Questions:

01:08: How have your personal experiences shaped your understanding of evidence, access, and impact in health policy?

03:24: What core principles have remained constant throughout your work across advocacy, government, and consulting in health policy?

05:20: Can you share an example of a well-designed policy that failed at the implementation stage, and what you learned from it?

06:26: What lessons from implementing the ACA have shaped your approach to structuring practical, workable health policy frameworks today?

08:45: If you were designing a US HTA framework today, what would you build differently to make it work in practice?

11:28: What are your reflections on ICER’s current assessment process, and how could it be improved to make its findings more useful and actionable across the healthcare system?

14:25: Why does the US continue to struggle to fully integrate evidence generation into its pricing and access frameworks?

16:35: If you could design an incentive structure to encourage pharmaceutical companies to share their data, what would it look like and how would you make it work in practice?

20:03: What do you see as the most effective way to align FDA and CMS around patient-centered access?

25:11: If you could design a structured communication process between CMS and industry, what would it look like?

27:28: Can you share an example of how stakeholder feedback directly improved CMS implementation efforts?

35:06: What emerging policy and regulatory trends will most influence pharma market access and RWE over the next decade, and which are still being underestimated?

39:57: Amid rising costs and solvency challenges, what gives you confidence that the US can bend the healthcare cost curve without stifling innovation?

Kristi Martin

Director, Camber Collective

Kristi Martin brings over 20 years of experience shaping health policy through practical, impactful solutions. Currently a Director at Camber Collective, she pairs analytic rigor with a human-centered approach to advance strategies that improve health and well-being. She guides mission-driven organizations through complex health policy landscapes through her own firm, Highway 136 Consulting, which was founded in 2020.

Kristi’s career spans government, philanthropy, and consulting – always focused on making healthcare better and fairer. Most recently, she served as Chief of Staff for Medicare at the Centers for Medicare & Medicaid Services (CMS), where she led strategy and execution for major initiatives under the Inflation Reduction Act, including Medicare drug price negotiations.

Previously, Kristi was Vice President for Health Care at Arnold Ventures, managing their portfolio to lower prescription drug costs. As Managing Director at Waxman Strategies, she provided strategic counsel to foundations and advocacy organizations on issues ranging from prescription drug pricing to women’s health. Earlier, she played a key role in implementing provisions of the Affordable Care Act, advising senior officials, and coordinating policy across federal agencies at the Department of Health and Human Services, CMS, and the Office of Personnel Management. Her federal service across these agencies as well as Government Accountability Office and National Institutes of Health gave her a strong foundation in policy development and implementation. Her roots in DC are in patient advocacy as she started her career with Easter Seals and the American Cancer Society.

Known for turning bold ideas into action, Kristi has advised the White House, represented US interests internationally, and built consensus among diverse stakeholders. She holds a Master of Public Administration from George Washington University and earned both a master’s and bachelor’s degree from the University of Kentucky.

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In this ‘Patti’s People’ episode, Patti Peeples of the The Peeples Collaborative speaks with Jason Shafrin, Senior Managing Director, Center for Health Economics and Policy, FTI Consulting.

Questions:

00:00: Introduction

01:15: You’ve worked across government, pharma, consulting, NGOs, and academia. What ties it all together, and what are you trying to solve now?

03:35: Was there a moment that drew you to health economics, or was it a gradual pull?

05:47: You’ve written on value frameworks and outcomes for reimbursement. If you could redesign HTA from scratch, what would you toss and what would you keep?

09:53: You’ve said incentives drive behavior, and competing incentives are a constant challenge. What’s the most misaligned incentive in healthcare today – and who does it hurt most?

15:19: With growing scrutiny of RWE and digital health, is oversight enabling or stifling innovation?

17:54: What’s one policy or regulation you believe is well-intentioned, but has led to poor health or economic outcomes?

22:31: On July 31, President Trump asked 17 pharma companies to match US drug prices to other developed nations. As a health economist, do you think this will work?

27:14: Rapid Fire Questions

Jason Shafrin

Senior Managing Director, Center for Health Economics and Policy, FTI Consulting

Jason Shafrin, PhD, is a Senior Managing Director at FTI Consulting's Center for Healthcare Economics and Policy. Dr Shafrin has over 20 years of health economics research experience serving as trusted advisor and expert to a wide variety of healthcare and life sciences companies, governments and non-governmental organizations (NGOs). Dr Shafrin is an Adjunct Professor at the University of Southern California, the former Director of Research at the Innovation and Value Initiative and the Founder and Editor of the Healthcare Economist blog. Dr Shafrin is an expert in applied economics with a specialty in health economics research. Over his career, he has developed novel methodological approaches, advanced quantitative analyses and innovative modeling to address some of the most difficult health economics problems and provide evidence-based solutions for clients across the healthcare industry. His work has assisted clients in addressing policy changes, navigating regulatory processes, evaluating pricing, value and outcomes and supporting innovation and transformative change. Dr Shafrin’s extensive experience includes projects on value assessment, alternative payment model design, discrete choice experiment survey, real-world data analysis, and digital medicine.

