Mark Hansan

CareMetx Co-founder, Executive Chairman, entrepreneur, investor, forceful advocate for patients and defender of medical innovation

[Adam J. Fein @DrugChannels]

From @CareMetx: New Study Reveals Five Crucial Priorities Shaping The Future of Patient Services

Download The 2025 Patient Services Report: https://t.co/rSpWJZVwD2

Read the article: https://t.co/GVlfVBtzYM

#sponsored

[Mark Hansan @markhansan]

In our new podcast episode, Vanderbilt University health economist Stacie Dusetzina, Ph.D., provides clear, expert insights into what we can expect—and what’s at stake in 2025 for health policy, drug pricing and patient affordability and access. Tune in: https://t.co/drCaGQQi4y

[Mark Hansan @markhansan]

Miracle cell and #genetherapies present access and affordability challenges. In a new #podcast, we are joined by experts to explore critical issues that jeopardize the balance of innovation, sustainable #reimbursement, and #patientaffordability. Join us: https://t.co/pWvvAusSCG

[Mark Hansan @markhansan]

In this new episode, we interview experts to explore how global regulatory environments, drug pricing controls, and reimbursement processes impact patient access to new therapies. YouTube channel: https://t.co/sSuYlPlohU or Spotify: https://t.co/kuGGNJjIJZ

[Mark Hansan @markhansan]

Our new episode is about the unsung heroes of access and affordability--#HealthcareAdvocates! They fight for #Patients and #Providers every day. We interviewed three amazing professionals about their efforts to elevate the work of advocates. https://t.co/swuUl7Wq9o

[Mark Hansan @markhansan]

NEW EPISODE: How did #PBMs go from lowering #drugcosts to embracing #rebates and higher drug prices? Why are there #formularies and #priorauthorizations?
Tune in for a comprehensive discussion on the past, present, and future of PBMs. https://t.co/ghz7kxaFvs

[Mark Hansan @markhansan]

Access and affordability challenges today threaten the development of tomorrow’s miracle drugs. Drug payment processes and policies have added new considerations for investors and drug manufacturers. We interview two industry experts to learn more: https://t.co/7Hf4kG6PrZ

[Mark Hansan @markhansan]

Today, we are releasing our second of two episodes from #Asembia's #AXS24 Summit. Key insights and ideas from #marketaccess leaders, shaping the future of #patientaccess and #affordability . Please listen: https://t.co/Nka08Px2LO

[Mark Hansan @markhansan]

We were a media partner for #Asembia's #AXS24 Summit where we had the opportunity to interview key speakers and attendees focused on improving patient access and affordability. This is the first of two episodes. Please listen: https://t.co/EHDNWlAcJc or https://t.co/U45BIbbQIY

[Mark Hansan @markhansan]

Antonio Ciaccia, CEO of 46brooklyn Research, explains the 340B Program and why patients end up shouldering the burden of high drug costs. Another example of our broken drug payment system. Tune in to hear Antonio's critical insights: https://t.co/AK5PYbZMuU

[Mark Hansan @markhansan]

Victor Bulto, President, US, Novartis, discusses the commitment to new treatments, navigating market access barriers, and the investments they make in patient support services to improve access and affordability. https://t.co/1GwPmk76KN https://t.co/fJv45a0SoJ

[Mark Hansan @markhansan]

In our new episode, Jason Shafrin and Marina Allen explain the complexities of the #biosimilar market, #payerformularies, provider acceptance, and the importance of branding and manufacturer-sponsored patient support services and programs. https://t.co/OuLM7qEViO

[Mark Hansan @markhansan]

Dr. Mark McClellan, ex-FDA Commissioner & CMS Administrator, unpacks 2024's significant policies and their impact on access & affordability. Essential listening for understanding the seismic shifts in health policy. Tune in: https://t.co/U45BIbbQIY

[Mark Hansan @markhansan]

Honored to interview @RachelKingBio, CEO of @IAmBiotech, for the final 2023 podcast. She helps make sense of #affordability and #patientaccess challenges and threats to #innovation that could hamper new #miracledrugs. Listen here: https://t.co/U45BIbbQIY

[Peter Kolchinsky @PeterKolchinsky]

Every day, all over America, insurance plans deny patients affordable access to treatments those patients thought their insurance would cover.

