Perspectives by the Leerink Center for Pharmacoeconomics

How Do WAC, AMP, ASP, 340B, and MFP Fit Together? A Branded Drug Pricing 101 with Inma Hernandez

Mon, 31 Aug 2026 16:39:54 -0400

Inma Hernandez, PharmD, PhD, Senior Advisor for Drug Prices at the Centers for Medicare and Medicaid Services, joins Perspectives to give an overview of drug pricing regulatory dynamics for branded drugs in the US. The episode is a step-by-step walkthrough of the different prices a branded drug can have in the U.S. and how those prices are established across commercial insurance, Medicaid, Medicare Part B, and Medicare Part D. Inma explains the alphabet soup of WAC, AMP, best price, ASP, and MFP; how rebates and statutory discounts translate list prices into the net prices realized by innovators; and how pricing decisions in one market can spill over into others. The episode then layers in 340B and the drug pricing provisions within the Inflation Reduction Act. Consider this a U.S. Branded Drug Pricing 101 taught by a nationally recognized expert in pharmaceutical pricing and policy with a graphical representation linked below that is worth printing for your desk.

Topics discussed include:

How net prices for branded drugs are established across commercial insurance, Medicaid, Medicare Part B, and Medicare Part D
The differences between WAC, AMP, best price, ASP, and MFP
How commercial rebates can spill over into Medicaid and 340B through best price
How 340B impacts the economics of a drug across different insurance markets
How inflation rebates and Medicare drug price negotiation add another layer to this framework

Graphical Representation Created by Dr. Hernandez: Microsoft PowerPoint - Keynote_OPENING_Inma_ISPOR 2026

Can Health Economics Lead to Better Biotech? A Conversation with Rob Abbott

Mon, 03 Aug 2026 11:14:08 -0400

Rob Abbott, CEO of ISPOR, joins Perspectives to talk about why health economics and outcomes research (HEOR) has become more relevant for biotech founders, executives, and investors. The conversation challenges the common perception that HEOR is primarily a post-approval exercise used to support pricing and reimbursement. Instead, Rob discusses how evidence generation, economic modeling, and value strategy can shape clinical development, inform investment decisions, and strengthen the commercial potential of new therapies. The episode concludes with a discussion of ISPOR's Healthcare Investment Summit that will be held in September 2026 and will convene investors, drug developers, and value strategists to translate HEOR into early-stage investment decisions and drug development.

Topics discussed include:

Two HEOR activities biotech companies should do before Phase III
Four questions investors can ask management teams to gauge commercial opportunity
Novel applications of HEOR and their usefulness for biotech executives and investors
ISPOR's Healthcare Investment Summit and what biotech leaders and investors might get out of attending

Show links: https://www.ispor.org/conferences-education/conferences/upcoming-conferences/ispor-healthcare-investment-summit-2026

What Happens When Drug Pricing Meets Trade Policy? A Conversation with Ron Lanton

Wed, 08 Jul 2026 09:48:17 -0400

Ron Lanton, the Founder and President of Lanton Strategies International, joins Perspectives by the Leerink Center for Pharmacoeconomics to discuss the use of trade mechanisms to address pharmaceutical pricing. Ron provides insight into the growing intersection of pharmaceutical pricing and international trade policy, why recent developments could be significant, and what it could mean for biopharmaceutical companies, investors, and patients.

Topics discussed include:

U.S. Trade Representative’s recent Section 301 investigation into Germany’s drug pricing and reimbursement practices
U.S.-U.K. drug pricing arrangement
Use of trade mechanisms to address pharmaceutical pricing
Implications for biotech investors and executives

Can Clinical Trial Failure Be Insured? A Conversation with Tomas Philipson

Tue, 19 May 2026 12:57:53 -0400

Dr. Tomas Philipson, former Acting Chairman of the White House Council of Economic Advisers and Professor Emeritus at the University of Chicago, joins Perspectives by the Leerink Center for Pharmacoeconomics to discuss a new insurance model he developed that insures biotech investments against clinical trial failure. He explains how this insurance could reshape the way risk is managed in life sciences innovation and could expand access to capital for biotech. The second half of the episode turns to drug pricing policy where Philipson shares his perspectives on current and proposed reforms.

