3. Breaking Down Barriers: An Interview with Peyton Howell

This episode features an interview with Peyton Howell discussing the evolution of patient access over the past three decades, the creation of the hub industry, and the continuing challenges faced by pharma companies and service providers in supporting patient access to medications.

Podcast: Prescription for Better Access

Episode: Ep 3

Welcome to Prescription for Better Access, a new interview-focused podcast brought to you by two healthcare industry veterans aimed to help shape the future of patient access and affordability! In this episode, co-hosts Mark Hansan and Dr. Scott Howell interview Peyton Howell, an early leader in the industry, about the evolution of patient access, the hub industry and where things are headed in terms of patient access. 

To begin, Peyton shares about her career background. She has always loved the healthcare field and worked in hospital administration to pay her way through college. While earning a Masters Degree in health administration at Ohio State University, she had the opportunity to work directly with the COO of the hospital on projects related to patient access. Thus, she was offered an early view into how to correct treatment therapies and improve patient access. After grad school she focused on the consulting side, helping hospitals and sites. She was approached by office administrators to join in on the creation of Lash Group, a practice group focused on the pharma industry.

Peyton sold Lash Group in 1998 during the early stages of her career. At AmerisourceBergen, she had the opportunity to grow the business for nearly a decade and was able to buy other access-related consulting businesses. Here, she was able to see the whole cycle of access from pharmaceutical treatments to how they work on all sides of care. Then, she was approached to work in clinical trials at Parexel, where she is now the COO. Among the major launches Peyton has played a role in, she highlights her very first one related to cystic fibrosis. She also touches on a project at Lash Group which created an explosive group and created a new model of looking holistically at patients rather than just at free drug programs.

The first launches of multiple sclerosis and rheumatoid arthritis are where the industry began to see the real challenges with payers in terms of prior authorization, certificates of medical necessity and other barriers delaying accessibility to care. This changed everything in terms of how to support patients and the new required investments of pharma companies. Looking back on her career, Peyton feels that those urgent moments are the ones she is most proud of. 20 years ago, she never would have guessed that there would be as many challenges for patients as we see today. As an industry, we need to get patients more comfortable talking about these hurdles to make people aware that they are not alone in facing them.

Payton is credited with coming up with the term “hub industry”, which is critically important for the launch of new healthcare products. It is all about efficiently removing barriers for patients and sites. Building on that, she shares her perspective on the evolution of the hub industry over the years. Today, there are so many more pieces to the puzzle and challenges to overcome than there were in decades past. Additionally, it doesn’t help that healthcare is still a very conservative industry.

Shifting gears, Peyton explains how various legislation and the government has influenced the industry overall. All of the OIG opinions that were intended to be helpful, she has found, were sometimes just more confusing for pharma companies to interpret and rely upon. We see that in the limits on the type of support pharma sponsors will typically provide. This makes the patient experience redundant, frustrating and confusing. Another major change driver has been the consolidation of major industry players, which we are seeing even more of now with vertical consolidation. Peyton’s main areas of concern are the consolidation of players and PBMs.

Next, Payton unpacks her perspective on the state of the industry today and the obstacles we are currently facing. What attracted her to clinical trials in the first place, she reveals, is the opportunity to put more of the evidence towards the next wave of breakthrough products. The only way to truly take costs out of the system is to let the data show us where it is not helping us. Before wrapping up, Peyton shares her own advice for the future of the podcast and the areas she might like to hear discussed in the future. Her desire is that things are made simple for the average family to understand how to navigate the system. Peyton, identifies the areas which make her feel hopeful about the future. The interest and awareness we are currently seeing are the major factors contributing to this hopefulness. In closing, she shares her own prescription for better access. We should all be better educated consumers for ourselves and for those patients who don’t have a voice of their own.

Timestamps:

1:14 – Introduction to today’s episode.

2:55 – Peyton’s journey in the healthcare field.

5:15 – Peyton’s time at AmerisourceBergen.

7:20 – The early career launches which stand out for Peyton.

9:37 – The evolution of biologics.

15:30 – The history of the hub industry.

20:33 – How legislation and the government has influenced the overall industry.

22:19 – The consolidation of major players.

23:23 – What are we seeing in the industry today?

26:02 – Peyton’s advice for the future of the podcast.

27:42 – How copays have evolved.

32:47 – Areas of hope in the industry today.

34:!9 – Peyton’s prescription for better access.

Links:

Learn more about Dr. Scott Howell.

Learn more about Mark Hansan.

Comments or suggestions for Mark or Scott: comments@prescriptionforbetteraccess.com

Learn more about Peyton Howell.

Related Episodes

October 21, 2024

23. Global vs. US Drug Pricing and Market Access

In this episode, we sit down with leading Market Access experts and members of ACCESS Forum to compare and contrast the drug pricing and access systems worldwide and the US. Our discussion delves into the distinct approaches taken by government vs. private markets, examining how regulatory environments, pricing controls, and reimbursement processes impact patient access to innovative therapies. We explore the challenges each approach faces, from cost pressures to affordability and access, and how they balance the interests of patients, governments, and pharmaceutical companies. Join us for a deep dive into how the global healthcare landscape is evolving and what lessons can be learned.

