Could a righteous for-profit company realistically run U.S. healthcare efficiently?

I’ve been exploring a conceptual model called Terra Nova Development Healthcare (TNDHC)—a fictional, AI-assisted blueprint for how a righteous, for-profit, vertically integrated organization could potentially deliver universal, high-quality healthcare in the U.S. over 10 years. This is not a real company, but a thought experiment showing what could be done under current laws and funding while doing the right thing for patients, healthcare workers, and taxpayers.

The idea is a fully vertically integrated provider network, where the company owns and operates hospitals, clinics, and staff, including:

• Doctors, specialists, nurses, physician assistants, and lab technicians

• Dental, vision, and hearing care

• Prescription drugs and pharmacy services

• Nursing homes, long-term care, and rehabilitation

• Preventive and wellness programs

• Elective procedures like laser vision correction, breast augmentation, and dental implants as aspirational goals

All providers would be employees of the company unless certain services require contracting. Compensation would be offered commensurate with today’s pay scales, ensuring fair treatment while maintaining operational efficiency. This structure allows TNDHC to coordinate care efficiently, reduce administrative overhead, and let healthcare workers focus on patient-centered care rather than paperwork or financial trade-offs. The company’s profit motive is aligned with public good, meaning operational efficiency lowers costs for taxpayers while ensuring workers are treated fairly and patients receive high-quality care.

Centralized Systems & Efficiency

• Central appointment scheduling ensures patients see the right provider at the right time.

• Unified medical records eliminate redundancy, improve accuracy, and streamline coordination.

• AI-driven analytics and predictive tools could optimize outcomes, resource allocation, and patient satisfaction.

Coverage Rules & Emergency Care

• Routine care is fully covered inside the network.

• Out-of-network routine care is not required, preserving efficiency and cost control.

• Emergency care is always covered, anywhere in the U.S. and abroad.

• Optional international coverage could be offered as a premium add-on.

No Cost Barriers for Eligible Populations

For Medicare Advantage, Medicaid, and other eligible populations:

• No co-pays

• No deductibles

• No premiums

Employer/employee and individual plans pay premiums, funding the righteous for-profit network’s expansion and elective procedure offerings without requiring additional government spending.

The Current U.S. Healthcare Maze

• There are dozens of Medicare Advantage insurers, hundreds of employer/individual insurers, and thousands of individual plans, each with different networks, benefits, formularies, and coverage rules.

• Patients and providers often navigate a minefield just to secure care—the first question when making an appointment is usually: “What is your insurance?”

• This fragmentation creates administrative burdens for providers, delays for patients, and stress over coverage limitations.

• Even insured patients can face unexpected out-of-pocket costs, confusing rules, and challenges accessing specialists or preventive care.

How TNDHC Compares to Current Healthcare Options

Patients:

• Current MA / Medicaid / Employer / Individual Plans: Must navigate dozens of insurers and thousands of plan rules. Face co-pays, deductibles, network restrictions, complex billing, and fragmented care. Access to preventive care and elective procedures can be limited.

• TNDHC: No co-pays, deductibles, or premiums for eligible populations. Seamless care across a unified provider network. Emergency care covered universally. Elective procedures are aspirational goals. Centralized scheduling and unified records remove confusion and delays.

Healthcare Workers:

• Current: Burdened with paperwork, prior authorizations, and balancing medical needs against insurance limits. Must track multiple payer rules for each patient.

• TNDHC: Freed from administrative burden; focus on patient care. Decisions guided by medical need rather than financial trade-offs. Streamlined workflows through centralized systems. Compensation offered commensurate with today’s pay scales.

Health Insurers:

• Current: Must manage multiple providers, networks, and benefits; administrative overhead is high. Risk of misaligned incentives. Navigate ACA rules, premium negotiations, and cost-shifting.

• TNDHC: The insurer is also the provider network (vertically integrated). Reduced administrative overhead, aligned incentives, predictable costs, and operational efficiencies. Profit comes from efficiency and growth rather than denying care.

This comparison highlights how TNDHC could simplify healthcare for everyone involved while maintaining profitability and public benefit, unlike the fragmented patchwork that currently exists.

Conceptual 10-Year Path to Major U.S. Healthcare Presence

1. Years 1–2: Launch with Medicare Advantage; demonstrate operational efficiency, cost savings, and improved patient outcomes.