Topics discussed include:

A new insurance model for clinical trial failure
The role of AI in underwriting these insurance policies
Perspectives on the Inflation Reduction Act, Medicare drug price negotiations, and Most Favored Nation pricing
A NATO-style approach to global drug spending

Episode Links:

https://www.mciuw.com/service/clinical-trial-funding-insurance/

Are We Pricing Drugs Right? A Conversation with Peter Neumann on How Innovation is Valued Globally

Mon, 11 May 2026 15:45:58 -0400

In this episode of Perspectives by the Leerink Center for Pharmacoeconomics, host Mel Whittington sits down with renowned health economist Dr. Peter Neumann following the annual meeting of the Center for the Evaluation of Value and Risk in Health (CEVR) at Tufts Medical Center. Drawing from conversations that took place at the meeting, Mel and Peter explore some of the questions that are shaping how innovation is valued globally.

The discussion covers:

Whether cost-effectiveness analysis captures all the factors that are considered when pricing a drug
How payers use outcomes assessments to shape, and sometimes restrict, coverage decisions
What Medicare drug price negotiations and MFN proposals reveal about “value-based pricing”
The distinction between price and value and whether current frameworks adequately reward innovation
The growing debate around centralized health technology assessment in the U.S.
Why the field may be moving toward narrower definitions of value over time

This episode offers a window into the economic debates influencing how medicines are evaluated, reimbursed, and ultimately brought to patients.

CEVR webpage : https://cevr.tuftsmedicalcenter.org/

US vs. MFN CEA thresholds paper: https://academic.oup.com/healthaffairsscholar/article/4/4/qxag081/8586328

Cost-effective price vs. Medicare negotiated price paper: https://pubmed.ncbi.nlm.nih.gov/40939703/

What’s Behind Drug Pricing: The Hidden Role and Limits of Cost-Effectiveness Analysis

Tue, 31 Mar 2026 13:30:00 -0400

In this episode of Perspectives by the Leerink Center for Pharmacoeconomics, Melanie Whittington breaks down a fundamental—and increasingly consequential—question in health economics: what counts as value in cost-effectiveness analysis? For biotech leaders and investors, Mel cautions that this isn’t just an academic debate. The frameworks adopted by HTA bodies influence pricing, access, and ultimately, how innovation is rewarded.

Making Value Propositions Clearer with Peter Kolchinsky, PhD, Founder and Managing Partner, RA Capital Management

Mon, 02 Mar 2026 13:00:00 -0500

Melanie Whittington, PhD, Head of the Leerink Center for Pharmacoeconomics, talks with Peter Kolchinsky, PhD, Founder and Managing Partner of RA Capital Management, to discuss if the U.S. market-based approach to pricing novel prescription medicines could result in paying more than they are worth and if companies and company builders should use health economic modeling to support their value propositions.

Specialty Drug Coverage Predictions with James Chambers, PhD, MPharm, Professor of Medicine, CEVR, Tufts Medical Center

Mon, 02 Feb 2026 13:30:00 -0500

Melanie Whittington, PhD, Head of the Leerink Center for Pharmacoeconomics, interviews James Chambers, PhD, MPharm, Professor of Medicine in the Center for the Evaluation of Value and Risk in Health at Tufts Medical Center, to dig into specialty drug coverage and what it might look like in 2026.

The National Pharmaceutical Council President and CEO & Former Trump Drug Pricing Advisor, John O’Brien, PharmD, MPH