Nikos Maniadakis, Ph.D., Professor, Health Management & Policy, University of West Attica
Kimberly Baldwin, Senior Vice President, Value & Access, Ipsen Biopharmaceuticals
Fauzea Hussain, Vice President, Public Policy, McKesson
CMS (Centers for Medicare & Medicaid Services)
European Medicines Agency
Health technology assessments (HTAs)
IRA (Inflation Reduction Act)
Medicaid
Medicare
National Institute of Clinical Excellence (NICE)
NCCN guidelines
P&T committee (Pharmacy and Therapeutics Committee)
PAP (Patient Assistance Program)
Part B (Medicare)
Part D (Medicare)
Pharmacy Benefit Managers (PBMs)
Quality-Adjusted Life Years
Tricare
Veterans Administration
Medical terminology referenced in this episode:

Questions or comments?
Email us at comments@prescriptionforbetteraccess.com.

 

September 12, 2024

22. Honoring the Work of Healthcare Advocates

In this episode, we explore the evolving role of healthcare and patient advocates and how this profession has become an essential part of the healthcare system. We begin by defining what a healthcare advocate is and tracing the development of the profession over the years. Key milestones are discussed, such as establishing codes of ethics, training, and certification processes. We also share real-world examples of how advocates help patients navigate the complexities of healthcare, making a measurable impact on patient outcomes. The discussion covers the scale of advocacy in the U.S., examining the roles of professional advocates compared to family members and volunteers. We also address how advocates are helping patients overcome barriers to accessing and affording medicines. Finally, we look to the future of advocacy, discussing potential healthcare reforms, the impact of technology, and practical advice for patients seeking an advocate in today’s challenging healthcare environment.

Rachel Westlake, Managing Director, Coalition of Health Care Advocacy Organizations
Danielle Marshall, Executive Director, Patient Advocate Certification Board
Fred Larbi, Chief Operations Officer, HealthWell Foundation
CHCAO
Patient Advocate Cerification Board
Healthwell Foundation
Greater National Advocates
NAHAC
HealthAdvocateX
Umbra
Solace 

Questions or comments?
Email us at comments@prescriptionforbetteraccess.com.
Find us on social media! Follow us on X, LinkedIn, YouTube and Threads.

August 21, 2024

21. Evolution of PBM’s

In this episode, we explore the evolution and future of the Pharmacy Benefit Management (PBM) industry with insights from two seasoned pharma managed care executives. We discuss the early role of PBMs, their acquisition by pharmaceutical companies, and subsequent industry consolidation. We examine how vertical integration of the PBMs transformed their business model, including the restricted formularies that gave rise to rebates. We also address evolving PBM-manufacturer relationships, the effects of public scrutiny, and predictions for key trends. Join us for a comprehensive look at the past, present, and future of PBMs, focusing on the changes needed to better serve patients.

Steve Stefano, Managing Director, ReprizioRx 

Steve.Stefano@repriziorx.com

Bill Leonard, Managing Director, ReprizioRX

wjl@repriziorx.com

ReprizioRX

PBMs

IPA model HMO

Medco

Metro Containment Services

Medicare Catastrophic Coverage Act of 1988

Merck

SmithKline Beecham

Eli Lilly

340B

NDC blocks

Group Purchasing Organizations (GPOs) 

Medicare

United Healthcare

FTC

CostPlusDrugs

Questions or comments?
Email us at comments@prescriptionforbetteraccess.com.
Find us on social media! Follow us on X, LinkedIn, YouTube and Threads.

July 16, 2024

20. How Access Challenges Impact the Drug Development Pipeline

In this episode, we dive into the pharmaceutical industry’s research and drug development side and the real threat that today’s access and affordability challenges and policies pose to innovation. While innovation often starts in universities with government support, biotech, and pharma companies take on the tough, costly job of clinical trials, development, and approval of new drugs. Investment dollars are limited, only the most promising projects get funded, with an expectation there will be a return. However, our current drug payment process and policies like the IRA have added new considerations for investors, risking fewer new drugs being developed. Without changes, patients could face the closing of our nation’s medicine cabinet, with fewer new treatments available. This would be an outcome that would be catastrophic for all of us.

Erin Mistry, EVP and Chief Commercial Officer, Cormedix, Inc.

Imran Nasrullah, JD., formerly VP & US Head of BD&L at Bayer, and now Founder, SNAP Life Sciences

Research and development (R&D)

FDA

CF Foundation

Vertex

NIH

AMR (antimicrobial resistance)

The Pasteur Act

HIV

Malaria

Flagship Pioneering Launches Metaphore Biotechnologies to Unlock the Therapeutic Potential of Biomimicry

Novo Nordisk Bets Up to $600 Million on Ozempic 2.0. Here’s Why the Stock Is a Buy.

