In this ‘Patti’s People’ episode, Patti Peeples of the The Peeples Collaborative speaks with Ramiro Gilardino, Healthcare Executive specializing in Global Access & Health Policy.
Questions:
00:00: Introduction
01:16: What’s changing in pricing reform, and why is this moment important?
03:11: How do MFN and reference pricing work, and how do they differ in purpose and impact?
06:18: Why are these tools so appealing to policymakers?
07:00: MFN pricing is often framed as a fairness issue. From an access and economics perspective, where does that argument fall short?
09:35: One concern is that MFN doesn’t just affect the US, it reshapes global pricing behavior. What ripple effects do you see internationally?
12:40: External reference pricing has been around for decades. Why does it feel more consequential, and more dangerous, now than it did 10 or 15 years ago?
15:18: People still talk about ‘Europe’ as if it’s one access environment. Why is that framing fundamentally flawed?
18:30: From your experience in consulting and industry, what does true organizational readiness for European access actually look like?
21:01: How early is ‘early enough’ when it comes to European access planning, and what needs to be decided before Phase III?
22:58: With more coordination across Europe, there was hope for simplification. Are we actually seeing simplification, or just a new layer of complexity?
25:39: As a CrossFit coach, you use “explain, demonstrate, practice, correct.” How does that approach apply to communicating value in access today?
27:15: What does it take to tell an access story that resonates with payers, policymakers, and patients beyond the science and policy?
28:38: Rapid Fire Questions
Ramiro Gilardino
Healthcare Executive specializing in Global Access & Health Policy
Ramiro Gilardino, MD, MSc, is a health policy and innovation specialist with a background spanning global institutions and the private sector. He brings over a decade of experience in HTA, market access policy, and evidence strategy. Ramiro has led and contributed to international collaborations focused on aligning HTA methodologies, advancing affordability frameworks, and enabling lifecycle approaches to decision-making. He currently serves on the Board of Directors at ISPOR, where he champions stakeholder engagement, equity, and policy reform to enhance patient access and making healthcare accessible and affordable.
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