$50 Billion Pharma Plant Built in Virginia?

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Episode Transcript

SPEAKER_00 (00:00):
Hello and welcome to Postscripts, the podcast
exploring what happens after thefirst prescription.
We cover the latest innovationsin patient access, support,
digital tools, HCP engagement,and pharma marketing that drive
better outcomes for patients, wehope.
This podcast is forinformational purposes only and
should not constitute anymedical advice or influence any

(00:23):
clinical decision making.
Patients should always consulttheir health care professionals.
Welcome to the podcast.
My name is Brian Carr.
I'm the Senior Vice President ofMarketing at Metasafe.
Although any of my opinionsexpressed here are my own and
not necessarily those ofMetasafe, its digital solutions,
or its partners.
So one thing's happening, we'rejust seeing the U.S.

(00:44):
pharmaceutical landscape reallyon the edge of a massive
transformation, potentially.
The challenge of the U.S.
administration's proposal to tieU.S.
drug prices to what they callthe most favored nation pricing
benchmark really has rattledsome boardrooms across the
globe.
For example, a concept whereU.S.

(01:04):
drug prices would be pegged tothe lowest price paid by all
developed countries could slashU.S.
pricing power significantly, andwhen the largest, most
profitable pharma market in theworld rethinks its pricing
standards, there are some rippleeffects that could be
unavoidable.
So today we're delving intothis, how this shift in drug
pricing regulation could beprompting some pharmaceutical

(01:26):
giants to rethink not only theirpricing, but also manufacturing,
and explore how it could reshapeinvestments in domestic
biopharma facilities, supplychain strategy, and patient
access programs.
So for those of you, the mostfavored nation rule is a pricing
model where the federal policymandates Medicare, for example,
pays no more for drugs than thelowest price charge for that

(01:48):
drug and other advanced nations.
So in essence, if Germany, theUK, or France gets a better
deal, so should the US.
While this proposal intends toreally alleviate the burden on
patients and taxpayers, it alsointroduces tremendous
uncertainty in to pricingforecasts for the pharma
companies.
Uncertainty that pharmacompanies, they don't take it

(02:08):
lightly, especially whenplanning billion dollar capital
investments and forecasting theefficacies and the financials on
medications for, you know, 10,20, 30 years in the future.
So when you look at, you know,for the life of the patent.
So according to the KaiserFoundation, U.S.
prescription drug spending, ofcourse, reached about$378
billion a few years back withMedicare Part D really costs

(02:31):
represent probably a largeportion of that, right?
So a RAND Corporation study alsofound in a few years back that
the US prescription drug priceson average are two and a half
times higher than those in 32comparable nations.
So there is this naturalfinancial pressure to reduce
costs.
That's understandable.
But the challenge is, will thispressure spur innovation and
investment in the US?

(02:53):
or send manufacturers searchingfor escape routes outside the
U.S.?
Well, we've seen some answersalready.
Surprisingly, some of the earlysigns point toward deeper U.S.
investment.
We're seeing companies likeAstraZeneca have already
announced they're doinggame-changing domestic
expansions.
They are committing to$50billion in U.S.

(03:13):
operations and new spending,encompassing R&D, manufacturing,
and supply chain expansion.
So this is one of the largerpharma infrastructure
investments in recent history.
The CEO said, quote, the policyenvironment may be changing, but
bringing production closer towhere care happens also allows
us to ensure supply continuity,lower logistic risk, and serve

(03:37):
American patients more directly.
So they're not alone,AstraZeneca, Pfizer, and Moderna
have also announced intentionsto expand their biomanufacturing
footprint in the U.S.
in recent quarters, and about 10other biopharma firms have
pledged over$120 billion in newor expanded U.S.
operations since Q2 of lastyear, and that's according to

(03:59):
BiopharmaDive.
So why would companies commit tobilling here while also facing
pricing headwinds?
Well, made in the UXA equalssome access and agility for
them, right?
So it's just one variable to bethe lowest price and have that
most favored nation pricing.
It's just one variable in a morestrategic equation that can

(04:20):
involve tax policy, tradetariffs, supply chain
resilience, and patient-centricbusiness models.
Think about it.
If you've got tariff pressureswith an increase in tariff on
imported pharma components, itdoes make sense to produce
domestically, could be a taxsavings and, you know, a little
bit more predictable coststructures, right?

(04:40):
If there's no tariffconversations going on that you
have very little influence on.
Also some supply chainredundancy, right?
One thing we did see withCOVID-19 was it highlighted how
fragile some of those offshoresourcing can be.
We sort of remember that withall the car battery challenges
and the car electronics.
So domestic production ensuresfaster delivery, especially

(05:03):
during any specific healthcrises, right?
And let's be clear, you know,political favor.
Companies that invest in theU.S.
jobs and infrastructure maygain, you know, goodwill and
regulatory goodwill orincentives during policy shifts,
right?
You could see, theoretically, wesee this with tariffs, that each
country is doing individualtariff deals.

(05:23):
Why not extrapolate that to eachpharma company is doing
individual pricing deals basedon their portfolio and what
they're committing to do in theU.S.?

UNKNOWN (00:00):
?

SPEAKER_00 (05:33):
And what you also see is patient-centric metrics
are really going to come to thefore, right?
So if there's faster access tothe medication, a simplified
distribution, and better patientsupport, where it's easier, you
can have supply and demandreally co-located, but you're
also going to see a lot more, Ithink, emphasis in how are the
outcomes, right, in remotemonitoring.

