Wednesday, April 12, 2023

"The Second Request" Podcast Episode Recommendation: Spotting Anticompetitive Conduct in Pharma Supply Chain, with 46brooklyn

The Capitol Forum is what I suppose can be called a Washington, DC-based, center-left leaning investigative news organization. In 2017, the website "Talking Biz News" (which is apparently about the news business) operated by Chris Roush, who's dean of the School of Communications at Quinnipiac University (a university which happens to be a few miles away from where I grew up, so it seemed legitimate to me) described The Capitol Forum this way: "Digging deep into the connection between business and government regulation."

Anyway, The Capitol Forum recently shared an excerpt from its "The Second Request" podcast. For its part, The Capitol Forum does not really get a lot of media headlines because most of its articles remain sealed tightly behind a paywall. However, I discovered its podcasts are assuredly more accessible, pretty much from wherever you get your podcasts. 

The "The Second Request" podcast description describes itself this way:

"Exploring Solutions to Monopoly Problems Following forty years of laissez-faire antitrust enforcement and industry consolidation, the White House is considering a fundamental rethink of how to interpret, enforce, and rewrite antitrust law, and many questions remain unanswered for the antitrust community."

That description really intrigued me, so I subscribed! 

Virtual and mostly unregulated monopolies now operate widely across the U.S. economy, which has contributed to inflation. One example: at the start of 2022, a dozen large eggs cost the average American shopper $1.93, but at the start of 2023, that carton cost an average of $4.82 – a 250% increase. The suppliers blamed the price increases on outbreaks of highly pathogenic avian influenza. Yet at the same time, Cal-Maine Foods, which happens to be the largest egg producer in the U.S., reported that company revenue doubled and its profit surged 718% last quarter because of sharply higher egg prices. Coincidence? Unlikely.

More recently, the "The Second Request" podcast has covered a variety of topics related to the healthcare industry, hence I have found recent episodes worth listening to. One recent conversation was with Antonio Ciaccia and Ben Link of 46brooklyn Research on "The Second Request" podcast.

As 46brooklyn dug into the pharmaceutical supply chain on behalf of the State of Ohio, it began uncovering hundreds of millions of dollars in state overspending on prescription drugs through its Ohio Medicaid program. 46brooklyn's founders had begun doing data analytics and research to help uncover massive disconnects between pharmacy reimbursements, the actual costs of prescription drugs, and what the state of Ohio was getting charged through its state Medicaid program.

In this podcast episode, In particular, they discuss the odd dynamic whereby generic drug prices no longer really save patients money anymore. But that is ominous for what it means to newer markets such as the biosimilar insulin market which expects a bunch of approvals starting in 2024. That partially explains why innovative startups such as Mark Cuban Cost Plus Drug Company have been able to disrupt what was previously an odd collaboration where no one discussed what prices really were.

Listen to the full discussion in its podcast below, also available on The Capitol Forum's website at and major podcast-streaming platforms.

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