Institute for Health Policy Forum

Unpacking Drug Value:
A Path to Fair Pricing

September 13, 2019

On September 13, 2019, the Kaiser Permanente’s Institute for Health Policy brought together leaders from across sectors to learn why drug value is a critical part of the national dialogue on drug pricing.

During this meeting, participants and speakers convened to:

  • Advance the conversation on how to define and assess drug value

  • Lift up existing and emerging policy opportunities that encourage a value-based approach to drug pricing

 

Welcome & Opening Remarks

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Murray Ross, PhD
Vice President
Government Relations & Institute for Health Policy
Kaiser Permanente

Anthony Barrueta
Senior Vice President
Government Relations
Kaiser Permanente

Sameer Awsare, MD, FACP
Associate Executive Director
The Permanente Medical Group
Kaiser Permanente

Morning Keynote Address

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Peter Bach, MD, MAPP
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Director
Center for Health Policy and Outcomes
Memorial Sloan Kettering Cancer Center

Panel: Defining and Assessing Drug Value

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Moderator

Maisha Draves, MD, MPH
Medical Director of Pharmacy
The Permanente Medical Group
Kaiser Permanente

Panelists

Sarah K. Emond, MPP
Executive Vice President and Chief Operating Officer
Institute for Clinical and Economic Review

Mark E. Miller, PhD
Executive Vice President, Health Care
Arnold Ventures

Rena Conti, PhD
Associate Professor
Department of Markets, Public Policy and Law
Questrom School of Business, Boston University

Chris Leibman, PharmD, MS
Senior Vice President, Value & Access
Biogen

Panel: Paying for Value

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Moderator

Murray Ross, PhD
Vice President
Government Relations & Institute for Health Policy
Kaiser Permanente

Panelists

Ameet Sarpatwari, PhD, JD
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Assistant Professor of Medicine
Harvard Medical School, Brigham and Women’s Hospital

Melissa Abbott, PharmD
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Clinical Pharmacist
Pharmacy Management Consultants

Anand Kapur, HBSc, MBA
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Executive Vice President
TwoLabs Pharma Services

Jennifer M. Day, PharmD
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Coordinator, Emerging Therapeutics Strategy Program
Kaiser Permanente

Networking Lunch

Views from Industry

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Moderator

Julie Rovner
Chief Washington Correspondent
Kaiser Health News

Panelists

Matt Eyles
President and Chief Executive Officer
America’s Health Insurance Plans

Stephen J. Ubl
President and Chief Executive Officer
Pharmaceutical Research and Manufacturers of America

Looking Forward: A Value-Based Approach to Drug Pricing

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Moderator

Polly Webster, JD, MPH
Senior Policy Advisor
Government Relations
Kaiser Permanente

Panelists

Hemi D. Tewarson, JD, MPH
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Director, NGA Health
National Governors Association

Leigh Purvis, MPA
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Director, Health Services Research
AARP Public Policy Institute

Bari Talente, JD
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Executive Vice President, Advocacy
National Multiple Sclerosis Society

Sean Dickson, JD, MPH
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Director, Health Policy
West Health Policy Center

Themes Emerging from Today’s Forum

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Anthony Barrueta
Senior Vice President, Government Relations
Kaiser Permanente

End of Day

Melissa Abbott, PharmD
Melissa Abbott is a clinical pharmacist for Pharmacy Management Consultants, a division of the University of Oklahoma College of Pharmacy, where she is a key decision maker with the design and implementation of alternate payment models/value-based contracts for Oklahoma Medicaid.

Dr. Abbott is also a primary presenter of clinical reviews and criteria reports for presentation to the Drug Utilization Review Board and Oklahoma Health Care Authority.

She received her Doctor of Pharmacy from the University of Oklahoma College of Pharmacy and maintains pharmacist licensure through the Oklahoma State Board of Pharmacy.

Sameer Ansare

Sameer V. Awsare, MD, FACP
Sameer Awsare, MD, FACP, is an associate executive director for The Permanente Medical Group in charge of pharmacy, adult and family medicine, mental health, risk adjusted coding, revenue cycle, outside medical services, pain management, and the opioid initiative.

