Gottlieb speaks at length about reimbursement issues and dysfunctional payment policies and how they are maladapted to innovation. Discussion that investors are forced to use arcane reimbursement rules to guide investments and what products can be brought to market - not medical science and best clinical advances and outcomes.
Find it here:
He builds to this conclusion:
Our biggest obstacles may be policy. Our biggest challenges may be our inability to devise coverage schemes that can enable the efficient, and when appropriate the rapid adoption of these innovations; allow for a return on capital that maintains investment in these high-risk endeavors; and most important, enables equal access to a cure regardless of a person’s wealth.
We must address these challenges directly. We must be willing to start over with new payment schemes when it comes to these paradigm leaps like cell and gene therapy.
There’s no need to try and fit a cure into the existing payment schemes, when we already know those structures have struggled to keep pace with this innovation.
If of interest, I've included a lightly annotated/highlighted version below the break.
See also an OpEd article by Gottlieb on CNBC, May 20, here.
In a March 2019 speech to the Federation of American Hospitals, the notable senior White House health policy expert Joe Grogan similarly decried a health financing system too dependent on gaming and coding. Summary here.