Genentech

Genzyme (Now Sanofi)

Medicare

IRA (Inflation Reduction Act)

COVID-19

Questions or comments?
Email us at comments@prescriptionforbetteraccess.com.
Find us on social media! Follow us on X, LinkedIn, YouTube and Threads.

June 4, 2024

19. Interviews from Asembia’s AXS24 Summit, Part 2

This is the second of two episodes dedicated to Asembia’s AXS24 Summit, where we were honored to be a media partner. In this episode, we learn from Sarah Butler, Chief Commercial Officer of ADVI Health and Lindsay Greenleaf, JD, MBA, Head of Federal and State Policy for ADVI Health how the 2024 election will impact patient access and affordability. Umar Afridi, Founder and CEO of Foundation Health, summarizes his session, From Opaque to Transparent: Transforming the Way We Pay for Drugs. Finally, we get a few minutes with Joe Boswell, the President of ACCESS Forum, leading an effort to create a network for market access professionals.

ADVI:
Sarah Butler (Chief Commercial Officer)
Lindsey Greenleaf (Consulting and Government Affairs Head)
R&D
Inflation Reduction Act
NCCN Compendia
Part D
CMS
Pharmacy Benefit Managers (PBMs)
Part B
FTC and Office of Inspector General (IG)
FTC’s Section 6B study
Foundation Health:Umar Afridi, Founder and CEO
Session: “From Opaque to Transparent: Transforming the Way We Pay for Drugs.”
Pharmacy Benefit Managers (PBMs)
Truepill
API platforms
International Access Professional Society:Joe Boswell. President
GenMAV
Asembia

May 24, 2024

18. Interviews from Asembia’s AXS24 Summit, Part 1 of 2

Asembia’s AXS24 Summit, a pinnacle of specialty drug and healthcare discussions, concluded earlier this month. We are thrilled to share that our podcast was selected as a media partner for this esteemed event. This is the first of two episodes dedicated to AXS24, where Scott and Mark had the opportunity to interview several key speakers and attendees. In this episode, we bring you the insights of Melissa Paige, a seasoned healthcare professional and President of the National Association of Medication Access & Patient Advocacy, who led a session on the Patient Financial Impact of IRA. We also present the perspectives of Renee Rayburg, RPh., VP, Clinical Strategy, Pharmaceutical Strategy Group and Morgan Lee, PhD, MPH, CPH, Senior Director, Research & Strategy, PSG, who are renowned for their study and session on Viewpoints in Specialty Drug Benefit Design.

Melissa Paige, President, (NAMAPA)
University of Virginia Health System
Asembia
Inflation Reduction Act
Dr. Madelaine Feldman
Renee Rayburg, Vice President Specialty Clinical Consulting, Artemetrx,
Morgan Lee, PhD, Senior Director, PSG
Pharmacy Benefit Managers (PBMs)
GoodRx
2024 Trends in Specialty Drug Benefits Report
Medical terminology referenced in this episode:
Generic ARBs
Multiple Sclerosis
Humira biosimilars
Albuterol inhaler
Email us:comments@prescriptionforbetteraccess.com.
Follow us on X, LinkedIn, YouTube and Threads.

April 25, 2024

17. Understanding 340B Programs: An Interview with Antonio Ciaccia, CEO, 46brooklyn Research

In this episode, we explore the 340B Drug Pricing Program, an essential yet complex component of the American drug supply landscape that aims to enable healthcare entities to offer more affordable medication to underserved populations. We interview Antonio Ciaccia, a drug pricing and 340B expert who provides an in-depth look at how the program works, its financial incentives, and how stakeholders have exploited this well-intentioned program, all to the detriment of patients.

March 28, 2024

16. Interview with Victor Bulto, President, US, Novartis

In this important podcast episode, we interview Victor Bulto, President, US for Novartis, to discuss the company’s efforts to develop groundbreaking treatments while ensuring accessibility and affordability for patients. We delve into how the pharmaceutical industry navigates numerous post-FDA approval barriers to launch new drugs and the importance of market access, patient support services, and a commitment by manufacturers to provide patient assistance and other support for patients.

Victor Bulto, President, Novartis

Novartis

FDA

Institute for Clinical and Economic Review (ICER)

American Heart Association (AHA)

Inflation Reduction Act (IRA)

Pharmacy Benefit Manager (PBM)

Medicare

Medical terminology referenced in this episode:

Cell therapy: CART-T

Radioligand therapy

RNA

Entresto

Molecular glues

Targeted protein degradation

Antisense oligonucleotides

Small interfering RNAs: siRNAs

LDL cholesterol

COVID

Hematological malignancies

Refractory autoimmune diseases

Questions or comments?
Email us at comments@prescriptionforbetteraccess.com.
Find us on social media! Follow us on X, LinkedIn, YouTube and Threads.

Scroll to Top