RealPharma: Conversations with Pharma Pathfinders

RealPharma

For biopharma pros seeking insightful discussions and a deeper understanding of the pharma world, join Dr. Na-Ri Oh and Ian Wendt as they talk with industry leaders and luminaries to delve into biotechnology, pharmaceuticals, and healthcare. RealPharma podcast aims to challenge your viewpoints, deepen your understanding of the pharma world beyond the headlines, and explore emerging trends in medical innovation.

  1. The Opioid Reckoning (Part 2): Paul Farrell Jr.

    3D AGO

    The Opioid Reckoning (Part 2): Paul Farrell Jr.

    The Opioid Reckoning (Part 2): Litigation, Accountability, and the Fight for Justice with Paul T. Farrell Jr. In Part 2 of our deep dive into the opioid crisis, hosts Dr. Na-Ri Oh and Ian Wendt continue their conversation with Paul T. Farrell Jr., the West Virginia attorney who helped lead the historic national opioid litigation. This episode moves beyond the legal strategy discussed in Part 1 and explores the human toll, the documentary that captured the battle, the controversial trial outcome, and the surprising legal reversal years later. It’s a story of perseverance, public health accountability, and the long arc of justice. 🎬 From Courtroom to Documentary Paul shares the unexpected origin story behind the PBS documentary The Bitter Pill, directed by Clay Tweel. What began as a filmmaker casually attending a hearing soon turned into a seven-year chronicle of the opioid litigation, capturing the rise of a local lawsuit in Huntington, West Virginia into a nationwide legal movement. The documentary highlights not only the legal fight but also the devastating real-world impact of the opioid epidemic on families, healthcare workers, and communities. ⚖️ The Trial That Shook the Case A major focus of the episode is the Cabell County trial, the first major test of the legal strategy that ultimately helped drive national settlements. Paul explains how: The case became the bellwether trial for thousands of similar lawsuits. A national settlement framework complicated the ability to settle locally. The federal judge ultimately ruled against the plaintiffs on legal grounds—even as similar arguments succeeded in other jurisdictions. For Paul and his team, the ruling felt like a devastating setback after years of work. 💰 The $50 Billion National Settlement Despite the loss in the bellwether trial, the broader litigation resulted in nearly $50 billion in settlements with pharmaceutical manufacturers, distributors, and pharmacies. Paul explains the goals behind the settlement: Transparency around how opioid pills were distributed across the U.S. Accountability for the systemic failures that fueled the epidemic Funding for opioid abatement programs, rather than compensation for individual claims In West Virginia, settlement funds were allocated through a unique structure that created the West Virginia First Foundation, a statewide public-private trust designed to ensure funds are used specifically to combat addiction and support recovery programs. 🔄 A Stunning Legal Reversal The documentary originally ends on a bleak note after the Cabell County loss. But the story didn’t end there. In October 2025, the Fourth Circuit Court of Appeals reversed the trial court’s decision, reopening the case and giving Cabell County another opportunity to argue its claims. For Paul, the decision brought a sense of vindication after years of uncertainty and reignited the fight for accountability. 🧠 Has the System Changed? The episode closes with a broader discussion about whether the opioid crisis could happen again. Paul reflects on changes across the healthcare ecosystem: Greater scrutiny and transparency in medical research and publishing Stronger safeguards for pharmacists and prescription monitoring Increased attention to controlled substance distribution practices But he also warns that the incentives in healthcare and pharmaceuticals remain powerful—and vigilance will be essential. 💡 Final Reflections When asked what sustains him through years of litigation, setbacks, and public scrutiny, Paul points to faith, community, and the people who show up along the journey at the right moments. It’s a fitting close to a story that began with one lawsuit in a small Appalachian city—and grew into one of the largest public health litigations in U.S. history. 🎧 In This Episode The origin and filming of The Bitter Pill documentary Inside the Cabell County bellwether trial Why the national opioid settlement unfolded the way it did The structure and purpose of opioid abatement funding The 2025 appellate reversal that revived the case Whether the healthcare system has truly changed 👥 Guest Paul T. Farrell Jr. Attorney and lead counsel in the Cabell County opioid litigation, which helped catalyze the nationwide opioid settlements.

