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In this ‘Patti’s People’ episode, Patti Peeples of the The Peeples Collaborative speaks with Michael Drummond, Professor Emeritus and former Director, Centre for Health Economics, University of York, where they discuss topics including the evolving role of health economists in policy, the ongoing debate about “Value” in healthcare, and budget constraints and opportunity cost in health systems.

Questions:

00:00: Introduction

01:23: Health economists now sit closer to power than ever. Is their role still primarily to inform policy, or has the field crossed into shaping it – and where should that line be drawn?

03:46: How can economists best help policymakers understand alternative options and opportunity costs without drifting into advocacy?

06:19: Have we reached a genuine stand-off in the healthcare value debate, or have underlying philosophical differences simply become impossible to smooth over?

15:58: Why do health systems and even health economists struggle to confront the reality of scarcity, and what real-world examples illustrate this?

21:22: Is HEOR being asked to stretch beyond its traditional focus on efficiency and equity into broader industrial strategy, and are we equipped to do that well?

Michael Drummond

Professor Emeritus and former Director, Centre for Health Economics, University of York

Michael Drummond is Professor Emeritus and former Director of the Centre for Health Economics at the University of York in the UK. His main field of interest is in the methodology and practise of economic evaluation in health care. He is the author of two major textbooks and more than 750 scientific papers. He has advised several governments on the assessment of health technologies and acted as a consultant to many life sciences companies. In October 2010 he was made a member of the National Academy of Medicine in the USA. He served for 14 years as Co-Editor-in-Chief of Value in Health and was made Editor Emeritus in May 2024.

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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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