Tradeoffs

For decades, the most effective treatment for addiction to methamphetamine or cocaine has been mired in stigma and mostly limited to small research studies. But with deaths involving meth and cocaine on the rise, policymakers across the country are turning to gift cards to fight drug use.Credits:Stephen Higgins, PhD, Professor of Psychology and Psychiatry, University of VermontRichard Rawson, PhD, Professor Emeritus, UCLA Department of PsychologyAndrew Dertien, Contingency Management Coordinator, HealthRIGHT 360Bernard GrovesAyesha Appa, MD, Assistant Professor of Medicine, UCSF and San Francisco General HospitalTyler Sadwith, Medicaid Director, California Department of Health Care ServicesLearn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.

Many potent new medicines pose a host of challenges for drug companies trying to copy and sell similar versions on the cheap. Can those companies find a sustainable path forward, or will patients get left stuck paying exorbitant prices?Guests:Christine Baeder, MBA, President, Apotex USAAlfred Engelberg, JD, retired attorney and former counsel to the Generic Pharmaceutical Industry AssociationJeremy Greene, MD, PhD, Professor of Medicine and the History of Medicine, Johns Hopkins UniversityCandy Meyer, PatientBhaven Sampat, PhD, Professor, Arizona State University School for the Future of Innovation in SocietyMarta Wosińska, PhD, Senior Fellow, Brookings InstitutionLeslie Walker, Senior Reporter/Producer, TradeoffsLearn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.

America pays less, on average, than any other major country for our generic drugs. But selling essential drugs at such low prices comes with hidden costs — from quality problems to frequent shortages.This is the second episode of Race to the Bottom, a three-part series by Tradeoffs on the problems plaguing the generic drugs we all rely on — and how we could fix them.Guests:Christine Baeder, MBA, President, Apotex USALaura Bray, MBA, Founder, Angels for ChangeCraig Burton, Senior Vice President of Policy and Strategic Alliances, Association for Accessible MedicinesIilun Murphy, MD, Director of the Office of Generic Drugs, FDALeslie Walker, Senior Reporter/Producer, TradeoffsMarta Wosińska, PhD, Senior Fellow, Brookings InstitutionLearn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.

Generic drugs are, in many ways, the unsung hero of America’s health care system, bringing powerful medical innovations within the reach of millions more people. These cheaper copies of brand-name drugs — from pills that stop heart attacks to antibiotics that cure life-threatening infections — save America hundreds of billions of dollars a year. But will affordable, high-quality generic drugs continue to be there when we need them?Some players are abandoning this business while others slash costs by cutting dangerous corners. Shortages of older generic drugs have become the norm, sending doctors scrambling. At the same time, crucial new medicines are proving tougher to copy on the cheap, saddling patients with brand-name prices.Over the course of “Race to the Bottom,” our new three-part podcast series, we’ll explore why this industry that’s so essential to our health is in trouble — and what could change that.In part one, we examine the history of this industry. Forty years ago this month, President Ronald Reagan signed groundbreaking, bipartisan legislation that gave birth to a new drug market. Lawmakers made choices back then that help explain the wild success and also the troubles we see today with generic medicines.Guests:Christine Baeder, MBA, President, Apotex USAAlfred Engelberg, JD, retired attorney and former counsel to the Generic Pharmaceutical AssociationLeslie Walker, Senior Reporter/Producer, TradeoffsLearn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.

One organization turns to a game to get employees to debate and decide together what health care they most value. Guests:Paul Fronstin, Ph.D., Director, Health Benefits Research, Employee Benefits Research Institute Jeanette Janota, Senior Research Associate, American Speech-Language-Hearing AssociationTavril Saint Jean, Senior Research Associate, American Speech-Language-Hearing AssociationJanet McNichol, Chief Human Resources Officer, American Speech-Language-Hearing AssociationEvan Reid, Senior Director of Analytics, American Speech-Language-Hearing AssociationJulia Reilly-Edwards, Data Scientist, American Speech-Language-Hearing AssociationLearn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.

A handful of states allow terminally ill people to take life-ending medications prescribed by a doctor instead of waiting for death. This week, we talk with journalist Steven Petrow about his sister’s choice to use medical aid in dying.Guest:Steven Petrow, Journalist and authorLearn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.

In The Fifth Branch, Tradeoffs explored new ways to respond to people in a mental health crisis, this week we have look at another area of the mental health crisis the country is grappling with. 'Lost Patients', a new podcast from KUOW and The Seattle Times, dives into why so many people with mental illness live on the streets, and lack long-term care.Heidi Aurand has watched her son Adam spiral from one psychiatric crisis to the next for about eight years, bouncing between emergency rooms, jails, and homelessness. Now, after treatment at the state's largest psychiatric hospital, Adam was just released back onto the streets of downtown Seattle. A mother asks: How could her son pass through so many institutions and none are able to stop his decline?Learn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.

The Inflation Reduction Act gave Medicare historic new power to directly negotiate the prices of some of the costliest prescription drugs. Now the federal agency must grapple with a difficult question: What makes a drug price fair?This week, we revisit our 2023 episode explaining how this negotiation process works and the impact it could have.Guests:Anton Avanceña, PhD, Assistant Professor of Health Outcomes, University of Texas Darius Lakdawalla, PhD, Professor of Pharmaceutical Economics and Public Policy, University of Southern California Lauren Neves, JD, Deputy Vice President, PhRMASteve Pearson, MD, MSc, Founder and President, Institute for Clinical and Economic Review (ICER)Ben Rome, MD, MPH, physician and researcher, Harvard Medical SchoolMeena Seshamani, MD, PhD, Deputy Administrator, Centers for Medicare and Medicaid ServicesLeslie Walker, Senior Producer/Reporter, TradeoffsLearn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.

Companies claim they can catch cancer sooner with new blood tests and full-body MRI scans. What are the risks and benefits?Guest:Ishani Ganguli, MD, MPH, Assistant Professor of Medicine, Harvard Medical School; primary care physician, Brigham and Women's HospitalLearn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.