Policy, Finance Chris Morrison Policy, Finance Chris Morrison

Discount rates and drug value: A Q&A with Josh Cohen

All else being equal, people care more about outcomes that happen in the near future than about outcomes that happen later. The discount rate represents how much timing matters. We sit down with Josh Cohen, Deputy Director of the Center for the Evaluation of Value and Risk in Health (CEVR) at the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center, and Research Professor of Medicine at Tufts University School of Medicine, to learn about how changes to the discount rate can alter how we value medicines.

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Policy, Science, Planetary Health Thomas Culman Policy, Science, Planetary Health Thomas Culman

Now boarding: Net-zero aviation

Whether you enjoy air travel or not, it’s increasingly common and persistently bad for the environment. Almost three million passengers fly in and out of US airports each day and global demand for air travel is expected to double by 2050. In addition to emitting pollutants that lower air quality, aviation is recognized as a hard-to-decarbonize sector and accounts for ~3% of global CO2 emissions. Airlines have recently announced commitments to switch to "green" fuels, but as of today 95% of jet fuel is produced from fossil fuels. Why is that? 

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Biotech, Policy, Culture Peter Kolchinsky Biotech, Policy, Culture Peter Kolchinsky

Eroding tolerance: A wonder drug shows us the drug industry’s fundamental failure to communicate

Many people who dedicate their lives to discovering, developing, and making new, lifesaving drugs don’t understand the extent to which the drug industry has failed to communicate its value proposition to society and to inspire its customers to pay for that value. That is to say, when the public and even legislators representing our biotech innovation hubs focus on the price of a breakthrough drug without a sense of its value or how it came into being and insist that innovators should not only invent medicines but pay for them, too, that’s a self-inflicted wound. Vertex’s Trikafta, one of our industry’s greatest success stories, provides an example.

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Policy, Planetary Health Thomas Culman Policy, Planetary Health Thomas Culman

Talking Trash 2: Getting Scrappy

Let’s dig into some of the most recycled materials in the world – metals – and how we might make metals recycling even better. We are obsessed with metals because they are critical materials to human civilization and well-being, which is why improved scrap metal recovery is good for the economy, good for the environment, and good for people – exactly the kind of win-win-wins we live for at Planetary Health.

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Policy, Biotech Thomas Culman Policy, Biotech Thomas Culman

US biosecurity starts at home, with insurance reform aimed at making innovation affordable

Congress has set its sights on China’s biotechnology industry and the US’s reliance on it. Legislators are worried about the Chinese Communist Party’s access to Americans’ genetic data and US taxpayer funds helping bolster CCP-affiliated companies and are proposing to sever ties between any federally funded work and Chinese “companies of concern,” which include BGI and Wuxi AppTech. 

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Policy, Planetary Health Thomas Culman Policy, Planetary Health Thomas Culman

Talking Trash 1: Why Sortation Matters

Let’s talk about something everyone produces but nobody really likes – trash. People produce billions of tons of waste annually. While there are many ways to reduce the amount of waste we produce, it is not possible to stop it entirely. Waste is, quite literally, inevitable. The disorder (entropy) in the universe increases with time, which just means that things will always break and there will always be some amount of waste. Once our things become our trash, we have two options: we can dispose of them or we can try to reclaim them as a resource. From a planetary health perspective, there are a lot of reasons to want to reclaim wastes as resources. Unfortunately, it is not easy to do so economically.

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Policy, Biotech Peter Kolchinsky Policy, Biotech Peter Kolchinsky

Egypt and hepatitis C cures — the gift that keeps on giving

In covering how Egypt managed to eradicate hepatitis C, the New York Times rewrites a key bit of history that betrays its misunderstanding of global drug pricing. Egypt’s access to the life-saving Harvoni was a gift from Gilead, not a result of a bare knuckle negotiation. It’s important to understand and explain the increasingly vulnerable system that underpins that gift before bad policy dismantles it.

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Policy, Biotech Peter Kolchinsky Policy, Biotech Peter Kolchinsky

Can the European scorpion hold its sting?

European central planners should stop trying to talk the US out of incentivizing the development of better medicines that then also help Europeans and the rest of the world. It’s one thing to argue that any one country can’t afford to pay more for new drugs. It’s another thing entirely to put new drugs in jeopardy for everybody by exporting that thinking to the one country whose market-based system has underpinned the last several decades of pharmaceutical advances.

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Policy, Biotech Chris Morrison Policy, Biotech Chris Morrison

Do we value curbing carbon emissions more than curing cancer?

It may surprise you to find out just how badly we’re failing to take a comprehensive approach to quantifying societal value from new innovations in medicine. The IRA’s investment in our climate future should be lauded; its treatment of medical innovation is unfortunately hobbled by its goal of lowering Medicare spending today at the expense of tomorrow’s patients – that is to say, all of us.

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Policy, Biotech Jessica Sagers Policy, Biotech Jessica Sagers

Toxic math: a British export that the US mustn’t import

It’s long been assumed that as long as NICE-like cost-effectiveness analyses stay on the other side of the ocean, our US biotech ecosystem will be fine. But in recent years, toxic math has begun to make its way to US soil. Peter Kolchinsky sat down with Jayson Dallas to get his take on NICE’s tactics, their increasingly global reach, and how biopharma can fight back.

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Finance, Policy, Biotech, Planetary Health Peter Kolchinsky Finance, Policy, Biotech, Planetary Health Peter Kolchinsky

Act now to prevent SVB’s failure from becoming a national crisis

The federal government must address the failure of Silicon Valley Bank (SVB) with speed and clarity before it metastasizes into a national crisis, so the ecosystem of institutions in which SVB has operated, including other banks and investors, can help bridge companies so that they can continue to operate while they wait for their deposits.

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Policy, Biotech Thomas Culman Policy, Biotech Thomas Culman

Getting animated about GCEA

Traditional cost-effectiveness analyses done by organizations like ICER and NICE overlook much of the value of new drugs, including factors with crucial societal impact like genericization, risk reduction, and community spillover. Peer-reviewed research has made this clear again and again, but these organizations continue to insist on using outdated formulas to determine the value of drugs. With the passage of the IRA and imminent drug pricing “negotiations” (read: price controls), it’s more important than ever to get the math that values our medicines right.

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