How will we pay for the cost of cures?
About This Event

Event Summary

 

How can the United States develop the financing mechanisms to pay for the development of transformative medicines? On Friday, AEI's Scott Gottlieb hosted Representative Michael C. Burgess and a panel of health care experts to discuss new financial models designed to keep apace of medical advances in the treatment of chronic illnesses.

Rep. Burgess emphasized follow-through in drug discovery, development, and market entry and encouraged fostering efficiency in the regulatory environment. He identified various obstacles to innovation, including the Medicare Sustainable Growth Rate, which is used as a method to control Medicare's spending on physician services — something he called a "missing link" in the Affordable Care Act. Rep. Burgess encouraged active dialogue with patients to help facilitate access to personalized, highly effective therapies.

During the panel discussion, Gregg Alton of Gilead Sciences cited Sovaldi as a major breakthrough in curing Hepatitis C and demonstrated that assessing new treatments involves comparing the total cost, value, and efficiency of the treatment to lifetime therapy. Dan Mendelson of Avalere Health illustrated how benefit designs are shifting costs onto patients and how quality metrics in current financial models are misaligned toward administrative measures rather than accommodating new cures.

Dr. Dirk Calcoen added that lack of treatment innovation can build financial burden for payers. Dr. Mark McClellan concluded by homing in on the question: How do you keep a population as healthy as possible? His suggestions involved moving away from pay-for-service plans and shifting the traditional insurance system to encompass the growing number of cures.
--Kelly Funderburk

Event Description

Imagine a pill that could cure cancer with one course of therapy or reverse an inherited, deadly disease. If it cost $1 million, could you access it?

These cures are in development, but the US health care system is not designed to cover the cost of such life-saving, short-term therapies. New approaches to how we pay for medical care could change the way we receive health care, create more incentives for finding cures, and spread the costs of curing diseases over many years.  At the same time, we also need to continue to make the critical path for developing cures lower cost and more efficient.

Please join us as a panel of top health care experts plot a path toward improving the development of transformative medicines and developing financing mechanisms to pay for them.

If you are unable to attend, we welcome you to watch the event live on this page. Full video will be posted within 24 hours. 

 

Agenda

7:45 AM
Registration and Breakfast

8:00 AM
Opening Discussion: Improving the critical path for developing cures
Michael C. Burgess, US House of Representatives (R-TX)
Mark B. McClellan, Brookings Institution

8:45 AM 
Panelists:
Gregg H. Alton, Gilead Sciences
Dirk Calcoen, Boston Consulting Group
Scott Gottlieb, AEI
Mark B. McClellan, Brookings Institution
Dan Mendelson, Avalere Health

9:45 AM
Adjournment

Event Contact Information

For more information, please contact Kelly Funderburk at [email protected], 202.862.5920.

Media Contact Information

For media inquiries, please contact [email protected], 202.862.5829. 

Speaker Biographies

Gregg Alton joined Gilead Sciences in 1999. From 2000 to 2009, he served as general counsel. In his current role, Alton is responsible for legal affairs, government affairs, medical affairs, public affairs, and emerging-market activities. Before joining Gilead, Alton was an attorney at Cooley Godward LLP, where he specialized in mergers and acquisitions, corporate partnerships, and corporate finance transactions for health care and information technology companies. Alton is a member of the boards of the AIDS Institute, BayBio, the Boys and Girls Clubs of Oakland, and the Celladon Corporation. He is also a member of the US government's Industry Trade Advisory Committee on Intellectual Property Rights, advisory board of University of California–San Francisco Global Health Group, and dean’s advisory council at Stanford Law School.