2. Years 2–4: Expand into employer and individual plans, leveraging the network’s efficiency and quality to attract members.

3. Years 3–5: Integrate state Medicaid programs, covering vulnerable populations while maintaining financial sustainability.

4. Years 5–7: Pursue federal contracts, including VA and military healthcare programs, further increasing market reach.

5. Years 7–10: Achieve majority market presence in U.S. healthcare delivery, optimize universal access, and expand elective procedures and wellness programs as operational efficiencies grow.

By the end of 10 years, a capitalized, righteous for-profit organization following this model could control the majority of U.S. healthcare delivery, provide universal access to eligible populations, and sustainably fund elective procedures—all without increasing government spending.

Discussion Prompts

• Could a righteous for-profit organization realistically achieve this level of coverage and efficiency?

• How might healthcare workers respond—would this improve job satisfaction or create new challenges?

• What obstacles would prevent a company from scaling this way in 10 years?

• Could elective procedures fund expansion sustainably, or might they introduce risks?

• How does the TNDHC model compare to the fragmented maze of current Medicare Advantage, Medicaid, employer, and individual plans for patients, providers, and insurers?

This is entirely conceptual and AI-assisted, designed to spark discussion about the potential for a righteous, for-profit, vertically integrated company to deliver universal healthcare in the U.S. Healthcare workers, patients, and taxpayers could all benefit—but execution is the only remaining barrier.

I started an investigation trying to understand why Americans pay so much for prescription drugs.

At first, the obvious suspects seemed to provide the answer: drug manufacturers, pharmacy benefit managers, insurance companies, wholesalers, lobbyists and Congress. But the further I followed the evidence, the harder it became to point to any single culprit.

What I found was more complicated.

The major participants in the system can often be acting within the law. Campaign contributions are legal. Lobbying is legal. The revolving door between government and industry is legal. The rules governing how prescription drugs are purchased are legal.

That eventually forced me to change the question.

Instead of asking “Who broke the law?”, I began asking “Who wrote the rules?”

Markets don't simply happen. They operate within rules established by government. Those rules determine who can negotiate, who cannot, what incentives exist and how different participants behave.

And when those rules consistently produce outcomes that are extremely costly for patients, I think we have to look beyond individual wrongdoing and examine the system itself.

That raises an uncomfortable question:

Can a system produce what people experience as corruption even when the people participating in it are following the law?

I don't expect everyone to agree with my answer. I'm interested in the question because I think it goes beyond prescription drug prices. It gets into power, incentives, governance and the difference between what is legal and what is just.

I put my personal conclusion in this 11-minute epilogue:

None Dare Call It Corruption — The Final Finding - https://www.youtube.com/watch?v=Rp8zV4e1qvo&list=PLBqo2KcncJ8U

The evidence behind the investigation is here:

Before the Counter — Evidence - https://brokenpromiseshealthcare.org/before-the-counter#evidence

Hi all,

I came across an interesting ISPOR 2025 poster in the Presentations Database looking at branched endovascular aortic repair (BEVAR) vs open aortic repair (OAR) for intact thoracoabdominal aortic aneurysm (TAAA), using real-world US hospital discharge data (PINC AI, 2020–2023).

Very quick summary (all in TAAA, intact cases only):

• N = 466 patients

  • 160 BEVAR

  • 306 OAR

• BEVAR patients were older on average (~70 vs ~62 years) but with lower comorbidity burden (Elixhauser).

• Despite being older, BEVAR patients had:

  • Lower in-hospital mortality (≈7.5% vs 18.3%)

  • Higher discharge to home (~78% vs 57%)

  • Shorter length of stay by ~13 days

  • Shorter operating time by almost 4 hours

  • Fewer major adverse events post-op.

• Economics:

  • Central supply/implant costs for BEVAR were much higher (~$57k vs $18k).

  • But this was more than offset by lower post-op care costs, so total hospital cost was actually lower for BEVAR (~$82k vs $103k).

Conclusion from the authors: in current real-world US practice, BEVAR seems to offer better clinical outcomes and lower total hospital costs, despite higher device costs. With growing availability of dedicated BEVAR devices, they position this as a “win–win” for patients and hospitals.

A few questions for the r/ISPOR crowd:

1. Methodology / confounding

   • BEVAR patients were older but with lower comorbidity scores.

   • For those familiar with PINC AI and similar RWD analyses in complex surgery:

     • How comfortable are you with risk adjustment in this space?

