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#32 - The Future of Drug Affordability and Access | Peter Kolchinsky

·57 min·4 clips

Janice Bork speaks with Peter Kolchinski about drug affordability and access. He frames the issue around what society and health insurers choose to reward. The conversation starts with innovation and then shifts to the harder question of who can actually afford the medicines that science produces. Kolchinski argues that the market already works to create incentives for many therapies. He says the remaining gap is concentrated in the patients who still cannot pay for treatment. The discussion contrasts that reality with policy proposals built around price controls. He treats those controls as a blunt response. A better fix, he argues, is to make insurance coverage more honest. If a drug is covered, he says, it should not come with hidden friction through out-of-pocket costs. Insulin becomes one of the clearest examples. Cancer drugs and eye injections are discussed in the same frame. Those cases are used to question the assumption that every medication needs patient cost sharing. Kolchinski pushes back on the idea that zero out-of-pocket cost automatically creates abuse. He argues that the real problem is access, not fake demand. The episode also connects these ideas to the business model for biotech. That means thinking about return on investment as well as FDA approval and societal impact. He brings in his No Patient Left Behind initiative as part of that broader picture. Near the end, the conversation turns toward how the industry tells its own story to the public. The result is a practical argument for preserving innovation while redesigning coverage so patients can actually use what gets approved.

As heard by us

A sharp argument for balancing access and innovation.

Peter Kolchinsky makes a clear case that drug affordability is not a price-only problem. Coverage, incentives, and the value placed on biotech innovation all sit in the same frame here, and the episode keeps returning to that tension without losing the thread.

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Why you'd press play

If you want the case against blunt drug-price controls, start here.

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