Latest news with #RobertPopovian
Business Wire
09-05-2025
- Health
- Business Wire
Pioneer Institute Launches Tracker Showing Drug Price Controls Are Raising Out-of-Pocket Costs for Medicare Patients
BOSTON--(BUSINESS WIRE)--A new data tool from Pioneer Institute reveals that federal drug price controls—intended to reduce out-of-pocket costs for seniors—are instead making many prescription drugs more expensive for Medicare beneficiaries. Its first analysis shows that among nine commonly prescribed medications which were subject to price setting by the IRA —used to treat conditions like heart failure, diabetes, and blood clotting—seven saw an increase in patient out-of-pocket costs. Share The IRA Medicare Drug Access Tracker, developed by Dr. William Smith and Dr. Robert Popovian, monitors the impact of the Inflation Reduction Act's (IRA) drug pricing provisions. Its first analysis shows that among nine commonly prescribed medications which were subject to price setting by the IRA —used to treat conditions like heart failure, diabetes, and blood clotting— seven saw an increase in patient out-of-pocket costs. (The insulin product was not studied since its price was fixed in statute under a separate IRA provision.) 'The price controls show that Congress fundamentally doesn't understand the rebate system that underpins the pharmaceutical market,' said Dr. William Smith, who built the Tracker with Dr. Robert Popovian. 'All the politicians who argued that the IRA law would make drugs more affordable should look at this new data.' Under the current system, drug manufacturers pay substantial rebates to pharmacy benefit managers (PBMs) such as Caremark and Optum. These rebates help offset costs but are invisible to patients. When CMS seeks to control prices by lowering a drug's official 'list price,' as it does with the anti-coagulant Eliquis —bringing the price down from $521 to $231—rebates disappear, likely eliminating hundreds of millions in rebate payments from manufacturers to PBMs. PBMs appear to be compensating for that loss by raising co-pays, co-insurance, and transferring other charges directly to patients. The IRA Medicare Drug Access Tracker focuses on Medicare patients served by the four largest PBMs, which account for 87 percent of the market. The tool is designed to measure whether federal price controls actually improve affordability for seniors by tracking out-of-pocket costs over time. It also follows administrative burdens that PBMs may have imposed on these drugs, which may strain already short-staffed providers, such as requiring them to fill out additional paperwork to secure a prescription (prior authorization) or placing quantity limits on the medications. Such administrative burdens are often used in the industry to discourage demand (demand management). Among the Tracker's key findings: Average out-of-pocket costs for the nine drugs rose 32 percent, from $74.51 to $98.42 Seven of the nine drugs saw individual cost increases ranging from $10.56 to $316.81 One of the two medicines seeing no increase in out-of-pocket costs faced competition from biosimilars that only became available in 2025 'Higher out-of-pocket costs are unlikely to be the only unintended consequence of drug price controls,' Dr. Popovian said. 'The IRA also creates less incentive for pharmaceutical innovation and increases the possibility that some popular drugs may be excluded from health insurance formularies.' This release marks the Tracker's first report. Pioneer Institute will publish additional data later this year, as more drugs fall under the Inflation Reduction Act's price-setting provisions. The public can find the tool at Dr. William S. Smith is Senior Fellow & Director of Pioneer Life Sciences Initiative. Dr. Smith has 25 years of experience in government and in corporate roles. His career includes senior staff positions for the Republican House leadership on Capitol Hill, the White House Office of National Drug Control Policy, and the Massachusetts Governor's office where he served under Governors Weld and Cellucci. He spent ten years at Pfizer Inc as Vice President of Public Affairs and Policy where he was responsible for Pfizer's corporate strategies for the U.S. policy environment. He later served as a consultant to major pharmaceutical, biotechnology and medical device companies. Dr. Smith earned his PhD in political science with distinction at The Catholic University of America. Dr. Robert Popovian is the Founder of the strategic consulting firm Conquest Advisors. He also serves as Chief Science Policy Officer at the Global Healthy Living Foundation, Senior Healthy Policy Fellow at the Progressive Policy Institute, and Visiting Health Policy Fellow at the Pioneer Institute. He previously served as Vice President, U.S. Government Relations at Pfizer. One of the country's foremost experts on every significant facet of biopharmaceuticals and the healthcare industry, he is a recognized authority on health economics, policy, government relations, medical affairs, and strategic planning. To learn more about Dr. Popovian please click here. About Pioneer Institute Pioneer empowers Americans with choices and opportunities to live freely and thrive. Working with state policymakers, we use expert research, educational initiatives, legal action and coalition-building to advance human potential in four critical areas: K-12 Education, Health, Economic Opportunity, and American Civic Values. Please see below the first group of drugs subject that Pioneer is studying. Eliquis Enbrel Entresto Farxiga Imbruvica Januvia Jardiance Stelara Xarelto