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In this ‘Patti’s People’ episode, Patti Peeples of the The Peeples Collaborative speaks with Kirsten Axelsen, Senior Policy Advisor, DLA Piper.

Questions:

00:00: Introduction

01:02: You entered biopharma through econometrics and discrimination litigation – what connects that work to what you’re solving now?

04:50: You built analytical tools to prioritize policy battles. What’s one battle you lost that still keeps you up at night?

09:03: You’ve said predicting this administration’s moves is impossible. What tools help you turn that chaos into strategy?

14:13: You’ve warned that China is overtaking US clinical development. How real is this shift, what’s driving it, and what are we still in denial about?

18:39: You’ve advocated for more carrots than sticks in policy. What’s the most promising incentive we’re overlooking to drive real health outcomes?

20:32: What, if anything, should health economists and outcomes researchers be saying about issues like biosimilars potentially disappearing and China’s rise?

23:04: If rebates disappeared tomorrow, what reform would you pursue to make formularies more clinically honest and economically sustainable?

25:48: You publish in both journals and op-eds—how do you balance academic neutrality with policy persuasion?

28:38: At recent ISPORs, there’s been debate that HEOR, RWE and market access departments struggle to clearly demonstrate their impact within pharma and policy. What’s your take?

30:22: Can you share an example where health economics truly shaped a policy decision?

32:12: Rapid Fire Questions

Kirsten Axelsen

Senior Policy Advisor, DLA Piper

Kirsten works with leaders in life sciences to navigate policy, competition, reimbursement and public perception for successful product launch, growth and profitability. She has developed and executed strategies at all stages of the biopharmaceutical lifecycle in all major markets. Kirsten brings more than 25 years of experience working in life sciences. She is a biopharmaceutical consultant and an Aspen Institute Health Fellow.

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In this ‘Patti’s People’ episode, Patti Peeples of the The Peeples Collaborative speaks with Melanie Whittington, Managing Director and Head of the Leerink Center for Pharmacoeconomics, MEDACorp.

Questions:

00:00: Introduction

01:03: You work at the intersection of health economics, policy, and investment. How do these domains influence one another in your work, and what gaps are you aiming to bridge?

04:34: Who are you informing differently than has been typical?

07:21: You’ve worked across leading institutions in healthcare. What connects these roles, and what core question or challenge has guided your career??

09:36: How does traditional cost-effectiveness modeling differ from risk-adjusted NPV models, and do you see a hybrid approach emerging? Who might lead that shift?

16:11: If you could redesign the value framework, what elements do you think are missing – and why?

19:27: As a CBO health adviser, what perspective do you bring, and what impact do you hope to make?

22:12: With policies like the IRA taking shape, are we striking the right balance between cost control and long-term innovation, or are new incentives needed?

24:55: In your view, what makes healthcare evidence resonate, and why is some data overlooked?

27:35: As health equity gains attention in economic evaluation, how is HEOR adapting – and where is it still falling short?

31:02: What advice would you offer to women starting out in health economics today?

33:45: Rapid fire questions

Melanie Whittington

Managing Director and Head of the Leerink Center for Pharmacoeconomics, MEDACorp

Melanie (Mel) Whittington is a Managing Director and Head of the Leerink Center for Pharmacoeconomics, which is a division of MEDACorp and an affiliate of Leerink Partners. In this role, she leads pharmacoeconomic evaluations of the societal impact of biopharmaceutical innovations. She is also a Senior Fellow within the Center for the Evaluation of Value and Risk in Health at Tufts Medical Center where she is interested in testing novel health economic methods.

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In this ‘Patti’s People’ episode, Patti Peeples of the The Peeples Collaborative speaks with Eberechukwu Onukwugha, Professor and Executive Director of Pharmaceutical Research Computing, University of Maryland, Baltimore.

Questions:

00:00: Introduction

01:26: What’s something outside your professional life that has shaped how you show up day to day?

07:14: Can you share a time when data conflicted with lived experience and shifted your perspective or approach to research?

11:06: Has a single patient story ever changed your perspective more than large datasets? How should research methods account for that?

16:03: As ISPOR President, what conversations are we still not having loudly enough in HEOR or HTA circles?

20:08: As AI scales, how can we ensure underrepresented regions aren’t left behind – and what’s your approach to bridging that gap?

24:49: What can behavioral science teach us about improving health outcomes that traditional models miss?

27:55: How should we address gaps in data that overlook patients’ economic realities, like out-of-pocket costs or caregiving burdens?

30:56: How do we train the next generation of HEOR professionals not just to code, but to care? Where are we missing the mark?