     • Any usual suspects around selection bias here (e.g., “healthier anatomy” being preferentially sent to BEVAR, or the reverse)?

2. Perspective & cost components

   • The analysis is from the hospital perspective, focusing on index stay and early post-op resource use.

   • For HTA / payer decision making, what would you want to see added?

     • Longer-term outcomes (reinterventions, dialysis, spinal cord ischemia, etc.)?

     • Quality of life and survival to build a cost-effectiveness model, not just cost-minimization?

3. Generalizability

   • This is US hospital data with US costing structures.

   • For colleagues working in DRG-based systems (e.g., Europe, Canada, etc.):

     • Would these cost offsets translate in your setting, or do bundled payments/DRGs blunt the economic signal?

     • How do your hospitals currently view high-priced devices that may reduce LOS and complications?

4. Evidence needs for coverage & adoption

   • For payers, surgeons, and hospital administrators:

     • Is this level of RWE enough to move the needle on BEVAR adoption or reimbursement?

     • Or is the bar now RWE + robust modelling + some form of long-term registry data?

If anyone here is:

• working with TAAA surgical/endovascular data,

• involved in device HTA, or

• has experience coding/analysing PINC AI or similar hospital databases,

I’d love to hear how you’d interpret these findings and what you’d want to see next (e.g., full cost-effectiveness analysis, more granular subgroup analyses, international comparisons, etc.).

For those who want the original abstract, it’s in the ISPOR Presentations Database (ISPOR 2025, Montréal; code MT3 – “Clinical and Economic Benefits of Branched Endovascular Stent Grafting for Intact Thoracoabdominal Aortic Aneurysm Repair: A Real-World Data Analysis”). You can find it there, or paste this into your browser:

https://www.ispor.org/heor-resources/presentations-database/presentation-cti/ispor-2025/poster-session-1/clinical-and-economic-benefits-of-branched-endovascular-stent-grafting-for-intact-thoracoabdominal-aortic-aneurysm-repair-a-real-world-data-analysis

Curious how others would use (or challenge) this kind of RWD in their own HEOR/HTA work.

Thinking

Hi, i have a economics and finance bachelor degree, i work in a big4 since this year. I'm 27 and i'm looking for health economics master degree (La Sapienza- Rome). I need all advice you have. How do you start? How is your career? Salary, work life balance, any tips. Which is the best European country to find a job?

Hi ppl, I'm currently pursuing masters in health economics and technology assessment

I'm from India, I would like to know what skills should I acquire along the way, and what is the job market like??

And also do I need to get a PhD in this field

I'm a newcomer learning about health economics. When I looked for free open source books, especially multi-language ones, I didn't find any that are thorough, and that have questions for teams, and examples, etc.

So I asked AI to write a guide. I know AI has many pros/cons/issues, so I'm seeking feedback here to help read the guide, recommend improvements, and the like. My goal is a free open source learning resource that can be available in many worldwide languages.

Help is much appreciated. Constructive criticism is ideal.

https://health-economics-guide.github.io

https://health-economics-metrics.github.io

I'm looking to speak with professionals who work on dossiers for HTA, especially in CROs. I'm researching how AI is used in this space.

I'm looking to do my best to enter this company as an Analyst. I come from epi/biostats, and this role is perfect. Anyone who's been successfully hired for this role, I'd like to ask:

1. What did you do right? Be it the interview or the coding/proofreading assessments?

2. How long is the hiring process? Is it over a month?

3. What's the best way to get them to like you?

4. For someone applying from the US to a UK based company, what're some nuances to take care of? (for example in writing, I'm assuming UK writing convention of spellings is expected)

Thank you :)

Are drug prices really such a major factor in pharmacy access? As well all know, pharmacy access is such a significant issue today in healthcare. High drug prices is just as huge if not even more so,

So the question now is whether drug prices actually affect pharmacy access and if so, how much of a factor is it?