    53 min
  2. The Opioid Reckoning (Part 1): Paul Farrell Jr.

    MAR 2

    The Opioid Reckoning (Part 1): Paul Farrell Jr.

    The Opioid Reckoning (Part 1): Paul Farrell Jr. on Litigation, Accountability, and the System That Failed West Virginia has had the highest drug overdose death rate in the United States for over a decade. In a state with fewer than 2 million people, 780 million prescription opioids were distributed in just six years. For Paul Farrell Jr., a Huntington, West Virginia native and mass tort attorney, those numbers weren’t abstract statistics. They were neighbors. Friends. Family members. In Part 1 of this two-part episode, hosts Na-Ri Oh and Ian Wendt sit down with Paul to unpack how the largest civil litigation in American history — the opioid multidistrict litigation (MDL 2804) — came together, and how it reshaped the conversation around corporate accountability in the pharmaceutical supply chain. This is not just a legal story. It’s a story about systems failure — across manufacturers, distributors, regulators, policymakers, and healthcare stakeholders — and what happens when transparency finally forces a reckoning. In This Episode Growing up in Huntington, WV as the opioid crisis escalated The investigative journalism that exposed 780 million pills — and the moment Paul decided to act What “public nuisance” law is — and why it became the legal breakthrough strategy The role of distributors as the “choke point” in the opioid supply chain How 3,000+ cases consolidated into the largest MDL in U.S. history Why abatement — not just financial damages — became central to the settlement strategy Internal company communications that revealed troubling attitudes toward affected communities The intersection of regulation, enforcement, and corporate responsibility How transparency and subpoena power changed the trajectory of the crisis Why This Conversation Matters For those working in pharma, healthcare, commercialization, policy, compliance, or distribution, this episode challenges us to examine difficult questions: Where does responsibility truly lie in a complex healthcare ecosystem? What happens when financial incentives distort oversight? And how do we prevent the next Pandora’s box from opening? This episode sets the foundation for a deeper conversation about accountability, culture, regulation, and reform. Coming Next Week: Part 2 There was simply too much to cover in one episode. In Part 2, we’ll explore: The evolution of the litigation and key tipping points The role of state attorneys general and settlement frameworks The ongoing PBM litigation The documentary The Bitter Pill And what lasting change should look like for the industry Make sure to subscribe so you don’t miss it.