39:38: Rapid Fire Questions

Eberechukwu Onukwugha

Professor and Executive Director of Pharmaceutical Research Computing, University of Maryland, Baltimore

Eberechukwu Onukwugha, PhD, is a Professor in the Department of Practice, Sciences, and Health Outcomes Research and is Executive Director of Pharmaceutical Research Computing at University of Maryland School of Pharmacy. She received a doctorate degree in economics from Virginia Tech and has 20 years of experience conducting health economics and outcomes research. She has authored 140 peer-reviewed articles. She is an editorial board member for PharmacoEconomics and an Associate Editor for Ethnicity & Disease.

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In this ‘Patti’s People’ episode, Patti Peeples of the The Peeples Collaborative catches up with RWE Pioneer, Jeff Trotter – one of the original Patti's People.

Jeff Trotter doesn’t just study evidence—he shapes how we think about it. A longtime advocate for the thoughtful use of real-world evidence (RWE) in healthcare decision-making, Jeff has helped pharma companies, service providers, and policymakers navigate the evolving landscape of value, validity, and what it means to “know” something in medicine. As the industry embraces new technologies, new stakeholders, and new threats to scientific integrity, Jeff remains a clear, incisive voice—grounded in rigor, yet open to rethinking the gameplan. In this conversation, we talk ROI, regulatory shifts, and what happens when facts become optional.

Questions:

00:00: Introduction

00:53: Since our last conversation, what shifts in the RWE landscape have caught your attention?

10:31: The ROI of RWE is getting clearer, but are we asking the right questions about value?

18:25: What happens when society starts to reject facts?

26:00: What’s one RWE project that exceeded expectations?

32:30: Is observational research declining due to the rise of secondary real-world data and AI, or is it poised for a resurgence thanks to its flexibility?

35:12: Can you share an example where you reached a demographic not captured in secondary data?

37:57: How are CROs being challenged to evolve in this new RWE era?

41:58: You’ve been a thought leader in this space for decades. What’s changed most about how you think about your own role in it?

44:29: Rapid Fire Questions

Jeff Trotter

RWE Pioneer

As an entrepreneur, researcher, consultant, and innovator, Jeff Trotter has been a pioneer in the evolving health economics and outcomes research community and is an industry leader in the design and implementation of patient registries, observational studies, and other RWE initiatives. Having founded, led, and sold two companies in the pharma services space and served as an executive with several global CROs, Jeff currently supports the scientific and strategic RWE initiatives of life-sciences and related organizations through his independent consultancy, J Trotter Research & Consulting.

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In this ‘Patti’s People’ episode, Patti Peeples of the The Peeples Collaborative speaks with Jeremy Rassen, Co-founder & CEO, Aetion.

Note, this interview took place prior to the Datavant acquisition of Aetion.

Questions:

00:00: Introduction

00:32: Tell us about your career trajectory, and what your focus is now.

05:00: How do you define ‘regulatory-grade’ RWE at Aetion, and how does it differ from evidence used for publications or internal decisions?

09:25: Do you think we've overreached in using RWD, and, if so, in what areas?

12:10: What is Aetion doing to improve RWD quality?

17:44: How are you applying your AI background to data analytics in your current work?

23:41: With rising scrutiny around commercial influence in RWE, what role do public-interest audits, independent replication, or open protocols play at Aetion?

30:29: How is Aetion addressing missing public health data, and can commercial groups help fill these gaps for public benefit?

32:04: Which thinkers have influenced your views on uncertainty and evidence, and how do those ideas shape Aetion’s platform?

34:31: Rapid Fire Questions

Jeremy Rassen

Co-founder & CEO, Aetion

Dr Rassen is an epidemiologist and computer scientist with more than 25 years of experience in how causal inference and AI can drive understanding of the safety, effectiveness and value of medical treatments. He co-founded Aetion to pursue a vision of technology providing the speed, scale and rigor required to answer high-stakes questions in healthcare. Dr Rassen has overseen Aetion’s work with 18 of the 20 top global pharma companies, as well as many other customers around healthcare. During the COVID-19 pandemic, he initiated Aetion’s research collaborations with the US FDA and was a leading voice on how RWE could be applied to decisions around COVID-19 and other critical decisions in healthcare. Prior to Aetion, Dr Rassen was an assistant professor of medicine at Harvard Medical School, where he developed methods to improve the quality and validity of RWD studies. He started his career in Silicon Valley, where he was the first employee at E.piphany to join the company’s founders to build a novel, data-driven customer relationship management (CRM) platform and sell it to Fortune 50 companies. Dr Rassen received a Bachelor of Arts in Computer Science from Harvard University and a Doctor of Science in Epidemiology from the Harvard TH Chan School of Public Health. He is a fellow and board member of the International Society of Pharmacoepidemiology.

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