Facebook Live Recap – Sue Peschin and Thair Phillips

On Thursday, March 21st, Seniors Speak Out held its first Facebook Live event of 2024. It was a conversation with Sue Peschin, the President and CEO of the Alliance for Aging Research, where we discussed ongoing and expected federal healthcare policies and developments and their impact on seniors’ access. I’ve known Sue for a long time, and she has always been an energetic and unrelenting advocate for older Americans. You can click here to see the entire event.

I started out our conversation by pointing out that the government’s continuing push to overhaul the drug pricing system has only served to further interject the government into our healthcare which has changed the risk equation for investors and chilled their investment in new cures. This reduction in investments has already started, with drug manufacturers hitting pause on some of their R&D. I pointed out that President Biden, in his State of the Union address further expanded the government’s power by recommending a fivefold increase in the number of drugs that are eligible for price controls from 10 to 50! I did point out that there is one area where lawmakers may intervene and fix one part of the Inflation Reduction Act (IRA). I then turned the time over to Sue Peschin.

Sue started out by explaining that the Alliance for Aging Research is the leading advocate for promoting healthy aging for seniors. She went on to point out that there were a few good parts of the IRA, the $2,000 yearly cap on out-of-pocket costs for Medicare Part D, the ability to spread these costs over the entire year, the elimination of co-pays for vaccinations and an expansion of the program to help those with financial needs. Having said this, she pointed out that the price fixing parts of the IRA, while marketed as a help to beneficiaries, really only affected the cost to Medicare and other parts of the system and didn’t directly affect seniors. She also explained that the 10 drugs that were ultimately selected weren’t the high-priced drugs but the ones that were used by a large part of the population. This ignored the very patients that were most affected by the cost of their medication.

Sue also reminded us that the insurance companies and drug manufacturers had always gone through heavy drug price negotiations as part of the business process. She said that when the burden is shifted to the manufacturers and insurance companies that they would need to react by increased monitoring and utilization management which is the result of a slash and burn approach to drug pricing.

I agreed with her and pointed out that when the government uses a sludge hammer to insert itself into the business process you can’t fault the players as they try to react to this catastrophic change which ultimately made the whole process less efficient.

I then asked Sue if there is any chance that there will be legislation coming up this year? She said that it will be hard to get anything passed this year given that it is an election year, but she said that most changes come from a multi-year process anyway, and we should continue to work on the important healthcare issues.

I then asked Sue about the President’s budget and his request to go from 10 drugs to 50 drugs eligible for price controls. I did rant a little during my question about what was the top number of drugs the President wanted to control, 100, 1,000, all of them? Sue brought me back to earth by pointing out that the President’s budget is usually pretty much ignored and is an election year ploy.

My next question asked how we could best monitor the implementation of the IRA. Sue said that the impact of the IRA as it is implemented will be substantial. The liability for paying the cost of drugs for insurance companies will go from 15% to 60%, and this could force the insurance companies to try to limit costs through utilization management. She mentioned that it made it even more important that seniors review their Part D plans during open enrollment to make sure they have the best plan for them. I echoed her advice saying that we have many choices, and we should be able to find one that fits each of us. I went on to say that increasing a business liability from 15% to 60% will have a huge impact on any business. The government seemed to ignore this impact as it took its bludgeon approach to this whole process.

I then asked Sue to tell us a little about one fix that Congress might do to improve things, passing the Ensuring Pathways to Innovative Cures (EPIC) Act. Sue explained that the most common drugs are the small molecule drugs that we have taken for years, the newer type of drugs are the large molecule drugs that usually have to be administered by a physician. The IRA gave the small molecule drugs 9 years before price setting while the large molecule had 13 years before price setting. It seems that Congress has given has favored the more complicated medicines while turning its back on the easier to administer and more effective for certain conditions. The EPIC Act will work to correct this error, and it has bi-partisan support. I pointed out that the weight loss drugs that have come into prominence was the result of research that found another use for an already-approved drug, this discovery would have been much more difficult under the existing provisions of the IRA.

I then asked Sue about telehealth and how it fits into the future of healthcare. She reminded us how important telehealth was during the pandemic, which magnified the importance of telehealth and showed that it wasn’t only for rural patients. She warned that the payment and authorization for telehealth was expiring, and we needed to advocate to our lawmakers that we need to make sure this efficient way of treating patients continues.

My final question was asking how do we advocate and make our voices  heard?

She stressed that we all can make a difference, especially if we are part of a patient group or any group effort. Contacting your lawmaker is a powerful tool, she said that people could go to her website, www.agingresearch.org and find information on communicating with their lawmakers. She emphasized the power that older Americans have since they are the most likely to vote and get involved with the issues that affect them. I seconded her comments and added that our website, www.seniorsspeakout.org, will also give you information on the issues and aid you in contacting your lawmakers. In closing, I thanked Sue for joining us and thanked everyone that tuned into the event.

Best, Thair