Michael C. Burgess spent nearly three decades practicing medicine in north Texas before serving the constituents of the state’s 26th Congressional District in the US House of Representatives since 2003. He currently serves on the House Energy and Commerce Committee and as vice chairman of both the Subcommittee on Health and Oversight and Investigations Subcommittee; he is also a member of the Energy and Power Subcommittee, Rules Committee, and Helsinki Commission. In 2009, he founded and currently serves as chairman of the Congressional Health Care Caucus. Because of his medical background, Rep. Burgess has been a strong advocate for health care legislation aimed at reducing health care costs and improving choices. During his time on Capitol Hill, Burgess has received several awards for his service, including the Guardian of Small Business award from the National Federation of Independent Business, Spirit of Enterprise award by the US Chamber of Commerce, and the Taxpayer Hero award from the Council for Citizens against Government Waste.

Dirk Calcoen is a partner and managing director in the San Francisco office of the Boston Consulting Group (BCG). Dr. Calcoen is a core member of the firm's health care practice. He has worked extensively in biotechnology, specialty pharma, and medical technology. He has extensive experience working in commercial, research and development, manufacturing, and support functions. Before joining BCG, Dr. Calcoen worked as an international public health physician with Doctors without Borders and as a researcher in neurophysiology labs.

Scott Gottlieb is a practicing physician and resident fellow at AEI. From 2005 to 2007, Dr. Gottlieb served as US Food and Drug Administration (FDA) deputy commissioner for medical and scientific affairs. From 2003 to 2004, he served as a senior adviser to the FDA commissioner and as the FDA’s director of medical policy development. He left the FDA in spring 2004 to work on the implementation of the new Medicare prescription drug benefit as a senior adviser to the administrator of the Centers for Medicare and Medicaid Services. Dr. Gottlieb is an editorial board member of the journal Value Based Cancer Care, the Food and Drug Law Institute’s Policy Forum, and is a member of the board of advisers of Cancer Commons. He writes a regular column for The Wall Street Journal. Dr. Gottlieb is also a member of the policy boards for both the Society of Hospitalist Medicine and the Leukemia and Lymphoma Society and serves as a director to public and private life science and health care services companies. He is likewise a clinical assistant professor at the New York University School of Medicine.

Mark B. McClellan is a senior fellow and director of the Health Care Innovation and Value Initiative at the Brookings Institution. Within Brookings, his work focuses on promoting quality and value in patient-centered health care. A doctor and economist by training, he also has a highly distinguished record in public service and academic research. Dr. McClellan is a former administrator of the Centers for Medicare & Medicaid Services and former commissioner of the US Food and Drug Administration (FDA) where he developed and implemented major reforms in health policy. These include the Medicare prescription drug benefit, the FDA’s Critical Path Initiative, and public-private initiatives to develop better information on the quality and cost of care. Dr. McClellan chairs the FDA’s Reagan-Udall Foundation, is cochair of the Quality Alliance Steering Committee, sits on the National Quality Forum’s board of directors, is a member of the Institute of Medicine, and is a research associate at the National Bureau of Economic Research. He previously served as a member of the President’s Council of Economic Advisers and senior director for health care policy at the White House, and was an associate professor of economics and medicine at Stanford University.

Dan Mendelson
is the founder of Avalere Health LLC and serves as its CEO and president. Mendelson served as senior vice president of The Lewin Group and director of its medical technology practice. During his eight-year tenure, he had a range of responsibilities, including management of a transnational pharmaceutical and medical-device consulting practice. From 1994 to 1996, Mendelson was closely involved in the operations of Value Rx, a pharmacy benefit-management company. From 1998 to 2000, he served as associate director for health at the Office of Management and Budget and was responsible for budget development and policy coordination across the administration. His work included development of presidential initiatives in pharmaceutical benefits, health information technology, medical error prevention, electronic disease surveillance, and other federal policies in reimbursement and technology assessment. Mendelson has been a director at HMS Holdings Corporation since 2013. He served as an independent director of Coventry Health Care Inc. until 2013 and Coventry Health Care of Georgia Inc. since 2005. He has been a director of Champions Oncology Inc. since 2013. Mendelson served as a director of PharMerica Corporation from 2007 to 2011. He is an adjunct professor of business administration at the Fuqua School of Business at Duke University.

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