    1h 4m
  3. Ending The Diagnostic Odyssey with Josh Resnikoff

    FEB 17

    Ending The Diagnostic Odyssey with Josh Resnikoff

    Ending the Diagnostic Odyssey: Rare Disease, Employers & Reimagining Health Plans Hosts: Na-Ri Oh & Ian Wendt Guest: Joshua Resnikoff, Founder & CEO, Sunstone Health Episode Overview What if the biggest innovation in rare disease wasn’t a new drug—but a new way to navigate the system? In this episode, Na-Ri and Ian sit down with Joshua Resnikoff, biomedical engineer turned founder of Sunstone Health, to explore how employers can fundamentally rethink healthcare spending—while dramatically improving outcomes for families facing rare diseases. Josh’s journey into healthcare reform wasn’t academic—it was personal. After years navigating the healthcare system to diagnose his son’s rare periodic fever syndrome, Josh experienced firsthand the emotional, financial, and systemic toll of what’s known as the diagnostic odyssey. That experience sparked a mission: compress a seven-year diagnostic journey into just 12 weeks. This conversation dives into rare disease, employer-sponsored health plans, insurance mechanics, and why aligning incentives might be the key to transforming care. 🔬 From Scientist to System Builder Josh’s background as a biomedical engineer at Harvard’s Wyss Institute The rare disease journey that reshaped his career Why getting a diagnosis—even without treatment—changes everything The emotional and economic cost of delayed diagnosis 🧬 The 7-Year Diagnostic Odyssey On average, it takes: 7 years from first symptom to effective treatment for rare disease patients Countless ER visits, specialist referrals, medication trials, and escalating costs Significant emotional strain—rare disease families face dramatically higher stress and divorce rates Sunstone’s model reduces that timeline to approximately 12 weeks using: Whole genome sequencing AI-powered clinical interpretation Expert clinician review (human-in-the-loop model) Direct coordination with local care teams The result? Earlier intervention. Reduced healthcare utilization. Better outcomes. 💼 Why Employers Are the Key Josh explains why self-funded employers—not traditional commercial insurers—are uniquely positioned to drive change. Key insights: ~2/3 of Americans receive insurance through employers Many large employers are self-funded, meaning they pay claims directly Employers think in long-term employee retention (not 12-month insurance cycles) Better healthcare = healthier employees = higher retention & productivity Sunstone’s innovative model: No per-employee-per-month subscription fees Employers only pay when a family receives actionable results High ROI through reduced ER visits, unnecessary treatments, and delayed care 🛡 Insurance 101 (Made Understandable) The episode breaks down: Fully insured vs. self-funded plans Third-party administrators (TPAs) Stop-loss / reinsurance How high-cost cases (like $2M gene therapies) are financially managed The takeaway: When diagnoses happen earlier, total system costs often decrease—even when advanced therapies are involved. 🤝 Mission-Driven Innovation A powerful theme throughout the conversation: Many leaders in the rare disease ecosystem—including Josh—entered the field because of their own children. That lived experience shapes: Sunstone’s patient-first data ownership model Continuous reanalysis of patient data Clinical trial matching Ethical alignment with families As Josh says: “Even if this whole thing went belly up, we will have helped hundreds of families—and I’d feel good about that for the rest of my life.” 🚀 Recent Milestones Successfully raised Series A funding 800+ community investors via WeFunder Integration with Broad Clinical Labs Expanded epilepsy and autism-focused programs Rapidly growing employer pipeline 🔗 Learn More 🌐 Sunstone Health: https://sunstonehealth.com 💼 Connect with Josh on LinkedIn

    58 min
  4. Beyond Survival: Why Empathy Is the Missing Prescription in Pharma with Matthew Zachary

    JAN 26

    Beyond Survival: Why Empathy Is the Missing Prescription in Pharma with Matthew Zachary

    🎙️ Beyond Survival: Why Empathy Is the Missing Prescription in Pharma Episode Summary: In this no-holds-barred conversation, Na-Ri Oh and Ian Wendt sit down with Matthew Zachary—brain cancer survivor, founder of Stupid Cancer, host of Out of Patients, and a relentless disruptor in patient advocacy. At 21, Matthew was diagnosed with brain cancer and faced a life-altering decision: take chemotherapy and lose his identity as a musician, or reject treatment and risk everything. That decision became the first of many moments where he saw the cracks in the healthcare system—specifically, the glaring absence of empathy. Now, nearly three decades later, Matthew shares how his experience transformed into a mission to fix what’s broken: in pharma, in media, in patient engagement—and in how we talk about what matters most. This isn’t your typical Pharma Podcast. It’s a masterclass in calling out BS, rethinking metrics that matter, and re-centering real human lives in healthcare strategy. What You’ll Hear in This Episode: 🎹 The life-defining decision Matthew made at 21—and why he turned down chemo 💊 How a lack of empathy almost cost him everything 🧠 The problem with patient engagement that’s all talk and no trust 🎤 The rise of Stupid Cancer and the “Howard Stern of Healthcare” era 📺 Why DTC ads may be a $28 billion distraction 🧵 The missing link between pharma marketers and patient communities 🔥 How compliance is killing creativity—and what to do about it 🗳️ Why Matthew is building a voter movement out of patient voices Memorable Quote: “If there is no empathy, there is no conversation.” – Matthew Zachary Mentioned in the Episode: Stupid Cancer Out of Patients Podcast Matthew’s upcoming book: We the Patients: How to Understand, Navigate, and Survive America’s Healthcare Nightmare WeThePatients.org Guest: Matthew Zachary (@MatthewZachary)   Let me know if you'd like a shorter version for Spotify/Apple Podcast platforms or suggested social media captions to promote the episode.

