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A Civic Vision for Biomedical Engineering

Guru Madhavan

GMadhavan@nae.edu @BioengineerGM

“Hard” Problem

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Image Source: https://commons.wikimedia.org/wiki/File:St_Mary%27s_Hospital_02.jpg

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Image Sources: https://upload.wikimedia.org/wikipedia/commons/1/16/First_page_of_Alexander_Fleming's_paper_on_penicillin_Wellcome_L0007150.jpg; http://www.nobelprize.org/nobel_prizes/medicine/laureates/1945/chain-facts.html; http://www.nobelprize.org/nobel_prizes/medicine/laureates/1945/florey-facts.html

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Hard Problem“Solved”

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“Soft” Problem

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Soft Problem“Resolved”

“Messy” Problem

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The New York Times

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C Phelps, G Madhavan, R Rappuoli, R Colwell, H Fineberg, Vaccine, 2017G Madhavan, C Phelps, R Rappuoli, Nature, 2017C Phelps, G Madhavan, Value in Health, 2017C Phelps, G Madhavan, Cost Effec and Res Alloc, 2018G Madhavan, C Phelps, W. Rouse, R Rappuoli, PNAS, 2018C Phelps, G Madhavan, Value in Health, 2019 (in press)

C Phelps, G Madhavan, R Rappuoli, R Colwell, H Fineberg, Vaccine, 2017G Madhavan, C Phelps, R Rappuoli, Nature, 2017C Phelps, G Madhavan, Value in Health, 2017C Phelps, G Madhavan, Cost Effec and Res Alloc, 2018G Madhavan, C Phelps, W. Rouse, R Rappuoli, PNAS, 2018C Phelps, G Madhavan, Value in Health, 2019 (in press)

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Messy ProblemsNeed to be

“Dissolved”

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Making Medicines Affordable

(and Available)

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Evergreening Pay-for-Delay

SubstitutionCost-sharing

Discount Programs

Product Marketing

**

**

** C. Phelps and G. Madhavan, “Clash of the Titans,” Science Translational Medicine, 2018

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https://www.nytimes.com/2017/11/30/us/politics/national-academy-of-sciences-prescription-drug-prices.html

Figure 2-5, Making Medicines Affordable, p.46

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https://www.statnews.com/pharmalot/2016/12/01/mylan-ceo-responsibility-epipen-price/

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Value

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Drugs that are not affordable are of little value and drugs that do not exist are of no value.

Augustine N, Madhavan G, Nass S (Eds), Making Medicines Affordable: A National Imperative, NASEM, 2018

Source: U.S. Senate HELP Committee

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“…recommendations I believe would make a real difference in bringing down drug prices.”

“These are thoughtful recommendations …that deserve careful analysis.”

Source: U.S. Senate HELP Committee

“Many of these strategies, and many of the specific actions we’ve taken, also map onto the

recommendations of the NAM report…on the national imperative of making medicines affordable.”

Source: NAM Annual Meeting

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SolutionsSystems

Strategies

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Preamble, Mike Wilkins, 1987 | Smithsonian American Art Museum, Washington, DC | Photo by Guru Madhavan

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Thank you

Photographs by Guru Madhavanunless otherwise noted.

GMadhavan@nae.edu@BioengineerGM