Latest news with #Popovian
Business Wire
25-06-2025
- Health
- Business Wire
Study Finds Trump's Most Favored Nation Drug Proposal Could Still Raise Out-of-Pocket Costs Without PBM Reform
BOSTON--(BUSINESS WIRE)--Out-of-pocket drug costs for seniors may rise under President Trump's Most Favored Nation (MFN) proposal if policymakers do not address the role of pharmacy benefit managers (PBMs), according to a brief released today by the Pioneer Institute. Smith and Popovian's brief hypothesize that under the Inflation Reduction Act (IRA), PBMs faced lost revenue due to federal price controls, leading them to shift costs to patients. According to Pioneer Institute's IRA Tool, out-of-pocket costs rose by 32 p Share The MFN proposal aims to link U.S. drug prices to the lowest prices in developed countries. However, if rebate contracting remains in place, lower drug prices could still translate into higher out-of-pocket costs for seniors, who may be forced to skip medications to avoid the financial burden. 'We can say with confidence that pharmacy benefit managers are profiting substantially from rebates, fees, and concessions tied to popular medications commonly prescribed to seniors,' said Dr. Bill Smith, co-author of the brief with Dr. Robert Popovian. 'These rebate payments can reach into the billions each year, creating strong incentives for PBMs to maintain the current system, even though many seniors on Medicare cannot afford the rising out-of-pocket costs. Policymakers must address this imbalance and ensure drug pricing works for patients, not just middlemen.' Under the current U.S. pharmaceutical market, PBMs negotiate deals with drug manufacturers promising better coverage in exchange for rebates, various concessions, and fees. To fulfill these contracts, PBMs may increase patients' out-of-pocket costs or impose extra paperwork to steer patients toward certain drugs. While generous rebates can sometimes reduce costs and administrative burdens, the system also incentivizes PBMs to favor higher-priced drugs that offer larger rebates, resulting in higher overall patient costs. This rebate system is largely unregulated and operates behind the scenes. PBMs argue rebates help lower overall drug costs and keep insurance premiums down. However, the lack of transparency creates incentives that don't always benefit patients. Smith and Popovian's brief hypothesize that under the Inflation Reduction Act (IRA), PBMs faced lost revenue due to federal price controls, leading them to shift costs to patients. According to Pioneer Institute's IRA Tool, out-of-pocket costs rose by 32 percent on average for nine commonly prescribed drugs, with seven seeing significant increases. 'Simply put, for the drugs with prices lowered by federal controls, seniors ended up paying more out-of-pocket,' said Dr. Popovian. 'If drug prices fall under the President's new policy but the flawed rebate system remains, patients will still struggle to afford their medications, and well-intentioned policies will backfire.' This warning follows last month's launch by Pioneer, a public tool to monitor the real impact of federal drug price controls under the IRA. The Medicare Drug Access Tracker focuses on Medicare patients served by the four largest PBMs, which cover 87 percent of the market, tracking whether price controls improve affordability over time. Pioneer's initial analysis found out-of-pocket costs increased for seven of nine drugs studied. Key findings include an average cost increase from $74.51 to $98.42 and individual drug cost hikes ranging from $10.56 to $316.81. The public can access the tool at and the full study 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. 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.