Yahoo
09-05-2025
- Health
- Yahoo
Pioneer Institute Launches Tracker Showing Drug Price Controls Are Raising Out-of-Pocket Costs for Medicare Patients
New data tool shows out-of-pocket costs have increased for most drugs targeted by Inflation Reduction Act price controls BOSTON, May 09, 2025--(BUSINESS WIRE)--A new data tool from Pioneer Institute reveals that federal drug price controls—intended to reduce out-of-pocket costs for seniors—are instead making many prescription drugs more expensive for Medicare beneficiaries. The IRA Medicare Drug Access Tracker, developed by Dr. William Smith and Dr. Robert Popovian, monitors the impact of the Inflation Reduction Act's (IRA) drug pricing provisions. Its first analysis shows that among nine commonly prescribed medications which were subject to price setting by the IRA —used to treat conditions like heart failure, diabetes, and blood clotting—seven saw an increase in patient out-of-pocket costs. (The insulin product was not studied since its price was fixed in statute under a separate IRA provision.) "The price controls show that Congress fundamentally doesn't understand the rebate system that underpins the pharmaceutical market," said Dr. William Smith, who built the Tracker with Dr. Robert Popovian. "All the politicians who argued that the IRA law would make drugs more affordable should look at this new data." Under the current system, drug manufacturers pay substantial rebates to pharmacy benefit managers (PBMs) such as Caremark and Optum. These rebates help offset costs but are invisible to patients. When CMS seeks to control prices by lowering a drug's official "list price," as it does with the anti-coagulant Eliquis—bringing the price down from $521 to $231—rebates disappear, likely eliminating hundreds of millions in rebate payments from manufacturers to PBMs. PBMs appear to be compensating for that loss by raising co-pays, co-insurance, and transferring other charges directly to patients. The IRA Medicare Drug Access Tracker focuses on Medicare patients served by the four largest PBMs, which account for 87 percent of the market. The tool is designed to measure whether federal price controls actually improve affordability for seniors by tracking out-of-pocket costs over time. It also follows administrative burdens that PBMs may have imposed on these drugs, which may strain already short-staffed providers, such as requiring them to fill out additional paperwork to secure a prescription (prior authorization) or placing quantity limits on the medications. Such administrative burdens are often used in the industry to discourage demand (demand management). Among the Tracker's key findings: Average out-of-pocket costs for the nine drugs rose 32 percent, from $74.51 to $98.42 Seven of the nine drugs saw individual cost increases ranging from $10.56 to $316.81 One of the two medicines seeing no increase in out-of-pocket costs faced competition from biosimilars that only became available in 2025 "Higher out-of-pocket costs are unlikely to be the only unintended consequence of drug price controls," Dr. Popovian said. "The IRA also creates less incentive for pharmaceutical innovation and increases the possibility that some popular drugs may be excluded from health insurance formularies." This release marks the Tracker's first report. Pioneer Institute will publish additional data later this year, as more drugs fall under the Inflation Reduction Act's price-setting provisions. The public can find the tool at Dr. William S. Smith is Senior Fellow & Director of Pioneer Life Sciences Initiative. Dr. Smith has 25 years of experience in government and in corporate roles. His career includes senior staff positions for the Republican House leadership on Capitol Hill, the White House Office of National Drug Control Policy, and the Massachusetts Governor's office where he served under Governors Weld and Cellucci. He spent ten years at Pfizer Inc as Vice President of Public Affairs and Policy where he was responsible for Pfizer's corporate strategies for the U.S. policy environment. He later served as a consultant to major pharmaceutical, biotechnology and medical device companies. Dr. Smith earned his PhD in political science with distinction at The Catholic University of America. Dr. Robert Popovian is the Founder of the strategic consulting firm Conquest Advisors. He also serves as Chief Science Policy Officer at the Global Healthy Living Foundation, Senior Healthy Policy Fellow at the Progressive Policy Institute, and Visiting Health Policy Fellow at the Pioneer Institute. He previously served as Vice President, U.S. Government Relations at Pfizer. One of the country's foremost experts on every significant facet of biopharmaceuticals and the healthcare industry, he is a recognized authority on health economics, policy, government relations, medical affairs, and strategic planning. To learn more about Dr. Popovian please click here. About Pioneer Institute Pioneer empowers Americans with choices and opportunities to live freely and thrive. Working with state policymakers, we use expert research, educational initiatives, legal action and coalition-building to advance human potential in four critical areas: K-12 Education, Health, Economic Opportunity, and American Civic Values. Please see below the first group of drugs subject that Pioneer is studying. Eliquis Enbrel Entresto Farxiga Imbruvica Januvia Jardiance Stelara Xarelto View source version on Contacts Media Contact: Amie O'Hearn aohearn@ Sign in to access your portfolio