Dr. Awsare joined The Permanente Medical Group in 1993. In addition to his clinical responsibilities, he is involved in resident teaching and has served on several boards in various leadership roles. He is currently the secretary and chair of the Governance Committee of the Mid-Atlantic Permanente Medical Group Board.

Dr. Awsare is board certified in Internal Medicine. He received his  medical degree from the University of California, Irvine. He has served on the voluntary clinical faculty at the Stanford University School of Medicine. Dr. Awsare is a fellow of the American College of Physicians.

Anthony Barrueta

Anthony Barrueta, JD
Tony Barrueta is senior vice president of government relations for Kaiser Foundation Health Plan, Inc. in Oakland, California. He oversees development of Kaiser Permanente’s public policy positions, in collaboration with senior leadership throughout the organization, to ensure that Kaiser Permanente maintains a common voice in support of the interests of the organization, its members, and the communities it serves.

Barrueta holds a law degree from the University of Texas at Austin.

Peter Bach, MD, MAPP
Peter Bach, MD, MAPP, is a physician, epidemiologist, researcher, and healthcare policy expert who studies U.S. pharmaceutical pricing and reimbursement policy. His work includes developing models for indication specific pricing, point of sale rebates, and subscription-based payment for drugs.

He has published more than 100 peer-reviewed articles and editorials in scientific journals such as the New England Journal of Medicine and the Journal of the American Medical Association and has been inducted into the National Academy of Medicine, the American Society for Clinical Investigation, and the Johns Hopkins Society of Scholars.

Dr. Bach graduated from Harvard College, the University of Minnesota Medical School, and the Harris School for Public Policy at the University of Chicago.

Rena M. Conti, PhD
Rena M. Conti is the associate research director of biopharma and public policy for the Boston University Institute for Health System Innovation and Policy. She is also an associate professor at the Boston University Questrom School of Business.

Dr. Conti’s research focuses on the organization, financing, and regulation of medical care. She has written extensively on the pricing, demand, and supply of prescription drugs.

Previously, Dr. Conti was an associate professor of health economics and policy at the University of Chicago Medical School and the Harris School of Public Policy.

Jennifer Day, PharmD
Jennifer Day is with Kaiser Permanente National Drug Information Services and serves as coordinator of the Emerging Therapeutics Strategy Program for Kaiser Permanente National Pharmacy. Dr. Day’s areas of expertise include drug information and analysis of clinical trial evidence, development of evidence-based guidelines, strategic planning for the use of biologics and emerging pharmaceuticals, biosimilars and specialty pharmacy oversight, and pharmaceutical pipeline forecasting.

She plays a key role in facilitating the development of innovative treatment pathways through collaboration with physicians and pharmacists in the various Kaiser Permanente regions to proactively evaluate and prepare for optimal use of new and pipeline emerging therapies.

Sean Dickson, JD, MPH
Sean Dickson, JD, MPH is a nationally recognized technical expert on the American drug system, including the full market lifecycle of pharmaceuticals. His career has focused on increasing access to healthcare, with specific attention to reducing prescription drug costs.

Before joining the West Health Policy Center, he led policy and research activities under The Pew Charitable Trusts’ Drug Spending Research Initiative. Sean’s research and analyses are often cited in government reports and by media, and he frequently advises state and federal policymakers on the technical aspects of proposals to reduce drug spending.

Prior to his work in domestic health policy, Sean worked in international development, focusing on HIV and maternal health policies in East Asia, East Africa, and the Caribbean. Sean completed his graduate studies at the University of Michigan, preceded by undergraduate studies at the University of Chicago.

Maisha Draves

Maisha Draves, MD
Maisha Draves is the medical director for Pharmacy in Northern California for The Permanente Medical Group. In this role, she collaborates with the chair of the Regional Pharmacy & Therapeutics Committee on formulary and pharmacy policy and with the Drug Information Services group on the strategies related to drug shortages and recalls. She provides oversight for pharmacy-related research and develops strategies for Kaiser Permanente Northern California’s drug utilization management efforts.  

