The Truth About Drug Prices & Patient Access with Ellis Wheby скачать в хорошем качестве

The Truth About Drug Prices & Patient Access with Ellis Wheby

AI in pharma market access & reimbursement. Ellis Wheby pulls back the curtain on how field reimbursement managers (FRMs), co-pay programs, and patient assistance actually work—and where patients still fall through the cracks. We dig into the $2,000 Medicare Part D cap and payment “smoothing,” why prior authorization denials delay care, and how education fixes avoidable bottlenecks. Pharma market access & reimbursement isn’t just policy—it’s patient outcomes. Ellis shares a career arc from sales to national FRM leadership, what great access teams do day-to-day, and how AI in e-prescribing and payer workflows will reshape approvals. If you care about affordability, access, and doing compliance right, this one’s for you. Pharma market access & reimbursement also means training the ecosystem. We talk practical tactics providers can use now, how manufacturers structure affordability support, and why standardized education (for FRMs and clinic staff) measurably reduces denials and delays. 00:00 Intro: market access, reimbursement & why it matters 00:44 Meet Ellis: career from sales to FRM leader 01:58 What an FRM actually does 03:38 Co-pays vs. patient assistance, explained 04:59 Why co-pay programs exist (commercial only) 06:15 Older patients, Medicare, and foundations 08:48 Education gap: patients, providers, pharmacies 09:31 2025 Medicare changes: $2,000 cap & smoothing 11:01 Why pharma gets a bad rap 12:00 List price vs. what payers actually pay 13:39 Compliance today: audits, reporting, guardrails 18:02 Personal story: stroke care & better access 24:22 How the sales model changed over time 26:12 Why FRM teams exploded in specialty 29:09 Training gaps in clinics & real impact 32:56 Prior auths: #1 driver of care delays 33:57 ACMA training data: cutting delays by ~50% 34:57 AI’s role in e-prescribing & real-time decisions 36:32 Using AI to prevent—not cause—denials 37:42 Wrap-up & how to get involved Resources Mentioned: • CMS Medicare Prescription Payment Plan (payment “smoothing”): https://www.cms.gov/medicare/lower-co... • Medicare Part D $2,000 annual cap (2025 redesign): https://www.kff.org/medicare/issue-br... • AMA Prior Authorization Physician Survey (care delays): https://www.ama-assn.org/system/files... • CoverMyMeds (PA workflow platform): https://www.covermymeds.com/ • ACMA (BCMAS, PACS): https://acmalifesciences.org/ • https://medicalaffairsspecialist.org/ Connect With Me:   / drwilliamsoliman     / will_soliman     / williamsoliman1     / willsoliman   #MarketAccess #PharmaReimbursement #PatientAffordability