Business Wire
07-05-2025
- Health
- Business Wire
Vaccines Still Matter – Global Healthy Living Foundation Sees Strong Patient Engagement Despite Current Negative Rhetoric
BUSINESS WIRE)--At a medical conference for vaccine professionals, Global Healthy Living Foundation (GHLF) social media posts, podcasts and YouTube videos had surprising uptake among chronically ill patients, despite continuing anti-vaccine rhetoric from many media, individuals and government sources. ...Surprising uptake among chronically ill patients, despite continuing anti-vaccine rhetoric from many media, individuals and government sources. GHLF's coverage of the World Vaccine Congress, held in Washington, D.C. last week, reached more than 23,000 non-attendees and generated more than 800 engagements across platforms including LinkedIn, X, Instagram, Facebook, TikTok, and YouTube. A special video podcast episode of Healthcare Matters recorded at the conference and published on April 25 has so far garnered more than 4,900 views/listens and continues to climb. 'These aren't big numbers for consumer-oriented social media posts or podcasts,' said Robert Popovian, PharmD, MS, GHLF's Chief Science Policy Officer. 'But GHLF's digital output is organic, high-credibility and tailored to niche audiences of professionals, as well as individuals and caregivers with specific chronic diseases. It isn't necessarily relevant unless you have, or care for someone, with a very specific disease, so these are significant numbers in a short time frame,' he said. 'It signals to us that maintaining and protecting health in the face of a chronic illness is important to this audience. They want information about vaccines, and they understand the value of vaccinations in reaching their health goals,' Dr. Popovian added. 'Before the current drop in vaccination rates among the general public in some areas of the U.S., people with ongoing illnesses who were often immunocompromised, could rely on the overall community immunity to add an extra measure of protection against disease. This extra protection, afforded by healthy vaccinated individuals who felt a responsibility to their neighbors, isn't as prevalent today so we lose community immunity and diseases that were eradicated in the U.S. many years ago are returning,' Popovian added. 'What really struck me at the World Vaccine Congress was how aligned people were — from pharma leaders to advocates to policy folks — about the urgency of fighting misinformation and navigating funding shortfalls. Even with different perspectives, there was a real sense of unity and shared purpose, which left me hopeful about the road ahead, especially with new applications for mRNA vaccines,' Ben Blanc, MS, GHLF's Director of Digital Production and Engagement said. The Healthcare Matters podcast, which proved immediately popular among patients, was recorded live at the Congress and hosted by Dr. Popovian and Mr. Blanc. The episode featured vaccine experts, including: Richard Hughes, Partner at Epstein Becker & Green and Lecturer in Law at George Washington University Tommy Acciani, Director, U.S. Vaccine Policy, GSK Abby Bownas, Co-lead, Adult Vaccine Access Coalition Rekha Lakshmanan, Chief Strategic Officer, The Immunization Partnership The podcast explored the current landscape of adult immunization policy, funding threats to vaccine infrastructure, misinformation challenges, and what's next for vaccine innovation. For continued updates and to access GHLF's World Vaccine Congress content, visit: All interviews, as well as our special video episode, can be found here: About GHLF The Global Healthy Living Foundation is a U.S. based, 501(c)(3) nonprofit, international organization whose mission is to improve the quality of life for people with chronic illnesses by advocating for improved access to health care through education, patient-centered clinical research, support, advocacy, and economic and policy research. GHLF is also a staunch advocate for vaccines. The Global Healthy Living Foundation is the parent organization of CreakyJoints®, the international, digital community for millions of people living with arthritis and their supporters worldwide who seek education, support, activism, and patient-centered research in English, Spanish, and French. In addition to arthritis and autoimmune disorders, GHLF supports dermatology, gastroenterology, neurology, cardiology, oncology, infectious disease, rare disease, and pulmonary patients through a host of different programs and activities which draw more than 700,000 patients a month to GHLF websites and create more than 10 million impressions a month on seven social media platforms. In 2024, GHLF had more than 1 million views and listens with its patient-centered audio-visual content, found on YouTube and podcast platforms. GHLF never asks the public for donations, receiving funding instead through governments, non-governmental organizations, foundations, industry, family foundations, and GHLF Co-Founder Louis Tharp. Visit for more information.