    59 min
  5. Breaking the Silence: Why Pharma Needs to Speak Up with Brian Reid

    JAN 12

    Breaking the Silence: Why Pharma Needs to Speak Up with Brian Reid

    🎙️ Real Pharma – Episode Title: Breaking the Silence: Why Pharma Needs to Speak Up Hosts: Na-Ri Oh & Ian Wendt Guest: Brian Reid, Founder & Principal at Reid Strategic 🔍 Episode Summary: In this episode of Real Pharma, Na-Ri and Ian sit down with Brian Reid—a healthcare communicator, strategist, and former journalist who's worked across government, pharma, and media—to explore a provocative question: Why is the pharmaceutical industry so quiet when it comes to telling its own story? Together, they unpack the communication failures shaping drug pricing, PBMs, the Inflation Reduction Act (IRA), biosimilars, and the broader healthcare system. Brian argues that the problem isn’t a lack of data or platforms—it’s a lack of courage, clarity, and commitment to narrative. From the importance of speaking up in a noisy media environment to the myth of reputational risk, this conversation is a must-listen for anyone in life sciences, policy, or healthcare storytelling. 🧠 What You’ll Learn: Why pharma’s “default to silence” is damaging public trust—and what the industry can do instead The communications trap around complex topics like PBMs, pricing, and benefit design How public perception problems could have been avoided with smarter storytelling (hello, Hep C) Why simplicity is power—and how “pharm-to-table” and Mark Cuban are reframing the narrative The case for overcommunication in the face of misinformation and AI-driven “slop” Why the Medicare Prescription Payment Plan was a missed communication opportunity—and how to fix it 🔊 Quotable Moments: “We're in a 30-year experiment of what happens when pharma steps back from the policy debate—and the results are in.” – Brian Reid “I just want pharma to beat Bigfoot in public trust. That’s my goal.” – Brian Reid “When in doubt, just shout. Say something. Do something.” – Na-Ri Oh “It’s not always about having the perfect message—it’s about showing up and making the case.” – Ian Wendt 🧭 Resources Mentioned: Cost Curve – Brian Reid’s daily newsletter on healthcare policy: ReidStrategic.com KFF’s piece on complexity as a barrier to affordability Examples from Mark Cuban’s Cost Plus Drugs and Eli Lilly CEO Dave Ricks’ public podcast appearances 👥 Connect with Brian Reid: 💼 Website: ReidStrategic.com 📬 Newsletter: Cost Curve 💬 LinkedIn: Brian Reid

    53 min
  6. Formulation as Strategy: Why CDMOs Matter More Than Ever

    12/15/2025

    Formulation as Strategy: Why CDMOs Matter More Than Ever

    Episode Title: Formulation as Strategy: Why CDMOs Matter More Than Ever Guest: Elizabeth Hickman, President & CEO, Austin Pharmaceutics Episode Overview In this episode of RealPharma, hosts Nari Oh and Ian Wendt sit down with Elizabeth Hickman, President and CEO of Austin Pharmaceutics, to unpack one of the most critical—and often misunderstood—elements of drug development: formulation and the evolving role of CDMOs. As drug molecules become more complex and solubility challenges grow, CDMOs are no longer just manufacturing vendors. They are strategic partners helping biotech and pharma companies bridge the gap between discovery and commercialization. Elizabeth shares her journey from commercial pharma leadership to running a science-driven CDMO, and explains why formulation decisions made early can determine whether a promising molecule ever reaches patients. 🔍 Key Topics Covered The expanding role of CDMOs Why CDMOs are shifting from executional partners to strategic extensions of pharma and biotech teams. Why formulation is make-or-break How solubility and bioavailability challenges derail up to 80% of modern drug candidates—and why these issues must be addressed early. From “undruggable” to developable How AI-driven discovery and structure-based drug design are unlocking new targets while creating new development hurdles. Inside Austin Pharmaceuticals’ approach A look at Austin’s proprietary Kinetisol® technology and how amorphous solid dispersion can improve bioavailability, scalability, manufacturability, and sustainability. Small biotech vs. big pharma dynamics What early-stage companies should look for in a CDMO partner—and the most common mistakes teams make when selecting one. Patient impact starts with formulation How pill burden, dosing frequency, and manufacturability directly affect adherence, cost, and competitiveness. The future of CDMOs Reshoring, cost pressures, AI adoption, and the growing need for talent with both scientific depth and entrepreneurial mindset. 💡 Memorable Takeaways “Formulation is where promising molecules either become viable drugs—or stall out.” Solving in-vivo performance alone isn’t enough; scalability and manufacturability must be designed in from day one. The best CDMO relationships are built on transparency, urgency, and shared long-term vision. Advanced formulation isn’t just a technical advantage—it’s a competitive and economic one. 👤 About the Guest Elizabeth Hickman is President and CEO of Austin Pharmaceutics, a U.S.-based early-phase CDMO specializing in formulation development for challenging small-molecule drugs. With a background spanning commercial strategy, drug launches, and executive leadership, Elizabeth brings a sponsor-centric mindset to CDMO partnerships—helping clients accelerate innovation while reducing risk.

