underserved communities, and cites data showing that many patients prefer to receive vaccines at pharmacies

05:27: Conrad highlights key statistics from the report, including that states requiring a physician’s prescription for RSV vaccines see a 14% lower vaccination rate, while states requiring a physician protocol see a 9% lower rate

07:41: Vibhu explains how pharmacy access is critical for people in low-income and minority communities, who often face additional barriers to seeing a physician during regular office hours

09:56: Dr. Popovian outlines policy recommendations, including eliminating physician prescription requirements and protocol restrictions, to make vaccinations more accessible

12:39: Dr. Popovian emphasizes the importance of collaboration between pharmacists and physicians and urges pharmacists to advocate for policy changes

14:10: Vibhu discusses how states that grant pharmacists independent vaccination authority tend to have higher immunization rates and how data should drive policy decisions

16:14: Dr. Popovian shares some final thoughts

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: rpopovian@ghlf.org

Ben Blanc, Director, Digital Production and Engagement at GHLF: bblanc@ghlf.org

A podcast series produced by Ben Blanc.

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to podcasts@ghlf.org

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.

In this episode of Healthcare Matters, Dr. Robert Popovian, Ben Blanc, and guest Corey Greenblatt, Director of State Policy and Advocacy at GHLF, dive into the complexities of vaccine guidelines and access. They discuss the role of the Advisory Committee on Immunization Practices (ACIP), with Corey sharing insights on GHLF’s advocacy to make vaccines more accessible. Dr. Popovian underscores the importance of aligning guidelines with FDA labeled indication or to institute more common sense ACIP guidance that can be applied at the community level to improve clarity for health care providers and access for patients.

Tune in to learn how streamlined guidelines, improved patient data access, and empowered health care providers can drive better patient care in the U.S.

Among the highlights in this episode:

02:41: Dr. Popovian explains the role of ACIP and its impact on vaccine recommendations, which are based on expert consensus and cost-effectiveness, emphasizing its relevance for patients with chronic illnesses

04:03: Corey Greenblatt shares GHLF’s feedback to ACIP regarding proposed RSV guidelines, focusing on the need for improved vaccine access for older patients and the limitations of relying on patient self-reporting for eligibility

06:35: Corey highlights the importance of pharmacies in vaccine access, especially in underserved communities, and stresses that empowering pharmacists to make informed decisions could increase vaccine uptake among high-risk populations

07:04: Corey discusses challenges of implementing ACIP’s RSV guidelines in community pharmacy settings, especially for patients aged 60 to 74, stressing the importance of aligning guidelines with FDA recommendations to empower pharmacists

09:01: Dr. Popovian elaborates on the limitations of patient self-reporting in health care, explaining how it can conflict with health care providers' training and undermine clinical judgment

11:57: Dr. Popovian and Ben discuss patient data ownership, with Ben explaining how France’s centralized health care system provides patients with direct access to their medical records, a stark contrast to the fragmented approach in the U.S.

15:35: Ben compares the U.S. and French health care systems, focusing on patient access to medical records, and how France’s centralized system enables better record access and coordination

19:55: Dr. Popovian advocates for alignment between ACIP guidelines and FDA labels, noting that clear, consistent guidelines would aid health care providers, particularly pharmacists, in safely delivering vaccines

24:47: Dr. Popovian shares some final thoughts

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: rpopovian@ghlf.org

Ben Blanc, Associate Director, Digital Production and Engagement at GHLF: bblanc@ghlf.org

A podcast series produced by Ben Blanc.

We want to hear what you think. Send your comments, or a video or audio clip of yourself, to podcasts@ghlf.org

Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.

See omnystudio.com/listener for privacy information.