Yahoo
10-06-2025
- Health
- Yahoo
Global Healthy Living Foundation Peer-Reviewed Research Shows Hidden Risks of the Inflation Reduction Act's Drug Pricing Reform
Report reveals potential for higher patient costs, worse health outcomes despite lower "fair prices" UPPER NYACK, N.Y., June 10, 2025--(BUSINESS WIRE)--The Global Healthy Living Foundation (GHLF) has launched a research-backed public education campaign to raise awareness about the unintended consequences of drug pricing reforms under the Inflation Reduction Act (IRA). This initiative stems from a recent peer-reviewed paper co-authored by GHLF's Chief Science Policy Officer, Dr. Robert Popovian, Pharm.D., MS, published in the Journal of Health Economics and Outcomes Research (JHEOR). It includes a podcast episode, an infographic, and an article aimed at informing patients, caregivers, and policymakers. "The IRA's "maximum fair price" (MFP) policy was designed to reduce out-of-pocket costs for Medicare patients. However, it may lead to the opposite: higher out-of-pocket costs and increased health risks for vulnerable patients," report author Dr. Popovian says "By suppressing the retail price, CMS is reducing the profit margins and revenue for pharmacy benefit managers (PBMs), which is good. Predictably, the PBMs will not stand pat—they can shift the drug to a higher formulary tier, where patients will pay more out-of-pocket to acquire the medicine so the PBM can protect its profit margin," said Dr. Popovian in a recent episode of GHLF's Healthcare Matters podcast. The study specifically modeled outcomes for two widely used blood thinners, Eliquis and Xarelto. If PBMs reclassify these drugs to higher cost tiers to compensate for lost profit, patients could face an estimated $688 million more in out-of-pocket costs. This cost-shift could result in over 320,000 patients abandoning treatment, potentially leading to 145,000 major cardiovascular events and up to 97,000 deaths. "This research underscores a serious gap in how drug pricing reforms are being implemented and monitored," said Dr. Popovian. "Without proper oversight and transparency, policies that were meant to help patients could end up hurting them." The GHLF education campaign includes: A peer-reviewed paper published in JHEOR: "Could the Inflation Reduction Act Maximum Fair Price Hurt Patients?" A patient-friendly article: "Lower Prices, Higher Risk: How Drug Reform Could Backfire on Patients" published on GHLF's website and supported by social media A special podcast episode of Healthcare Matters, co-hosted by Dr. Popovian A downloadable infographic explaining the findings at-a-glance "This campaign is not about politics—it's about patients," said Seth Ginsberg, GHLF Co-Founder and President. "We want people to understand what's at stake when reforms don't account for the full complexity of our health care system." GHLF encourages policymakers, journalists, and patient advocates to explore these resources and consider how reforms like the IRA impact access to critical medications. 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. View source version on Contacts Louis Tharpltharp@ Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Business Wire
10-06-2025
- Health
- Business Wire
Global Healthy Living Foundation Peer-Reviewed Research Shows Hidden Risks of the Inflation Reduction Act's Drug Pricing Reform
UPPER NYACK, N.Y.--(BUSINESS WIRE)--The Global Healthy Living Foundation (GHLF) has launched a research-backed public education campaign to raise awareness about the unintended consequences of drug pricing reforms under the Inflation Reduction Act (IRA). This initiative stems from a recent peer-reviewed paper co-authored by GHLF's Chief Science Policy Officer, Dr. Robert Popovian, Pharm.D., MS, published in the Journal of Health Economics and Outcomes Research (JHEOR). It includes a podcast episode, an infographic, and an article aimed at informing patients, caregivers, and policymakers. they can shift the drug to a higher price tier where patients will pay more out-of-pocket Share 'The IRA's 'maximum fair price' (MFP) policy was designed to reduce out-of-pocket costs for Medicare patients. However, it may lead to the opposite: higher out-of-pocket costs and increased health risks for vulnerable patients,' report author Dr. Popovian says 'By suppressing the retail price, CMS is reducing the profit margins and revenue for pharmacy benefit managers (PBMs), which is good. Predictably, the PBMs will not stand pat—they can shift the drug to a higher formulary tier, where patients will pay more out-of-pocket to acquire the medicine so the PBM can protect its profit margin,' said Dr. Popovian in a recent episode of GHLF's Healthcare Matters podcast. The study specifically modeled outcomes for two widely used blood thinners, Eliquis and Xarelto. If PBMs reclassify these drugs to higher cost tiers to compensate for lost profit, patients could face an estimated $688 million more in out-of-pocket costs. This cost-shift could result in over 320,000 patients abandoning treatment, potentially leading to 145,000 major cardiovascular events and up to 97,000 deaths. 'This research underscores a serious gap in how drug pricing reforms are being implemented and monitored,' said Dr. Popovian. 'Without proper oversight and transparency, policies that were meant to help patients could end up hurting them.' The GHLF education campaign includes: 'This campaign is not about politics—it's about patients,' said Seth Ginsberg, GHLF Co-Founder and President. 'We want people to understand what's at stake when reforms don't account for the full complexity of our health care system.' GHLF encourages policymakers, journalists, and patient advocates to explore these resources and consider how reforms like the IRA impact access to critical medications. 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.