She received her medical degree from Harvard Medical School.

Sarah K. Emond, MPP
With over 20 years of experience in the business and policy of health care, Sarah Emond leads the strategic operations of the Institute for Clinical and Economic Review, a leading non-profit health policy research organization, as executive vice president and chief operating officer.  She is responsible for overseeing ICER’s public programs, stakeholder engagement, and finances.

Emond speaks frequently at national conferences on the topics of prescription drug pricing policy, comparative effectiveness research, and value-based health care.

She holds a master’s degree in public policy with a concentration in health policy from the Heller School for Social Policy and Management at Brandeis University.

Matt Eyles, MPP
Matthew (Matt) Eyles is president & chief executive officer of America’s Health Insurance Plans (AHIP), the national trade association representing health insurance providers. He joined AHIP in 2015 and led its Policy & Regulatory Affairs team, and he was chief operating officer before his appointment as president & CEO.  He has more than two decades of health care experience in the private sector and in government. He has led teams at Fortune 200 health care companies in diverse roles — including public policy, government affairs, advocacy, and corporate communications — with both a U.S. and global focus.

In 2018, he was named among the 100 Most Influential People in Health Care by Modern Healthcare.

Eyles earned a graduate degree in public policy from the University of Rochester (NY).

Anand Kapur, MBA
Anand is the executive vice president of market access at MKO Global Partners. As a partner and co-founder of MKO Global Partners (which became the Market Access division of Two Labs in 2018), Anand leads pricing and market access projects domestically and globally. As a seasoned management consultant, Anand has focused his career on commercial strategy and analysis in the biopharmaceutical industry, including commercial launch planning, pricing, market access, and lifecycle management. Anand received an Honors Bachelor of Science in Biology and Physics from the University of Toronto and an Masters in Business Administration from the Ivey School of Business.

Chris Leibman
Chris Leibman is senior vice president, value and access at Biogen in Cambridge, Massachusetts where he leads the payer evidence planning and access strategy organization globally.  He joined Biogen in 2014, and until his move back to the U.S. last year, was most recently vice president of Europe and Canada Market Access and Pricing at Biogen, where he led the European/Canada regional team responsible for value, access, and pricing strategy development and execution across the Biogen portfolio.  

He brings two decades of diverse experiences in biopharmaceutical development, commercialization, and working across multi-company alliances.  

Mark E. Miller, PhD
Mark Miller leads Arnold Ventures’ work to lower the cost and improve the value of health care. He has more than 30 years of experience developing and implementing health policy, including prior positions as the executive director of Medicare Payment Advisory Commission; assistant director of Health and Human Resources at the Congressional Budget Office; deputy director of Health Plans at the Centers for Medicare and Medicaid Services; health financing branch chief at the Office of Management and Budget; and senior research associate at the Urban Institute.

Miller has been directly involved in the development of major health legislation such as the Balanced Budget Act; the Medicare Prescription Drug, Improvement, and Modernization Act; and the Affordable Care Act.

He holds a doctorate in public policy analysis from the State University of New York at Binghamton.

Leigh Purvis, MPA
Leigh Purvis is the director of Health Services Research in AARP’s Public Policy Institute. She leads a team of policy analysts and researchers who work on health care issues that are relevant to the 50+ population.

In addition, Purvis heads the Institute’s work on prescription drug issues. Her primary areas of expertise are prescription drug pricing, biologic drugs, and prescription drug coverage under Medicare. She is also a coauthor of the Public Policy Institute’s annual Rx Price Watch reports, which track price trends for prescription drugs widely used by older Americans.

Julie Rovner
Julie Rovner is chief washington correspondent for Kaiser Health News and host of the all-women panelist podcast, KHN’s “What the Health?” Prior to joining KHN in 2014, she spent 15 years as health policy correspondent for NPR, specializing in the politics of health care. Rovner served as NPR’s lead correspondent covering the passage and implementation of the Patient Protection and Affordable Care Act of 2010.

