Saum Sutaria, M.D.

And so I think cracking that door open is good. Look, we get into these philosophical debates about we're a free economy, a free market economy. The government should not be engaged in price controls. But think about this. Doctors are price takers for Medicare. Medicare sets their reimbursement. It's price controlled.

And so I think cracking that door open is good. Look, we get into these philosophical debates about we're a free economy, a free market economy. The government should not be engaged in price controls. But think about this. Doctors are price takers for Medicare. Medicare sets their reimbursement. It's price controlled.

Hospitals take Medicare prices as they're given. So Medicare is a monopsonist. They're a monopsonist at the end of the day. They've applied it to doctors and to hospitals and other infrastructure-based care where they set the prices based upon their purchasing power. It just hasn't happened yet on the drug side.

Hospitals take Medicare prices as they're given. So Medicare is a monopsonist. They're a monopsonist at the end of the day. They've applied it to doctors and to hospitals and other infrastructure-based care where they set the prices based upon their purchasing power. It just hasn't happened yet on the drug side.

And you have to think, obviously, the debate is, how do you do that in a way that doesn't deter innovation? Is there a sharing with the rest of the world that needs to happen? Or how do you do it in a way where if it's just the US, it doesn't deter innovation? Because that innovation has been incredibly beneficial to us in a number of different ways.

And you have to think, obviously, the debate is, how do you do that in a way that doesn't deter innovation? Is there a sharing with the rest of the world that needs to happen? Or how do you do it in a way where if it's just the US, it doesn't deter innovation? Because that innovation has been incredibly beneficial to us in a number of different ways.

And again, we're going to get into health status and outcomes and why they aren't so good. But it has been helpful. And at the same time, leave enough of a return that actually the innovation won't stop and start to take advantage of some of that purchasing power. And I think that that's going to be an ongoing policy debate now that that door has been cracked open.

And again, we're going to get into health status and outcomes and why they aren't so good. But it has been helpful. And at the same time, leave enough of a return that actually the innovation won't stop and start to take advantage of some of that purchasing power. And I think that that's going to be an ongoing policy debate now that that door has been cracked open.

And I think what's new is that both the more, and I really don't want to get into politics, but both the more populist brand of Republicans and Democrats seem to have a understanding drug prices are on their radar screen on both sides, maybe in different ways. The industry will evolve and we'll see how that goes.

And I think what's new is that both the more, and I really don't want to get into politics, but both the more populist brand of Republicans and Democrats seem to have a understanding drug prices are on their radar screen on both sides, maybe in different ways. The industry will evolve and we'll see how that goes.

So let's talk about what a PBM is because there's two issues with the PBMs that we should talk about. One is what do they do and how effective are they? Let's start there. Then there's the question of who owns them and how do they work and is that vertical integration helpful or not helpful to the system, which we can get into. But the PBMs, in essence...

So let's talk about what a PBM is because there's two issues with the PBMs that we should talk about. One is what do they do and how effective are they? Let's start there. Then there's the question of who owns them and how do they work and is that vertical integration helpful or not helpful to the system, which we can get into. But the PBMs, in essence...

are organizations that formed as intermediaries between pharma companies, insurers, and pharmacies, where you get much of your medication, in order to help manage an increasingly large complexity of drugs. I mean, today there are probably 15,000 pharmaceuticals available. The PBMs were designed to do a few things. Understand the market for those drugs.

are organizations that formed as intermediaries between pharma companies, insurers, and pharmacies, where you get much of your medication, in order to help manage an increasingly large complexity of drugs. I mean, today there are probably 15,000 pharmaceuticals available. The PBMs were designed to do a few things. Understand the market for those drugs.

Make formularies that were either broad or restrictive. Manage benefit plans for employers who were looking to have preferred pricing on certain drugs versus other drugs. So they were created to try to say, OK, we've got a lot of expenditure here in the drug arena. The choices are complex. The number of drugs has gone up 15 or 16,000, whatever that number may be.

Make formularies that were either broad or restrictive. Manage benefit plans for employers who were looking to have preferred pricing on certain drugs versus other drugs. So they were created to try to say, OK, we've got a lot of expenditure here in the drug arena. The choices are complex. The number of drugs has gone up 15 or 16,000, whatever that number may be.

And we need entities that help people make more informed decisions in some ways at scale through employers or insurers. and in some ways at the retail pharmacy level when individuals are going to fill prescriptions, by the way, which includes things like generic substitution and things of that nature when that's appropriate and is allowed. That's what they were created to do. What did that create?

And we need entities that help people make more informed decisions in some ways at scale through employers or insurers. and in some ways at the retail pharmacy level when individuals are going to fill prescriptions, by the way, which includes things like generic substitution and things of that nature when that's appropriate and is allowed. That's what they were created to do. What did that create?

It created a complex payment system because it used to be you buy a drug, the money goes to the pharma company from the pharmacy, the pharmacy buys a drug, they pay the pharma company, you have a direct interaction or...

It created a complex payment system because it used to be you buy a drug, the money goes to the pharma company from the pharmacy, the pharmacy buys a drug, they pay the pharma company, you have a direct interaction or...