Rationing Medication Therapy

___ Make sure to subscribe to get the latest episode. Contact Us: Pharmacy Benefit News: http://www.propharmaconsultants.com/pbn.html Email: [email protected] Website: http://www.propharmaconsultants.com/ Facebook: https://www.facebook.com/propharmainc Twitter: https://twitter.com/ProPharma/ Instagram: https://www.instagram.com/propharmainc/ LinkedIn: https://www.linkedin.com/company/pro-pharma-pharmaceutical-consultants-inc/ Podcast: https://anchor.fm/pro-pharma-talks

___ Make sure to subscribe to get the latest episode. Contact Us: Pharmacy Benefit News: http://www.propharmaconsultants.com/pbn.html Email: [email protected] Website: http://www.propharmaconsultants.com/ Facebook: https://www.facebook.com/propharmainc Twitter: https://twitter.com/ProPharma/ Instagram: https://www.instagram.com/propharmainc/ LinkedIn: https://www.linkedin.com/company/pro-pharma-pharmaceutical-consultants-inc/ Podcast: https://anchor.fm/pro-pharma-talks

____ Make sure to subscribe to get the latest episode. Contact Us: Pharmacy Benefit News: http://www.propharmaconsultants.com/pbn.html Email: [email protected] Website: http://www.propharmaconsultants.com/ Facebook: https://www.facebook.com/propharmainc Twitter: https://twitter.com/ProPharma/ Instagram: https://www.instagram.com/propharmainc/ LinkedIn: https://www.linkedin.com/company/pro-pharma-pharmaceutical-consultants-inc/ Podcast: https://anchor.fm/pro-pharma-talks

1. The science of Covid-19 2. Pneumonia Vaccine 3. Immunocompromised patients do well with most vaccinations including RSV – these patients at increased risk of infections – new research indicates that vaccinations against human papillomavirus, hepatitis B, herpes zoster are not a problem to give 4. Misinformation Prevention is KEY! Once you have Covid-19, now what? – Access Precautionary responsibility Super-spreaders 5. Supporting Information ____ Make sure to subscribe to get the latest episode. Contact Us: Pharmacy Benefit News: http://www.propharmaconsultants.com/pbn.html Email: [email protected] Website: http://www.propharmaconsultants.com/ Facebook: https://www.facebook.com/propharmainc Twitter: https://twitter.com/ProPharma/ Instagram: https://www.instagram.com/propharmainc/ LinkedIn: https://www.linkedin.com/company/pro-pharma-pharmaceutical-consultants-inc/ Podcast: https://anchor.fm/pro-pharma-talks

PP Talks – A Model for High Quality, Low Cost Health Care Rational -Arguments over ACA indicate that it is worthwhile to find another solution that uses basic principles to deliver high quality at low cost –The Cure That Works, by Sean Masaki Flynn Message  -- health care first rate, easily accessible, and inexpensive Singapore health care system Target – Singapore:  Elements of health care services Insurance Examples US Examples ____ Make sure to subscribe to get the latest episode. Contact Us: Pharmacy Benefit News: http://www.propharmaconsultants.com/pbn.html Email: [email protected] Website: http://www.propharmaconsultants.com/ Facebook: https://www.facebook.com/propharmainc Twitter: https://twitter.com/ProPharma/ Instagram: https://www.instagram.com/propharmainc/ LinkedIn: https://www.linkedin.com/company/pro-pharma-pharmaceutical-consultants-inc/ Podcast: https://anchor.fm/pro-pharma-talks

1. Who Makes HC Policy?      a. State differences – access, price and coverage      b. Individuals affected –            i. 17M buy insurance           ii. 29M don’t have insurance           iii. MCare & Medicaid not affected – State expansion of Medicaid, but higher rates of inflation in Red States 2. Hospital Closures & Medicaid Expansion      a. ACA improving health care?           i. Hospitals closed in States rejecting Medicaid                1. States expanding Medicaid – lower and falling hospital closures                2. ACA – improved hospital financial performance w/lower probability of closure for rural markets and counties w/large amt of uninsured                3. Supreme Court left Medicaid expansion to the States                4. Hospital closure leads to loss of well-paying and skilled jobs 3. Wall Street – Another Option for Paying For Health Care Benefits      a. Sell wealth management to individuals           i. Lower cost method to gain new customers           ii. Morgan Stanley, Goldman, Fidelity, Charles Schwab, E*Trade, Amazon/JPMorgan/Berkshire Hathaway           iii. Wall St has the analytics to redeploy investment dollars to benefits           iv. Same as insurance brokers?           v. TPA/PBM – middleman model to transactional model 4. Geography Matters – John Wennberg, MD      a. Dartmouth Atlas of Health Care – cost of living, site of care, volume of services delivered, hospital/MD salaries      b. Example –            i. SF Chronicle reports cost in No. CA 30% > So. Ca d/t UC Berkeley Petris Center on Health Care Markets and Consumer Welfare           ii. Primary reasons -- D/t consolidation in hospitals, insurance and MD practices b/w 2010-2016 (adj for higher cost of living and wages)           iii. Result – mergers/acquisitions in health care = HP+PBMs, MD practices, Plans, Pharmacies lead to higher costs           iv. Marketplace competition, technology, telehealth, international competition, competitor ads leverage cost differences ____ Make sure to subscribe to get the latest episode. Contact Us: Pharmacy Benefit News: http://www.propharmaconsultants.com/pbn.html Email: [email protected] Website: http://www.propharmaconsultants.com/ Facebook: https://www.facebook.com/propharmainc Twitter: https://twitter.com/ProPharma/ Instagram: https://www.instagram.com/propharmainc/ LinkedIn: https://www.linkedin.com/company/pro-pharma-pharmaceutical-consultants-inc/ Podcast: https://anchor.fm/pro-pharma-talks