Yahoo
10-06-2025
- Health
- Yahoo
Global Healthy Living Foundation Says Vaccine Committee Firings Before Respiratory Virus Season Creates High Risk Of Illness In the Chronic Disease Community
HHS Interrupts "The Most Cost-Beneficial Intervention In Healthcare" UPPER NYACK, N.Y., June 10, 2025--(BUSINESS WIRE)--Yesterday, the Secretary of Health and Human Services (HHS) removed all sitting members of the Advisory Committee on Immunization Practices (ACIP), the expert panel that advises the Centers for Disease Control and Prevention (CDC) on vaccine use. While the groups such as the Global Healthy Living Foundation (GHLF) recognize the Secretary's right to do this, the decision made just ahead of the upcoming respiratory virus season puts at risk chronically ill patients who rely on vaccines to fight respiratory virus infections. ACIP is often critical in shaping public health strategies with its advisory recommendations. While the FDA-approved label remains the definitive, enforceable standard for how vaccines should be used in clinical practice, ACIP guidance often informs insurance company coverage, determines whether vaccines are free under the Affordable Care Act, provides healthcare provider protocols, and helps ensure vaccination campaign success , especially for vulnerable populations. "Removing the entire committee without immediate replacement or clear guidance creates uncertainty when COVID-19, flu, and RSV are expected to circulate widely in the coming months," said Robert, Popovian, PharmD, MS, GHLF's Chief Science Policy Officer. "Now is the time when the advisory committee makes its recommendations, and disruption in the advisory process could have profound implications for individuals with chronic illnesses who depend on timely vaccine access to protect themselves against these viruses. "We support the need for ACIP to remain independent, and we recognize the Secretary's authority to appoint new members," Dr. Popovian added. "But removing all members without naming successors or offering a timeline to replace them so close to respiratory season could delay essential recommendations. "Vaccines are the most cost-beneficial intervention in healthcare—we should do everything possible to maintain uninterrupted access to expert guidance including ensuring there is no gap in expert advice during this critical period for immunization planning," Dr. Popovian added. 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. View source version on Contacts Louis TharpLTHARP@ Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Business Wire
10-06-2025
- Health
- Business Wire
Global Healthy Living Foundation Says Vaccine Committee Firings Before Respiratory Virus Season Creates High Risk Of Illness In the Chronic Disease Community
BUSINESS WIRE)--Yesterday, the Secretary of Health and Human Services (HHS) removed all sitting members of the Advisory Committee on Immunization Practices (ACIP), the expert panel that advises the Centers for Disease Control and Prevention (CDC) on vaccine use. Vaccines are the most cost-beneficial intervention in healthcare While the groups such as the Global Healthy Living Foundation (GHLF) recognize the Secretary's right to do this, the decision made just ahead of the upcoming respiratory virus season puts at risk chronically ill patients who rely on vaccines to fight respiratory virus infections. ACIP is often critical in shaping public health strategies with its advisory recommendations. While the FDA-approved label remains the definitive, enforceable standard for how vaccines should be used in clinical practice, ACIP guidance often informs insurance company coverage, determines whether vaccines are free under the Affordable Care Act, provides healthcare provider protocols, and helps ensure vaccination campaign success , especially for vulnerable populations. 'Removing the entire committee without immediate replacement or clear guidance creates uncertainty when COVID-19, flu, and RSV are expected to circulate widely in the coming months,' said Robert, Popovian, PharmD, MS, GHLF's Chief Science Policy Officer. 'Now is the time when the advisory committee makes its recommendations, and disruption in the advisory process could have profound implications for individuals with chronic illnesses who depend on timely vaccine access to protect themselves against these viruses. 'We support the need for ACIP to remain independent, and we recognize the Secretary's authority to appoint new members,' Dr. Popovian added. 'But removing all members without naming successors or offering a timeline to replace them so close to respiratory season could delay essential recommendations. 'Vaccines are the most cost-beneficial intervention in healthcare—we should do everything possible to maintain uninterrupted access to expert guidance including ensuring there is no gap in expert advice during this critical period for immunization planning,' Dr. Popovian added. 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.