Sometimes it's no big deal. Maybe there is a similar but less expensive treatment that is covered. Maybe the patient didn't really need it. Maybe it was unproven and the physician made a mistake.

Denials in those cases don't raise alarm bells... they aren't outrageous... they don't feel unconscionable. They get little if any news coverage and if anyone writes about them, they don't make for as riveting reading so they don't get as many clicks... so next time journalists won't cover similar cases.

But sometimes a denial is unconscionable. A journalist covers it. People click. They show their outrage. They call the insurance plan. Employers reconsider working with that plan since they don't want to do wrong by their employees (a key consideration in a tight labor market).

Maybe the plan holds firm and insists it is right and maybe it doesn't lose business. In that case, what it did might not have been unconcionable after all. After all, their revenues are a referendum on the quality and value of their insurance product. But if they sense they will lose revenues unless they cover the treatment and overturn their denial and even have to raise premiums a bit to cover it and people pay those higher premiums for the more generous coverage (instead of switching to a less generous cheaper plan that would deny that treatment), then that too is a referendum on the value of that treatment.

Here is one such case of an unconscionable denial and the resulting outrage and the ultimate decision of the plan.

I would like to make the case that countless corrections like this are what ultimately calibrate the prices for countless treatments. This is the language of the market. It's not precise. It's not entirely direct. It's not even instantaneous. But compared to any alternative, over the long run, it's how the values of hundreds of millions of Americans are converted into payments that guide how what healthcare providers are paid and therefore how many doctors and nurses we have and what revenues drugs generate and therefore what innovators and their investors pursue and therefore what new medicines we will someday get.

Plans competing for the favor of the mostly healthy people who pay more into healthcare today than they get today is how insurance plans get shaped (i.e. what they cover is decided) and the "insurance value" of those plans is assessed, with value information passed along to every product that those plans cover.

So it's what those mostly healthy customers of healthcare insurance find conscionable and unconcionable that drives the direction of healthcare investment. It's important that they not be misled into thinking that they can pay as little as they want for everything they could want. Government has a tendency to promise that and fall short.

There are things worth paying for. People sense that and are willing to pay. Central planners would do well to study such revealed values, not override them.

Affordability is a function of insurance. When a person get sick, they don't have to be made to buy their treatment. They already paid for that treatment through their premiums. They don't need more skin in the game. No one fakes cancer to joyride free chemo. Let's lower OOP costs for all appropriately prescribed treatments. Why settle for $35 for insulin. How about $0? No one is going to jab themselves with insulin if they don't need to and, if they don't have diabetes and for some reason want to take insulin, just deny it... that's not unconscionable.

@TheEconomist @PhRMA @IAmBiotech @rapport_bio @NPLB_org @SenateHELP @BioCentury

https://t.co/UcidNUxrAH

[Mark Hansan @markhansan]

In this @RX4BetterAccess episode, Kyle Crowell from @ZSAssociates and Amy Niles from @PAN_Foundation explain how #AFPs eliminate coverage of #specialtydrugs, force patients to enroll in #PAPs, and put the nation’s drug safety net programs at risk. https://t.co/IGsqQfI9vn

[Mark Hansan @markhansan]

For #ObesityWeek2023, we interview distinguished clinician @DrAngelaFitch, President, #ObesityMedicineAssociation. We explore the intersection of #obesity and #GLP1s and the challenges with #drugsupply, #coverage, #access and #affordability. https://t.co/BdzL7OP5sL

[Mark Hansan @markhansan]

Congrat's to Carl Schmid, @HIVHep, @DiabetesLeaders and Diabetes Patient Advocacy Coalition on the copay accumulator legal victory! Scott and I interviewed Carl last spring: https://t.co/F5r358kWGB

[Mark Hansan @markhansan]

#employerplandesign is vital for #accesstotreatments. We interview Matt Ohrt, an award-winning executive and author of a new book to help #selffundedemployers lower insurance costs while ensuring optimal access to care and treatments. https://t.co/jMu4TiE43i

[ArthritisCenterSTL @ArthritisSTL]

Pleasure to talk about the access issues. And…the access issues are Insurnace companies & their corrupt #PBM looking at @Cigna @ExpressScripts