The State of Health with Gunnar Esiason Audacy

Today on the show we take a look at the shadow world where pharmacy benefit managers or PBM’s operate to influence drug prices. Joining us is Antonio Ciaccia, the CEO of 46Brooklyn Research, an Ohio non-profit corporation whose purpose is to improve the accessibility and usability of U.S. drug pricing data.
PBMs are a meaningful part of the US drug supply chain, but until just recently, their outsized role has been hidden in the shadows. Antonio has been on the front lines introducing transparency into the prescription drug marketplace, including just recently in front of the Ohio state legislature.

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Kevin Outterson, the Executive Director of Boston-based CARB-X, a global non-profit partnership dedicated to accelerating antibacterial research to tackle the global rising threat of drug-resistant bacteria, joins the podcast to talk with Gunnar about the early-stage landscape for biotechnology companies developing novel antibiotics. Unlike the AMR ActionFund, CARB-X doesn't take equity positions in new companies, but rather provides grants and infrastructure support for companies moving through the drug development process. Gunnar and Kevin also talk about the PASTEUR and DISARM Acts as potential legislative fixes for the antibiotic marketplace. Kevin also points to an assumption that has long been made about generic drugs, which falls short for antibiotics and leaves them in a place that leaves them vulnerable to present market conditions.

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The antibiotic resistance series on the State of Health has discussed, at length, the policy and market dysfunctions at the heart of the antibiotic crisis. This week, Gunnar talks with Dr. Ben Chan, an Associate Research Scientist in the department of Ecology and Evolutionary Biology at Yale University, and Ella Balasa, a cystic fibrosis patient advocate who advocates for new options to treat highly antibiotic resistant bacteria. The show details a chance meeting for Dr. Chan and Ella, which led to Ella being one of the first cystic fibrosis patients in the US to dose a phage cocktail fresh out of Dr. Chan's lab work. The two talk about what needs to happen to bring a technology out of academic to patients and how clinical research happens outside of a randomized clinical trial.

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Senator Michael Bennet, a co-sponsor of the bipartisan PASTEUR Act, joins Gunnar on the State of Health to talk about his proposed legislation to correct the dysfunctional antibiotic market. Senator Bennet makes his pitch for why he believes people should care about antibiotic resistance, talks about how the PASTEUR Act can become law, and shares how the economics at the heart of PASTEUR differ from current reimbursement practices for antibiotics. Gunnar talks about relying on antibiotics of last resort, how PASTEUR complements another piece of legislation called the DISARM Act, and how new antibiotic options would benefit people living with drug resistant infections.

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The State of Health continues the Antibiotic Resistance series with an episode featuring Henry Skinner, the CEO of the AMR Action Fund, a novel kind of investment fund that aims to catalyze the innovation ecosystem for novel antibiotics. Gunnar and Henry talk about the challenges of bringing new antibiotics to market, the difference between the AMR Action Fund and a traditional Biotechnology VC, and the pharmaceutical industry's role in tackling antibiotic resistance. The conversation turns to emerging antibacterial technologies, antibiotic market dynamics and what success means for the AMR Action Fund in the long term.
Earlier episodes in the Antibiotic Resistance Series are in the show's feed!

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Senator Todd Young from Indiana joins the podcast to talk about the PASTEUR Act, a bipartisan piece of legislation that he is co-sponsoring with Senator Michael Bennet that aims to reform the way novel antibiotics are paid for in the United States. Unlike most prescription drugs, antibiotics are unique in that they lose their efficacy over time thanks to bacteria evolving to become impervious to antibiotic exposure. PASTEUR is similarly unique because it delinks government reimbursement from prescription volume a pays for novel drugs in the same way you and I pay for our Netflix subscriptions. This episode is part of the State of Health's antibiotic resistance series.

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