What do people believe in fake medicines? 1. Differences between fake and counterfeit?      a. Counterfeit is medicine without active ingredient, contaminated, or wrong ingredient           i. Counterfeit examples – Fentanyl, Oncology meds – BCNU, Botox, Artesunate for malaria, antibiotics, meningitis vaccines, ED drugs      b. False treatments            i. Examples – fake miracle cancer cures, coronavirus treatments, nutritional supplements, cosmetic treatments, beauty treatments      c. Result – harm, loss of hope and money 2. Fake coronavirus treatments      a. Fake tests      b. Alcohol-based hand sanitizers, counterfeit respirators, biomagnetism magnetic therapy, covid-19 test packages, OMI sale therapy pipes inhalers, amniotic fluid products, colloidal silver, CBD      c. Fake treatments           i. Hydroxychloroquine, chloroquine           ii. Natural treatments and cures                1. Herbal cold remedies, immune system support products, nutritional vitamins from natural sources to protect from infection, covid-19 cough syrups, natural zinc and vitamin C 3. Why do people believe?      a. Confirmation bias      b. Lack of credible evaluation      c. Attention and impatience      d. Cognitively lazy      e. Emotions      f. Reiteration      g. Social pressure 4. Conclusion      a. Skeptical of treats & cures      b. Evidence, and confirmation ____ Make sure to subscribe to get the latest episode. Contact Us: Pharmacy Benefit News: http://www.propharmaconsultants.com/pbn.html Email: [email protected] Website: http://www.propharmaconsultants.com/ Facebook: https://www.facebook.com/propharmainc Twitter: https://twitter.com/ProPharma/ Instagram: https://www.instagram.com/propharmainc/ LinkedIn: https://www.linkedin.com/company/pro-pharma-pharmaceutical-consultants-inc/ Podcast: https://anchor.fm/pro-pharma-talks

PP Talks -- Is It Common for Compounds to Fail the FDA Approval Process? 1. Stages of FDA Approval Process IND a. Phase 1 – Safety – 20-100 healthy, 2 yrs. b. Phase 2 – Effectiveness – 100-500 patients, 2 yrs. c. Phase 3 – Effectiveness & ADR, 1K-5K, 3.5 yrs. 2. Vaccines a. Phase I fails = 37% b. Phase II fails = 69% c. Phase III fails = 42% d. Biologics License Application (BLA) application e. Vacc & Related Biologics Prod Adv Cmte (VRBPAC) 3. Risks a. New vaccine for new virus b. Clinical trials never succeed c. Vaccine induced enhancement d. Acquire study population ____ Make sure to subscribe to get the latest episode. Contact Us: Pharmacy Benefit News: http://www.propharmaconsultants.com/pbn.html Email: [email protected] Website: http://www.propharmaconsultants.com/ Facebook: https://www.facebook.com/propharmainc Twitter: https://twitter.com/ProPharma/ Instagram: https://www.instagram.com/propharmainc/ LinkedIn: https://www.linkedin.com/company/pro-pharma-pharmaceutical-consultants-inc/ Podcast: https://anchor.fm/pro-pharma-talks

What is it? Colorectal cancer 3rd most diagnosed cancer in US (men & women) S/S = blood in stool, GI irritation, irregular stools, chronic diarrhea, sudden weight loss Diagnostic = colonoscopy – polyps, inflammation, ulcers, abnormal growths ACS testing guidelines Asymptomatic, negative family history, no polyps – every 10 years Low-risk polyps – 5 years High-risk polyps What causes it? Cause Age (90% of cases for people > 50 y/o) Family history Race – African Americans (new Dx 20% higher in Blacks, and death rates 40% higher) Ethnicity – Ashkenazi Jews Ulcerative colitis, Crohn’s disease Low whole grain diets Genetic predisposition Smoking, alcohol use, lack of exercise, diabetes How is it treated? Stage O, I -- Sx Stage II – Sx + Adj Chemo Stage III – Sx + Adj Chemo Stage IV – Sx + Chemo Chemo + Targeted Tx Gene types – + immunotherapy Radiation ____ Make sure to subscribe to get the latest episode. Contact Us: Pharmacy Benefit News: http://www.propharmaconsultants.com/pbn.html Email: [email protected] Website: http://www.propharmaconsultants.com/ Facebook: https://www.facebook.com/propharmainc Twitter: https://twitter.com/ProPharma/ Instagram: https://www.instagram.com/propharmainc/ LinkedIn: https://www.linkedin.com/company/pro-pharma-pharmaceutical-consultants-inc/ Podcast: https://anchor.fm/pro-pharma-talks

What aren’t people talking about health care? Rationale Covid-19 Disruptions POV and lab decreased MDs financially restrained Hospitals losing money Patients lack access New diagnoses/therapies down Telehealth rising Unemployment rising Drug cost reduction CMS force PhRMA to publish drug prices on TV Legislation disallowing gag clauses Expand pricing transparency to radio, web, print and       social media HHS maintain a public list of drugs violating rule Exempt Rx < $35/Rx Health Care Benefits Price transparency Health care = Consumer product Retailers offer basic services Robotics Convenience ____ Make sure to subscribe to get the latest episode. Contact Us: Pharmacy Benefit News: http://www.propharmaconsultants.com/pbn.html Email: [email protected] Website: http://www.propharmaconsultants.com/ Facebook: https://www.facebook.com/propharmainc Twitter: https://twitter.com/ProPharma/ Instagram: https://www.instagram.com/propharmainc/ LinkedIn: https://www.linkedin.com/company/pro-pharma-pharmaceutical-consultants-inc/ Podcast: https://anchor.fm/pro-pharma-talks