(05:54):
And to show proof of impact cancertainly have impact on pricing
paid for Medicare models, right?
All this ladders up to whatpharma companies really consider
agility and increasinglyvaluable currency when they look
at today's landscape ofvalue-based care price scrutiny,
right?
So they're looking for safehavens where they know they can

(06:16):
control costs the best and theycan be forecasted going forward
without as much, you know, maybeinterference or other variables
where they can't control, right?
So what's this mean for patientaccess and affordability?
Well, you know, for patientaccess teams, this is great
because the move towardsdomestic production could create
new challenges but also newopportunities right short-term

(06:36):
price controls could limitrebate structures that fund
company assistance or hubservices but longer-term
domestic manufacturing could infact lower some of the overhead
streamline some logistics andallow pharma to really
reallocate resources to patientsupport programs so there's some
considerations there right sothat you might see some
evolution in the hub model wherefaster delivery from domestic

(06:58):
production could eliminate somesteps in the reimbursement or
activation work workflows.
Pricing alignment.
Most favored nation could prompta national realignment of
pricing that better supportstransparent models tied to
outcomes.
And collaboration with payers.
You may see a greater emphasisthat access programs that

(07:19):
deliver treatment efficacyfaster could secure broader
coverage, particularly intighter priced environments.
So that's where companies likeMedisave Full Disclosure could
also play a critical role herewith patients getting quicker
access to therapies because ofthe local production.
The focus could shift tosupporting adherence, behavior

(07:39):
change, real-time feedback loopsthat widen the impact of
price-controlled drugs andprotect market share, frankly.
So what's some of the marketingstrategies you're likely to see
come out of the most favorednation era?
Well, brand markers are going tobe strategically challenged,
right?
How do you position a brand whendrug uniformity is becoming the

(07:59):
norm, right?
If all, Diabetes and insulinmedications, right, have to be
priced the same.
How do you really strategicallychallenge to position one brand
over the other, right?
So you may see MFN flatteningthe market on price, which then
shifts brand advantage toexperience, trust, patient
support services.
So if they can show two things.

(08:20):
One is, well, with thismedication, even though it's
maybe the same price, we'reseeing better outcome, impact,
and our patients feel supportedmore.
That's where you're going to seesome of those differentiators
come to the market if price isgoing to be really controlled,
basically.
So you may see that supportpivot to support tools a little

(08:40):
bit more, right?
You're going to see, you know,digital companions, adherence
platforms, proactive CRMcampaigns to really not only
capture the mind share of HCPs,but also consumer loyalty.
You might see greaterpartnership between the
commercial and patient supportteams because they're both going

(09:00):
to be tied to patient outcomesrather just promotional return
on investment.
So if you look at this valuevalue-focused landscape.
And again, if pricing is prettymuch consistent across the
board, you're going to look forwhat's the best value for those
prices, which medications aregiving you the best outcome,
which have the best patientratings, right?
And the patients feel the mostsupported with other value adds

(09:22):
that are put into the equation.
So it's just not about themolecule anymore.
It's about the journey thatexactly the story that, you
know, postscript platforms andinnovative tools, like Medisafe
and others, help bring to lifeby integrating those medication
routines into daily behavior insmarter, personalized ways.
So when you look ahead, ifthere's constraint, how do you

(09:47):
innovate?
So what's unfolding is not justa political maneuver or price
policy.
it could be a realignment of thecommercial pricing model for
pharma, right?
So companies used to chase, theymight be chasing blockbuster
revenues, but they may face afuture where, you know what,
efficacy, efficiency, trust, andaccess kind of define the

(10:07):
winners, right?
So if this becomes a cementedpricing policy, You've got to
expect more of manufacturers whowant to justify innovation spend
with production dividends,right?
So improving margins withdomestic agility, faster time to
therapy, better patient support,and enhanced outcome metrics.

(10:28):
So this really does offer brandsa little bit of a tipping point.
They can enhance collaborationbetween internal teams, breaking
down any of those silos betweenmarket access, supply chain,
digital brand strategy,committing to deep integration
of digital tools, right, intothe therapeutic journey so they
can measure those ratings andtake action on what's happening
with, you know, market accessand support and adoption by

(10:52):
patients and general overalloutcomes.
And, you know, really align withhealth systems and government
partners to really create thatvalue frameworks that respond to
the real world and not justcontainment directors that have
about price, right?
So the challenge is going to be,how do we show more value for
the same price?

(11:13):
And outcomes are going well.
Hey, final takeaway, the modelis more than just a price reset
when it comes to the four.
It's kind of a philosophicalone.
America's pharma companies,they're adjusting to price
tables, but they can berethinking presence,
partnerships, proximity to thepatient, right?
So if we look at AstraZeneca's$50 billion investment that

(11:35):
they're working on, it's goingto be a production facility in
Virginia, I believe.
And, you know, other farmerleaders are going to follow.
So we may be quietly witnessingthe renaissance in U.S.-based
manufacturing.
Now, that takes time, and it'snot just about jobs, but it's
about patient agility, supplysecurity, and drug delivery.
You know, one of the things thatcame across in the executive

(11:56):
order from the US administrationwas, yeah, not only would there
need to be MFN status onpricing, but another bullet
point there that was kind ofunderreported was the
administration's commitment tothe pharma companies that if you
are setting up a new productionfacility in the United States,
that the administration iscommitting that their agencies,
particularly FDA and EPA, willstreamline approvals to get

(12:19):
those production facilitiesonline so that could be
something really has beenreported that much but you know
the whole five to ten years tobuild a plant may actually get
down to the two to three yearsand that's what they were
talking about trying to do itStay tuned.
The first deadline for pricingtechnically was September 29,
2025.
As we approach that, obviouslywe'll be tracking these stories

(12:42):
on a daily basis.
So thank you so much for joiningus on Postscripts.
If you found this conversationvaluable, please follow and
subscribe for more insights atthe intersection of pharma
technology and patient impact.
Until next time, my name isBrian.
Keep looking forward.
The real work begins after thescript is written.