Oncology Unscripted With John Marshall: Episode 5: PBMs—The Middlemen Shaping Treatments and Costs

John Marshall, MD: Hey, everybody. John Marshall with Oncology Update. Welcome back. This is episode 5. 

We now have a really cool function called ask a question. Click on that. Send us something. We hope to get back with you with an answer.

Most of the time, you know, you see these things and it's all nailed down, and you know exactly what you're about to get. Not so much with this. We’re really trying to bring to you the current days news. What's going on in our world in the world of cancer, both in the science world, the social world, and the business world. And you know what? You just can't script that kind of stuff. It just happens as it happens—so a little bit of Oncology Unscripted. 

OncoBuzz

First, the news of the day. U.S. News and World Report just came out again. Guess which one was the number 1? Of course, it's MD Anderson. Number 1 again. The top tier teams, it's like the Yankees going against the Dodgers. It's always the same teams year after year. But congratulations to that fabulous group down in Houston, Texas.

We here at Georgetown are just pumped that we got our NCI renewal; our comprehensive status for a fresh five years. Always a good moment for NCI Cancer Centers, either to get it or to maintain it. So, thank you for all the hard work that went into that. 

Big news out there. Friends of Cancer Research gave out annual leadership awards—Monica Bertagnolli, our new head out at the NCI doing a fabulous job, as well as Brett Guthrie. So great people who well deserve the Friends of Cancer Research Leadership Award. So, kudos to them. 

Just some business news out there. 

Lei Zheng, MD, PhD, who was a UT San Antonio person all along, just named the Executive Director of their fabulous Mays Cancer Center.

Mark Burkard, MD, PhD, he's a good human as well. University of Iowa, just named him their new cancer center director. He was at University of Wisconsin. So, he moved kind of, I don't know, south a little bit. Still will not be such great weather, although it was probably a little better weather than Wisconsin. We'll see how it goes there. So, congratulations to him. 

On the clinical research front, some news that maybe doesn't really make it here to the U.S. so much, is that the E.U., which has been doing a lot of our major clinical research lately, making up for some of the gaps that we certainly haven't been filling as well. They've had a sort of sudden halt to clinical research because of some new regulations around devices and things one uses to test and measure stuff. So, you can imagine scans and other things like that. So, there's some new regulations there that is sort of thrown a monkey wrench into E.U. clinical research. And my guess is, it may take them a bit of time to figure that out, but hopefully they will figure that out fast. 

The one piece of news that really caught my eye this cycle was not something you would see in the journals that hit your door. Maybe not something you'd see in any of your feed, and this is from the Federal Trade Commission. So, there was a Federal Trade Commission report that had to be voted on, and it's all about the anti-competitive harms of pharmacy benefit management industry, PBMs, pharmacy benefit managers, PBMs, and we know in the cancer world, these things have become huge. But on July 9th, not too long ago, the FTC voted 4 to 1, I'm reading this to not get it wrong, to release an interim staff report around pharmacy benefit managers, the powerful middlemen, inflating drug costs, and squeezing Main Street pharmacies.

You and I know this is going on out there. We're feeling it. Our patients. Maybe not. Interestingly, they're a little bit on the sideline about this because in the United States, we don't judge value around here. 

PBMS: THE POWERFUL MIDDLEMEN

John Marshall, MD: This is going to kick off one in a series of the middlemen in our world. We are going to talk about CROs, clinical research organizations, certainly going to talk about electronic medical records. They're sort of our data middlemen. But for this episode, we'r