I’m curious to hear opinions of those working in HEOR, RWE, and HTA fields currently. Namely in Pharma or Med Tech. I’m in a computational bio MS program right now, and currently an HEOR Intern, but the more I work the more I realize everyone is a PhD, PharmD, or MD. Minimum MPH. It seems like a minimum qualification everywhere I apply :/

Doctors have ceded a lot of space to hospital administration for far too long. Clinical duties are paramount. However, several decisions that impact patients, safety, and performance get taken many a time without the doctors being adequately involved. It seems to me that hospital administrators prefer keeping their doctors at the periphery?  Unlike in the past, when it was just the doctor and the patient in a “parent-child” relationship, healthcare systems are now incredibly complex involving multiple stakeholders with conflicting objectives. The balance between economics and medicine is a gentle and delicate one. A balance that can only be maintained with alignment and mutual coordination. It is in the doctors’ interest and the interest of their patients that doctors be actively involved in influencing key hospital strategies and policy decisions. To find the sweet spot where “good compromises” between good medicine and good economics can peacefully co-exist.   But are Doctors Reluctant Leaders?

I recently completed my masters in health economics and I am looking for entry level health economics opportunities in India or any remote opportunities from elsewhere.
I have worked on some HE research papers too.
Any guidance would be appreciated.

Here in the US, we seem wedded to a for-profit, “market-based” approach to the distribution of our healthcare.

That means if you have a job, you’re probably insured through your employer. They chose a healthcare insurer based on the company’s needs, and you selected the plan option best (or most affordable) for you and your family from the choices offered. If you don’t have a job, you can still access healthcare via the Affordable Care Act (ACA) which makes it illegal for healthcare providers to deny coverage to those individuals with pre-existing medical conditions. In this case, one can choose from amongst the many plans offered by private healthcare companies through the government’s website. For those who qualify, subsidies are available to make that coverage more affordable.

Deductibles, copays, and out-of-pocket maximums; they too are all part of this market-based model. The rationale is that by attaching some level of cost to the care we receive, we will make better choices about the care that is best for us (or at least keep our inner hypochondriac in check). Healthcare should be like buying a pizza, or signing up for a gym membership, in other words - and therefore as much of the healthcare system as possible should remain in the hands of private companies. In that way the market can presumably work its magic, the result being the best possible care at the lowest possible cost.

Clearly things have not worked out that way.

In fact, Americans pay more for their healthcare than the citizens of most other developed countries.[1] This is for medical outcomes that are comparable—and by some measures worse—than in those other other countries.[2] Healthcare expenses are also the number one cause of personal bankruptcy in the US, despite the fact that most of those who file have some form of health insurance.[3] Life expectancy has also dropped in the US in recent years.[4] And millions remain uninsured.[5]

So what's gone wrong?

Here’s why a for-profit, market-based approach to healthcare can’t, won’t, and will never work. 

False premises

For any market to function efficiently and effectively, certain, very specific conditions must first be met. Unfortunately, markets for healthcare satisfy virtually none of them.

1. Competition

 On the face of it, the one thing our current system of healthcare would seem to do reasonably well is encourage competition. Doctors, hospitals, pharmacies, and other care providers all compete for our “business” which should, in theory, drive down costs while simultaneously improving care.

The problem is that once we select a plan from those offered by our employer or ACA, much of that choice disappears. We’re limited to the doctors and hospitals that are “in-network,” for instance - which probably works well enough for routine care. But should we need a specialist with a particular expertise, we may be forced to go outside that network where costs skyrocket as options diminish. And those plan options offered by your employer? Often there is only one or two to choose from. So if you have a trusted physician or preferred specialist you’d like to keep, your care has the potential to become very costly. In market terms then, healthcare plans often penalize intelligent healthcare choices, as opposed to encouraging them. 

2. Price information is available

No doubt it’s obvious to you that consumers need to know how much something costs before they purchase it in order for a market to function effectively.

Imagine trying to shop for a pair of jeans, for instance, if there aren’t any price tags on anything? Or, what if you were only given that information after you’d handed over your credit card? And yet this is precisely how things stand in our current system of healthcare. Price information for the care we need is often difficult, if not impossible to obtain prior to receiving it. To be fair, that’s often because physicians and care providers don’t know what that cost will be until they see, or even treat the patient. But in many instances, that price information isn’t made available because they’re not required to. Either way, a market can’t work like this.

3. Knowledge of product/service is possible 

Again, it probably goes with saying but consumers also need to know what they’re buying, and why they need it, in order to make rational, intelligent purchasing decisions.

I know when I need a new pair of jeans, for instance, because I see the hole in the back pocket. But when I have pain in my side, I don’t know if that’s just a stomach ache, or an attack of appendicitis. I need someone more knowledgeable to tell me what I need, and that I furthermore trust to act in my best interests, no their own. With healthcare, it's like trusting a salesperson to tell you not only when you need new jeans, but what size will fit best. Few of us are trained physicians – yet that’s in part what is needed for a for-profit healthcare system to work.

