This year’s State of Possible Conference gave attendees a glimpse at the passion and purpose that fuels scientific breakthroughs—long before these innovations enter your newsfeed or reach the headlines of your favorite outlet. If your newsfeed is anything like mine, you’ve likely seen many recent headlines featuring one word in particular: Affordability.
It’s no secret that the cost of health care and prescription drugs is now at the forefront of many Americans’ minds. In response, legislators at the federal and state level are weighing new policies that hold wide-ranging consequences for drug developers and patients at the pharmacy counter.
At the State of Possible Conference, speakers gave voice to both the state of drug pricing and the ripple effects of proposed solutions.
An Honest Conversation
John Stanford, partner and CEO at Novel Strategies, moderated what he described as “a conversation on the price of innovation. But most importantly, it’s an honest conversation.”
The conversation that followed touched on all the “truths about our industry” that impact what patients pay for medicines, from R&D costs to AI to geopolitics. One throughline of the discussion, however, was how communication shapes perceptions of drug pricing in America.
Chris Garabedian, venture portfolio manager at Perceptive Advisors and chairman & CEO of Xontogeny, kicked off the panel by bringing up an area “we don’t talk enough about”: the cost of health care overall.
“When you really look at it, 85 to 90% [of spending] is not branded pharmaceuticals. And when you think of the efficiency of that, of being able to get a prescription bottle or take a subcutaneous injection to treat a serious disease, it’s one of the most efficient ways that we can deploy health care.”
Garabedian noted that the biopharma industry has previously struggled to communicate how such novel therapies have significantly alleviated the burden—and cost—of treating disease in the U.S. He shared how, in certain cases, “it’s antiquated to have to drive to a clinic or a hospital setting” where a patient may receive a bill in the “tens of thousands of dollars” rather than receive a therapy administered in a more cost-effective setting.
“We still continue to need to do a better job of explaining how these drugs—even though they’re branded and they might have a high sticker price initially—that these are the most efficient way that we can treat disease.”
The industry was also encouraged to have more open and forthcoming discussions on prices that convey a medicine’s value. Melanie Whittington, managing director of the Leerink Center for Pharmacoeconomics, cited the lack of such discourse as one reason for the biopharma industry’s mixed reputation among Americans in recent surveys.
“Everyone in this room are heroes. But outside of these walls, because of the high costs that patients have to pay at the pharmacy counter, they see this industry as the antihero.”
As an illustration, Whittington flipped the notion of ‘the price of innovation’ on its head: “What is the price of not innovating?”
“I would really challenge us all in this room to talk about price. To think about price. To evaluate the amazing societal and health system and patient impacts that the products you’re working on could do or are doing, and really celebrate that and communicate that.”
The Importance of Incentives
Another theme in drug pricing is the role of federal policymakers in maintaining an ecosystem ripe for investment and innovation.
Regulators and members of Congress have several levers at their disposal to create incentives for drug development, as well as the potential to enact policies that hold unintended consequences on innovation.
Garabedian asserted that federal incentives have seen good results, such as the FDA’s priority review vouchers for therapies treating rare pediatric diseases. Still, the biotech industry would benefit from more programs and incentives: “I think we need to figure out how to have a better collaboration.”
Such a partnership requires a united front among the biotech industry. Scott Robertson, co-founder and managing partner at Dauntless Ventures, believes “the industry is in real trouble if we can’t figure out a holistic, systematic way to go to the U.S government” to discuss key issues.
The goal, Robertson says, would not only be participation in dialogue already underway, such as the impacts of most-favored-nation drug pricing or the regulatory arbitrage of nations like China and Australia.
“There are things that we have not touched in the R&D tax code for early-stage innovation in 40 years. We should address all of those.”
Uncertainty in Washington
Another area impacting pricing is predictability, which helps biopharma companies plot crucial timelines that support a sustainable future. Legislative changes, especially the Inflation Reduction Act (IRA), have shifted the paradigm for how drugmakers price their medicines.
Chris Viehbacher, president and CEO of Biogen, noted that the IRA serves as “a de facto reduction in patent life” because of the timeline for when a drug becomes eligible for the Medicare Drug Price Negotiation Program. The presence of the IRA means that “suddenly, whoop, that [timeline] is now shorter,” meaning companies must adjust strategies on the fly to compensate for it.
Additionally, the FDA has historically been a pillar of stability for biotech companies. However, staff reductions and leadership turnover have brought new questions about the agency’s future, noted Tamar Thompson, VP, patient experience and insights at Alexion, AstraZeneca Rare Disease.
Thompson, also the Outgoing MassBio Board Chair, gave voice to the “tremendous uncertainty” at the agency in contrast to similar review bodies around the world.
“Other countries are moving quickly to accelerate clinical development pathways and attract innovation to their shores. And the FDA is under real pressure, adding real complexity to this moment. And that should be a moment of a wakeup call and focus.”
Massachusetts Takes Action
In remarks, Massachusetts Governor Maura Healey acknowledged how abrupt federal changes have brought about several new challenges for our industry.
“They are stripping billions of dollars out of funding for health care and science and research. We’ve lost 75,000 scientists out of the federal government to date. That’s staggering.”
Those impacts are acutely felt in Massachusetts, which has cultivated a legacy as the epicenter of the global biopharma industry. The Commonwealth features a unique blend of academic research, venture capital and public policy that has fueled business and innovation over several decades.
It’s legacy that has prompted public servants like Governor Healey to act. As she puts it: “We haven’t been taking it lying down. And we’re not going to. We’re going to continue to stay true to who we are.”
In 2025, Governor Healey signed legislation to reduce insurer cost sharing on prescription medicines. The state has built on the momentum by working collaboratively with insurers to streamline prior authorization practices that too often delay care and worsen outcomes.
The commitment to public-private partnership has led to the creation of a Health Care Affordability Working Group tasked with advancing proposals to reduce health care costs across the system.
“I know people think working groups get nothing done. My teams get stuff done.”
The Business of Hope
The conversation around drug pricing often feels weighed down by the gravity of the status quo. With so many fronts of conflict and so many players involved, any inch of progress could be viewed as a reminder of the miles of issues that lie ahead.
Still, the State of Possible Conference reminded attendees that fixing the system takes time, open discussion and – most importantly – a commitment to getting better. The same spirit that drives science to new frontiers can also advance access and affordability for the patients we serve.
Governor Healey said it best when reminding us of the business we’ve chosen to enter.
“You’re in the business of hope…Hope for cures that patients depend on. Hope for great careers that students are looking for. Hope for a better, healthier world.”
Andrew Wishon is an associate director at Real Chemistry, a tier-one partner to the world’s most innovative life sciences and health care companies. He is the editor-in-chief of Real Chemistry’s Value Report, a free weekly newsletter on biopharma policy and pricing.