    46 min
  7. Untangling the IRA with Emma Cousin

    12/08/2025

    Untangling the IRA with Emma Cousin

    🎧 Hosts: Na-Ri Oh & Ian Wendt 🎓 Special Guests: Emma Cousin (PhD Candidate, Choice Institute – UW), Amos Fung (RealPharma Intern & Student Pharmacist) 🔍 Episode Summary: In this thought-provoking episode, hosts Na-Ri Oh and Ian Wendt sit down with Emma Cousin, a PhD candidate at the Choice Institute, University of Washington, to unpack the real-world implications of the Inflation Reduction Act (IRA)—particularly the Medicare Drug Price Negotiation Program. Joining them is Amos Fung, a RealPharma intern who brings a front-line pharmacy perspective to the policy conversation. Together, they discuss: 📜 A primer on the IRA’s healthcare provisions—what it is, how it came to be, and why it matters now. 💊 How CMS selects drugs for Medicare negotiation and whether this process constitutes true “negotiation.” 👩‍⚕️ The ripple effects on pharmacists, pharmacies, and patient care. 💸 The looming concerns around cashflow, operational readiness, and access as the 2026 implementation date approaches. 🧠 How researchers like Emma are modeling long-term effects—and what metrics we’ll need to track to assess the IRA’s success. 🔄 Unintended consequences and who might be left behind—especially independent pharmacies and vulnerable communities. 📈 A candid discussion on myths around drug pricing and why “good intentions” in policy still need strong evidence and thoughtful execution. 🎯 Key Takeaways: The IRA marks the first time Medicare can directly negotiate drug prices—albeit in a tightly structured format that raises questions about the fairness of “negotiation.” Pharmacies face operational and financial strain, particularly smaller or independent ones, due to rebate lags and implementation complexities. Patients will benefit from caps on out-of-pocket costs, but awareness and education are lacking—many don’t realize what the law offers. Stakeholders like pharmacists, researchers, and policy influencers need better communication and clearer technical standards from CMS. Evidence-based policy should be the north star for drug pricing reforms, but real-world implementation remains messy and evolving. 🧠 Resources & Mentions: Brian Reid & Adam Fein – Top newsletters to follow for updates on drug pricing policy. CMS Guidance Documents – Frequently updated, but often inaccessible to non-policy experts. National Pharmaceutical Council, Milliman, Portal (Harvard) – Organizations doing forward-looking modeling and policy impact research.