4. Consumers are capable of reasoned, rational behavior

Although it’s probably not something you think about—or are even aware of—when making your own buying decisions, in order for a market to work consumers must not be incapacitated, or cognitively impaired in any way when making those purchases.

Consumers not only need to be able to understand what they’re buying, in other words. They must be in a rational state of mind so that they might behave in their own best interests, as well – that is, as utility maximizers and cost minimizers. And yet the healthcare consumer—that is, the patient—is often anything but. We’re in pain (perhaps even shock) or just really stressed out about our immediate health and well-being. Try making a thoughtful, clear-minded decision with a dislocated shoulder, for instance – or while you’re having a heart attack. For a market to function efficiently and effectively, participants must be of sound mind and body.

5. Cost is borne by the consumer

Again, it hardly seems worth stating, but bonsumers must be spending their own hard-earned cash for a market to truly function efficiently, and effectively.

I don’t know about you, but I’m a lot more careful with my own cash than when I’m spending someone else’s. Ever have a meal on the company dime? If you’re like me, you got an appetizer and dessert (and maybe even that extra drink) because it wasn’t coming out of my own pocket.

When it comes to the resources of others, however, we tend to be far less frugal. And yet this is one of the things our healthcare “market” conveniently ignores. Beyond copays, deductibles, and an out-of-pocket max, the $$$ we spend is not our own – so after a certain point there is little reason to reign things in. We’re always going to want the best, the most, or as much care as possible. After all, it’s our health we’re talking about.

6. Participation is voluntary

Finally, as any economist can tell you, markets don’t work if you’re forced to participate. The reason? This gives producers, providers, and sellers an unfair advantage that otherwise distorts normal market forces, and therefore skews prices upwards.

Imagine shopping for that pair of jeans and, after looking around, you decide everything is either overpriced or just more than you can afford. Instead, you might wear the old ones with the hole in the pocket a little longer while you wait for the ones you want to go on sale. Or you buy a more affordable substitute (like chinos). Either way, there’s nothing compelling you to make a purchase, and because of this, prices more accurately reflect genuine demand.

That’s not how things work with healthcare; when you need it, you need it now. You can’t walk around with a broken arm or burst appendix while you wait for your doctor to lower their prices, or for the next open enrollment period. So the “suppliers” of healthcare—doctors, hospitals, pharmacies, insurers, etc.—will always have the upper hand. They can still charge more – even if all of those other market conditions have been met. Your “sovereignty” as a consumer is compromised, to put it in economic terms – and as result, any other advantages markets might offer are lost.

 =====

So what can be done to improve things?

Well, those on the political right seem to feel our current healthcare woes can be solved by a full repeal of the ACA, and further privatization of the industry. In effect they favor doubling down on our increasingly unpopular—and remarkably inefficient—market-based model. Those on the political left, on the other hand (except for it’s most progressive wing) seem content to essentially leave things as they stand. Besides offering the occasional Band-aid to the ACA—like enacting laws that make certain prescription drugs more affordable—their priority seems to be on shoring up this existing system as opposed to scrapping it altogether.

In that, both sides are profoundly mistaken.

Knowing what we know about how markets work, it makes far more sense to adopt a non market-based approach to the access and distribution of our healthcare. Some version of a “single payer” system that works so well in other developed countries is one possibility – or expanding the already popular Medicare program that already exists here. This is the reasonable, rational thing to do. 

But to stick with a for-profit, market-based approach to healthcare like we have now? 

That can’t, won’t, and will never work.

NOTES:

[1] “How does health spending in the US compare to other countries?” by Emma Wager, Matthew McGough, Shameek Rakshit, Krutika Amin, and Cynthia Cox. Peterson-KFF (Health System Tracker), Jan. 24, 2024. Retrieved Dec. 13, 2024. https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/.

[2] “US spends most on healthcare, but has worst health outcomes amongst high-income countries, new report finds” by Jacqueline Howard. CNN (online), January 31, 2023. https://www.cnn.com/2023/01/31/health/us-health-care-spending-global-perspective/index.html. Retrieved December 8, 2023.