Thu, 08 Jan 2026 17:10:00 -0500

Melanie Whittington, PhD, Head of the Leerink Center for Pharmacoeconomics, talks with John M. O'Brien, PharmD, MPH, President and CEO of the National Pharmaceutical Council & Former Trump Drug Pricing Advisor, to tackle some big questions like if it is possible to reward innovation without busting budgets and how to get to a sustainable, innovation-friendly, patient-centered drug pricing system. Additional resources: Subscribe to NPC’s Newsletter https://www.npcnow.org/subscribe-updates IRA Impact on Pharmaceutical Investment: Insights From Investor Interviews (Health Affairs Scholar) https://academic.oup.com/healthaffairsscholar/article/3/9/qxaf156/8223954 How Time Is Accounted For When Modeling Pharmaceutical Impacts: Investment vs Assessment Perspectives (Health Affairs Scholar) https://academic.oup.com/healthaffairsscholar/article/3/9/qxaf169/8244606 The IRA and Drug Development: Potential Early Signals of Impact on Post-Approval Clinical Trials (Therapeutic Innovation & Regulatory Science) https://link.springer.com/article/10.1007/s43441-025-00774-2 Subsequent Indications in Oncology Drugs: Pathways, Timelines, and the Inflation Reduction Act (Therapeutic Innovation & Regulatory Science) https://link.springer.com/article/10.1007/s43441-024-00706-6 Unintended Consequences of the Inflation Reduction Act: Clinical Development Toward Subsequent Indications (American Journal of Managed Care) https://www.ajmc.com/view/unintended-consequences-of-the-inflation-reduction-act-clinical-development-toward-subsequent-indications The Impact of the Inflation Reduction Act’s Drug Price Negotiation Program on Incentives for Clinical Development of New Drugs (Value in Health) https://www.valueinhealthjournal.com/article/S1098-3015(25)02527-6/fulltext?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1098301525025276%3Fshowall%3Dtrue Follow John O’Brien on LinkedIn https://www.linkedin.com/in/drjmob/

David Hong, MD, Steve Potts, PhD, MBA, and Vivek Subbiah, MD talk Pan-Tumor Approvals in a Post-IRA World

Tue, 02 Dec 2025 14:00:00 -0500

Melanie Whittington, Head of the Leerink Center for Pharmacoeconomics, talks with Vivek Subbiah, MD, David Hong, MD, and Steve Potts, PhD, MBA to discuss if pan-tumor approval strategies offer a path forward for broader, faster adoption across larger patient populations. Given the slow adoption curves typical of new therapeutics and the potential for government price negotiation as early as nine years after market entry, the experts hash out if pan-tumor approval is a potential development and commercialization pathway to ramp up clinical adoption and sales early on. They discuss the challenges, data requirements, and opportunities of this relatively new development path. Dr. Hong is the Deputy Chair of the Department of Investigational Cancer Therapeutics at MD Anderson Cancer Center. Dr. Steve Potts is the CEO and Co-Founder of a Stealth Cancer Biotech. Dr. Subbiah is the Chief of Early Phase Drug Development at the Sarah Cannon Research Institute. All bring firsthand experience – wins and battle scars - with pan-tumor approvals.

Head of the Leerink Center for Pharmacoeconomics, Melanie Whittington, PhD

Mon, 03 Nov 2025 14:00:00 -0500

Diane Vieira, Head of Marketing & Communications at Leerink Partners, interviews Melanie Whittington, PhD, Head of the Leerink Center of Pharmacoeconomics (CPE), to discuss the one-year anniversary of CPE and everything they thought they knew but actually didn’t.

Steve Potts, PhD, MBA, CEO and Co-Founder, Stealth Cancer Biotech

Mon, 06 Oct 2025 14:00:00 -0400

Melanie Whittington, Head of the Leerink Center for Pharmacoeconomics, interviews Steve Potts, PhD, MBA, CEO and Co-Founder, Stealth Cancer Biotech, to discuss the impact of the Inflation Reduction Act on cancer drug development and a middle ground between a market-based approach and a government-based approach to drug pricing.

The IP Policy Institute’s Joshua Kresh and Emily Michiko Morris

Mon, 08 Sep 2025 14:00:00 -0400

Melanie Whittington, Head of the Leerink Center for Pharmacoeconomics, interviews Joshua Kresh and Emily Michiko Morris from The IP Policy Institute at the University of Akron School of Law to discuss the critical importance of protecting intellectual property for the biopharmaceutical innovation ecosystem and their recent research around evergreening and patent thickets.

Director of Access and Policy Research at Johnson & Johnson, Ulrich Neumann, MBA, MSc, MA

Wed, 13 Aug 2025 14:30:00 -0400

Melanie Whittington, PhD, Head of the Leerink Center for Pharmacoeconomics, interviews Ulrich Neumann, MBA, MSc, MA, Director of Access and Policy Research at Johnson & Johnson, to discuss the motivation behind the recent launch of the J&J Center for U.S. Healthcare Policy Research, the interconnectedness and importance of the various players within the biopharmaceutical R&D ecosystem, and the private capital that is required to develop new drugs. Resources mentioned in this episode: https://policyresearch.jnj.com https://jnjinnovation.com/home https://www.nature.com/articles/d41573-024-00131-2 https://www.ispor.org/docs/default-source/intl2024/j-j-access-policy-research---ispor-2024---pharma-r-d-ecosystem-investment137860-pdf.pdf?sfvrsn=d28181d4_0 https://www.tandfonline.com/doi/full/10.1080/13696998.2024.2405407