    47 min
  8. Reinventing Cell Therapy with Acoustics

    11/24/2025

    Reinventing Cell Therapy with Acoustics

    Reinventing Cell Therapy with Acoustics, Microfluidics & High-Throughput Engineering In this episode, hosts Na-Ri Oh and Ian Wendt sit down with Dr. Andrew Gray — immune cell engineer, biotech founder, venture capitalist, and CEO of CellEcho — to explore how a new acoustic-powered gene-delivery platform may redefine the boundaries of cell therapy. The conversation spans the current state of the cell therapy landscape, the persistent barriers to scalability, and why CellEcho’s ASOP platform (Acoustically Stabilized Oscillatory Pockets) could unlock a new era of faster, cheaper, and more effective cell engineering. 🔬 Episode Highlights 1. The State of Cell Therapy: Breakthroughs & Bottlenecks Despite scientific success, many pharma companies are exiting cell therapy due to cost, complexity, and manufacturing burdens. Conversely, major players like BMS continue doubling down, acquiring companies such as Orbital Therapeutics. Autologous therapies remain logistically overwhelming and expensive—often ~$400k per dose. 2. Why Cell Therapy Is So Hard to Scale “Vein-to-vein” timelines are still measured in weeks, not days. Manufacturing is bespoke: each patient’s cells must be extracted, engineered, expanded, frozen, shipped, and reinfused. Viral vectors and current non-viral delivery methods introduce cost, complexity, and biological limits. 3. The Next Frontier: In Vivo, Allogeneic & Beyond Allogeneic CAR-Ts remain challenging due to immune rejection and complex engineering. In vivo CAR-T offers promise but is limited by the small genetic “payload capacity” of lipid nanoparticles. Solid tumors remain particularly difficult: only ~9% response rates in some indications. 4. Introducing CellEcho & the ASOP Platform CellEcho’s technology emerged from UC Irvine’s microfluidics program. By applying precision acoustic energy, the platform can: Hold cells in place using thousands of stable micro-eddies Open controlled, programmable “portals” in cell membranes Sequentially deliver multiple genetic payloads with high efficiency Achieve 1 billion cells/hour processing rates Reduce dose production costs by ~100× Enable high-throughput engineering, not just manufacturing This unlocks the ability to test dozens to hundreds of engineered CAR-T variants in days—rather than the years needed today. One academic lab spent 6 years evaluating 11 CAR-T variants. CellEcho tested 8 variants in under 48 hours — and aims for 100+ per week. 5. From Better Manufacturing to Better Medicines While CellEcho originally targeted faster manufacturing, Andrew shares that the bigger opportunity is designing entirely better therapies, not simply making today’s ones faster. This includes: Engineering CAR-Ts with multiple CAR constructs Arming cells with resistance to tumor suppression signals Precise control over expression levels (avoiding under- or over-expression) Unlocking new indications: autoimmunity, neurodegeneration, regenerative medicine 6. Personal Motivation & Mission Andrew shares how his mother's struggle with myasthenia gravis sparked his lifelong journey in immunology. His 20-year career investigating immune evasion, Tregs, and tumor microenvironments culminated in his conviction that next-generation cell engineering is essential. 7. What’s Next for CellEcho Currently initiating pre-seed fundraising Supported by multiple federal grants (including NSF SBIR) Expanding early partnerships with Stanford, Mass General Brigham, and industry collaborators Building a fully automated, AI-augmented cell therapy design platform Dual strategy: Cell-therapy-development-as-a-service Proprietary therapeutic pipeline in select indications 💡 Key Takeaways Cell therapy works — but not broadly or efficiently enough. Engineering complexity, not biology alone, is the rate-limiting step. Acoustic microfluidics enables a scalable, programmable, non-viral way to engineer living cells. High-throughput screening for cell therapies could transform discovery the way combinatorial chemistry transformed small molecules. The real revolution isn’t just faster production — it’s better, more sophisticated therapies. 🔗 Learn More About CellEcho Visit: https://cellechobio.com Contact: Via the Info link on the website (messages route directly to Dr. Gray).

    52 min
5
out of 5
13 Ratings

About

For biopharma pros seeking insightful discussions and a deeper understanding of the pharma world, join Dr. Na-Ri Oh and Ian Wendt as they talk with industry leaders and luminaries to delve into biotechnology, pharmaceuticals, and healthcare. RealPharma podcast aims to challenge your viewpoints, deepen your understanding of the pharma world beyond the headlines, and explore emerging trends in medical innovation.

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