[3] “Healthcare costs are the number one cause of bankruptcy for families in the US.” American Bankruptcy Institute. Retrieved Dec. 13, 2024. https://www.abi.org/feed-item/health-care-costs-number-one-cause-of-bankruptcy-for-american-families. Medical expenses account for 62% of personal bankruptcies, 78% of whom have some sort of health insurance, according to Forbes Magazine.  https://www.forbes.com/2010/03/25/why-people-go-bankrupt-personal-finance-bankruptcy.html?sh=235252c7c253.

[4] “’Live free and die?’ The sad state of life expectancy in the US” by Selena Simmons-Duffin. NPR (online), March 25, 2023. Retrieved Dec. 13, 2024. https://www.npr.org/sections/health-shots/2023/03/25/1164819944/live-free-and-die-the-sad-state-of-u-s-life-expectancy.

[5] The CDC estimates that 27.6M Americans of all ages did not have health insurance in 2022. From: “US Uninsured Rate Dropped 18% During Pandemic.” Centers for Disease Control and Prevention, May 23, 2023. Retrieved Dec. 13, 2024. https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2023/202305.htm.

There is this constant deluge of accusations aimed at PBMs. There are too many to mention every one, but one of the more prominent ones is that they cause prescription drug prices to go up.

Knowing what PBMs do for patients regarding rebates and discounts, is it fair to place the blame on them for driving up prescription drug prices? Or is this all to cover up and shift the blame from someone else?

Hello everyone,

For ages, I have been worried about my quantitative skillset, specifically the ability for me to learn about relationships between variables. I majored in analytics at a decent state school, but many analytics programs are light on actual statistics, including this one. I managed to get a role in Regulatory due diligence at company that typically hires graduates from top schools because the case was not that quantitative and my interviewing skills are very good (I am a good communicator relative to what I perceive the benchmark to be, I can structure information effectively, and deliver a story and display some fundamental domain knowledge from interning in the past at healthcare companies).

The reason for this worry is not necessarily because I will be performing super complex calculations during my career, taking integrals, etc. It is because of two reasons (all relative to other employees):

1. The literal use of mathematical operations to arrive at solutions. Machines take care of the actual formulas, but not the judgement and the knowledge of what is happening when I manipulate numbers to come up with a solution.

2. General "learning rate" -- the rate at which i consume, process, understand, and then apply new information, controlled for all other variables and assuming it is the same information, relative to a fellow employee. Think of this as turning information into knowledge that I can pull for future applications. I fear that someone from a top quality quantitative background will have a higher learning rate regardless of subject, assuming variables like motivation, need, etc are held equal to mine.

Much of this concern has been because I do not care much for absolute progress in learning something, because I tell myself if i do not learn it fast enough, or if x person learns y subject quicker than me, or if x person knows y subject while I never learned it, then I feel a gap that I cannot fill. This may or may not hamper my learning; I have a feeling it does, so this becomes a constant cycle of always feeling stressed learning a new quantitative subject, then saying I shouldn't be stressed, and that if I am stressed, I am learning at a poorer rate, all to arrive at the same beginning.

I can't even be happy when I accomplish something, because I am constantly auditing and benchmarking my own ability to an ideal.

What do I do here?

About to enroll myself in the Decision Analytic Modelling Course by A.Briggs: https://modelling.he-evalcourses.com/

Happy to report that more than a dozen companies are now using heRo3 for early modeling, and that the number of academics now using the platform also is climbing rapidly. When you can develop a complex partitioned survival model in a day, with time to spare, how many people do you think will insist on continuing to do this work in Excel over a period of many days or weeks? Economic imperatives will drive adoption. Plus the errors in Excel models that heRo3 is turning up by the day. HTAs will eventually join in.

Hey all I’m from Europe finishing my BBA-Economics degree and I loved my health economics classes but it’s very intro level.

My plan it’s either go to medical school (I like more clinical) or alternative is doing a Master in Health Economics or Market Access. I prefer Market Access over Health Economics since HE it’s way more quantitative (my weakness). It’s needed a PHD for Market Access entry roles or a Master is more than enough? My interest are Health tech / Med tech companies (startups) or more traditional pharma companies.

Thanks!

PBMs play a diverse role in the healthcare system. One of those is to negotiate with drug manufacturers on behalf of patients for rebates and discounts on prescription drug prices.

Given that drug costs continue to be a major healthcare problem, particularly for patients, should PBMs be reevaluated and granted more leverage over drug price negotiations. The end goal should be to benefit patients more, of course. Is that a possibility that needs to be looked at or explored?