A noted expert on health policy issues, Rovner is the author of a critically-praised reference book Health Care Politics and Policy A-Z and was awarded the Everett McKinley Dirksen Award for distinguished reporting of Congress for her coverage of the passage of the Medicare prescription drug law and its aftermath.

Rovner has a degree in political science from University of Michigan-Ann Arbor.

Ameet Sarpatwari, PhD, JD
Ameet Sarpatwari is an assistant professor of medicine at Harvard Medical School, an associate epidemiologist at Brigham and Women’s Hospital, and assistant director of the Program on Regulation, Therapeutics, and Law (PORTAL) within the Division of Pharmacoepidemiology and Pharmacoeconomics. His research draws upon his interdisciplinary training as an epidemiologist and lawyer and focuses on the effects of laws and regulations on therapeutic development, approval, use, and related public health outcomes.

Dr. Sarpatwari studied epidemiology at the University of Cambridge, and studied law at the University of Maryland as a John L. Thomas Leadership Scholar.

Bari Talente, JD
Bari Talente is the executive vice president of advocacy at the National Multiple Sclerosis Society. In her role, Bari highlights the voices of people affected by MS to drive public policy change. Prior to being named EVP in February 2012, Bari led the Society’s state and local activism efforts for nine years. She has been instrumental in integrating federal and state perspectives to drive policy change, increasing opportunities for those living with MS to engage in advocacy and leading the Society’s work to increase affordability and access to MS medications. In 2018, Bari was elected president of the MS Coalition and explores opportunities to leverage the collaborative efforts of the nine different organizations in the Coalition to improve the lives of people affected by MS.

Bari received a law degree from the University at Buffalo School of Law and a bachelor’s degree from Binghamton University. She is a member of the New York and District of Columbia bars.

Hemi Tewarson

Hemi Tewarson, JD, MPH
Hemi Tewarson serves as the director for the National Governors Association (NGA) Center for Best Practices’ Health Division, where she oversees all the Health Division projects, which include Medicaid transformation and coverage, Medicaid data systems, health care delivery and payment system reform, workforce, opioids, and behavioral health and social determinants.

She has decades of experience in health care policy in the private and public sectors, previously serving as senior attorney for the Office of the General Counsel at the U.S. Government Accountability Office and was in private practice as a health policy attorney where her practice included advising states on how to reform their Medicaid programs.

Tewarson holds a law degree and a master’s degree in public health from the George Washington University.

Stephen J. Ubl
Stephen J. Ubl is president and chief executive officer of the Pharmaceutical Research and Manufacturers of America (PhRMA), which represents America’s leading biopharmaceutical research companies. He leads PhRMA’s work preserving and strengthening a health care and economic environment that encourages medical innovation, new drug discovery, and access to life-saving medicines.

He is routinely recognized as one of Washington’s most effective advocates, and, in 2018, was named for the third year in a row to Modern Healthcare’s “100 Most Influential People in Healthcare” and a top health influencer by Medical Marketing & Media and PR Week magazines.

 

Polly Webster, JD, MPH
Polly Webster is a senior policy advisor in Kaiser Permanente’s government relations department in Washington, DC. She provides counsel and legislative support on federal and state policy issues, focusing on drug pricing, the Food and Drug Administration, and pharmacy benefits and reimbursement.

Prior to joining Kaiser Permanente, Polly was the health policy director for Congresswoman Diana DeGette (D-CO), where she played an instrumental role in drafting and passing the 21st Century Cures Act and other laws. Polly also held health policy positions on the Senate Committee on Finance and in the Office of former Senator Jay Rockefeller (D-WV). Before her time on Capitol Hill, Polly was part of the government affairs groups at APCO Worldwide and Sidley Austin LLP in Washington, DC.

Polly received Bachelor of Arts in Political Science and Communication from Denison University, a Master of Public Health from the George Washington University, and and a law degree from Georgetown University Law Center.

 

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