Head of Patient Engagement and Patient-Centered Innovation, Raven, RA Capital’s healthcare incubator, Gunnar Esiason, MBA, MPH

Mon, 14 Jul 2025 13:30:00 -0400

Melanie Whittington, Head of the Leerink Center for Pharmacoeconomics, talks with Gunnar Esiason, Head of Patient Engagement and Patient-Centered Innovation at Raven, RA Capital's healthcare incubator, where they discuss the far-reaching impact of biopharmaceutical innovation, as well as the time, effort, and capital that goes into developing new treatments.

Vice Chair of Research and Associate Professor, University of Utah, Joey Mattingly, PharmD, MBA, PhD

Tue, 17 Jun 2025 14:00:00 -0400

Melanie Whittington, PhD, Head of the Leerink Center for Pharmacoeconomics, interviews Joey Mattingly, PharmD, MBA, PhD, Vice Chair of Research and Associate Professor at the University of Utah, to learn about the history of the pharmaceutical supply chain and the origins of some of its components.

Chief Science Officer, National Pharmaceutical Council, Jon Campbell, PhD

Wed, 21 May 2025 14:00:00 -0400

Melanie Whittington, Head of the Leerink Center for Pharmacoeconomics, interviews Jon Campbell, Chief Science Officer of the National Pharmaceutical Council, to discuss what makes biopharmaceutical innovation special and why judging and interpreting their prices is nuanced and requires context.

Head of U.S. Public Affairs and Patient Advocacy, Oncology with Sanofi, Elizabeth Franklin, PhD, MSW

Wed, 23 Apr 2025 14:00:00 -0400

Melanie Whittington, Head of the Leerink Center for Pharmacoeconomics interviews Elizabeth Franklin, PhD, MSW, Head of U.S. Public Affairs and Patient Advocacy, Oncology with Sanofi where they discuss what it means to be a patient advocate, how innovators and investors can partner with patients, and patients' contributions to drug development and market access.

Senior Policy Advisor at DLA Piper & Non-Resident Fellow at the American Enterprise Institute, Kirsten Axelsen

Wed, 26 Mar 2025 14:00:00 -0400

Melanie Whittington, Head of the Leerink Center for Pharmacoeconomics interviews Kirsten Axelsen, Senior Policy Advisor at DLA Piper & Non-Resident Fellow at the American Enterprise Institute where they discuss drug prices, their opportunity costs, and the effect today’s prices have on future drug developments.

Managing Director of Pharmagellan and Professor of the Practice at Tufts University, Frank S. David, MD, PhD

Wed, 26 Feb 2025 14:00:00 -0500

Melanie Whittington, Head of the Leerink Center for Pharmacoeconomics interviews Frank S. David, MD, PhD, Managing Director of Pharmagellan and Professor of the Practice at Tufts University. The healthcare investing and development world and the pharmacoeconomics world have historically operated separately despite drug pricing being core to both worlds. In this episode, Mel and Frank contrast how models are used and built in their respective worlds of pharmacoeconomics and healthcare investing and development.

Author of the Cost Curve & the Principal and Founder of Reid Strategic, Brian Reid

Wed, 29 Jan 2025 14:00:00 -0500

Melanie Whittington, PhD, Head of the Leerink Center for Pharmacoeconomics interviews Brian Reid, Author of the Cost Curve & the Principal and Founder of Reid Strategic. In this episode they discuss Brian's background in the health journalism space, Generalized Cost Effectiveness Analysis (GCEA), and how the industry can better communicate the impact of healthcare innovation.

Welcome to Perspectives by the Leerink Center for Pharmacoeconomics

Mon, 06 Jan 2025 05:00:00 -0500

In our signature podcast series, Dr. Mel Whittington, a health economist and Head of the Leerink Center for Pharmacoeconomics, talks with people from across the industry to hear their stories and to better understand the societal impact of healthcare innovations. If you’re interested in participating in future podcasts or would like to learn more about the Leerink Center for Pharmacoeconomics, please email cpe@medacorp.com.