Author of the Cost Curve & the Principal and Founder of Reid Strategic, Brian Reid 

Welcome to Perspectives, a signature podcast series from The Leerink Center for Pharmacoeconomics. Hosted by Dr. Mel Whittington, a health economist and Head of the Center for Pharmacoeconomics will be hearing from individuals across the industry to better understand and appreciate the societal impact of healthcare innovations.

Mel Whittington: Hi everyone, I’m Mel Whittington, Managing Director and Head of the Center for Pharmacoeconomics, which is a division of MEDACorp, an affiliate of Leerink Partners. The Center for Pharmacoeconomics was launched to evaluate and communicate the impact of healthcare innovations on patients, caregivers, the health system, and society as a whole. I’ve been evaluating innovations for many years, but I have to admit that I have not prioritized communicating the findings beyond peer reviewed manuscripts or white papers, and I haven’t really thought about who the findings should be communicated to and how. And so, at CPE, we want to change that. We want to think about communicating and have that at the top of our mind. And so today, I’m honored to be joined by one of the best communicators in the healthcare industry, Brian Reid. Brian is the principal and founder of Reid Strategic and author of the must-read newsletter, The Cost Curve. You’re all probably already familiar with his tremendous work, but if not, please do give him a follow on LinkedIn and subscribe to his newsletter. Brian, thank you for joining us.

Brian Reid: Oh, it’s a thrill to be here.

Mel Whittington: Can we start with just a little bit of your background? What is Reid strategic? What did you do before Reid strategic?

Brian Reid: Sure. So, I started my career as a journalist, which is probably not surprising given the full circle and the fact that I wake up every day and write for three hours, but I started as a health and science journalist doing a lot of really interesting things. I worked for Bloomberg News for a period of time. So, I covered almost a hundred FDA advisory panel meetings, got really into the process by which medicines moved from phase three through the FDA.  I got a really up close view of that process. And then I spent 20 years at a PR agency doing largely media relations and then kind of issues management. And what I realized in about 2014, 2015 was that a lot of what issues management meant in PR for pharmaceuticals was explaining price and there wasn’t a really good roadmap. So, I went to my CEO at the time and said, “I think we need to launch a practice that’s devoted to the idea that we can help companies speak more thoughtfully about pricing.” He said “Fantastic. Go for it.” We launched this practice and three weeks later, Martin Shkreli crawled out from under his rock, raised the price of Daraprim. And so, I’ve got an excellent sense of timing. And that was really what started this pivot from a guy who was really interested in the communication of phase three data to a guy who was really interested in how we talk about value, how we talk about the financing of these sorts of things, so really deep there. And then a couple of years ago, I launched my own consultancy. So, I could really focus on these topics, in a way I wasn’t necessarily able to before. And so that’s how I got to where I am now. This belief that if we really want a good and smart and thoughtful healthcare system, we have to understand what’s going on. We have to understand how we think about value, how we talk about payment. These are things that are not hot. They are not sexy. They’re not really usually part of the public discourse, even though I think there are pockets where this is very much discussed, and I really want to bring some of that thinking into a broader conversation.

Mel Whittington: Interesting. Why the healthcare industry? This seems like one of the hardest things to communicate. There’s a lot of issues in the healthcare industry. Why choose the healthcare industry?

Brian Reid: For me, I’ve always been fascinated by science. So, I was a biology major in college, which is, yeah, which would be impressive if there’s anything I did with that after the fact, but it became very clear to me.

Mel Whittington: I was also a biology major in college. I don’t do anything with that.

Brian Reid: It became very clear to me that I wasn’t going to spend the next 11 years of my life, like, doing the postdoc thing and washing test tubes. It also became very clear to me that I wasn’t gonna spend the next 11 years of my life going through the med school process and it seemed like the best way of really engaging in these super interesting topics without mortgaging my 20s and 30s was in in health communications, in journalism, in writing about all this really interesting technology. That was kind of the decision I made as I came out of college, I went to journalism school, and I wanted to be a business journalist covering the business of biotechnology because that seemed to be this really fascinating intersection of science, which I loved of writing about and I think I learned early on that if you see things through a business lens, you’re going to have a little bit more of a,  I don’t want to be dismissive, but if you have a little bit more of an accurate take of things, because again, if you look at the way the business world looks at these things, there’s a little bit less room to be self-deceiving. And that’s not an absolute, and there’s plenty of great counterexamples, but I’ve really loved the way that markets can, pick winners in a way that’s a little more objective.

Mel Whittington: I like it. So, you’ve chosen the healthcare industry, biotechnology in particular. How is communicating biotech different from other things?

Brian Reid: I think the standard answer here is you’re supposed to say, “well, you know, there’s a lot more regulation, there’s a lot more, I think, process in terms of the way we communicate about these things is, is very much dictated by the process of getting things published. And is it peer reviewed?

Is it in the literature?” But I think that the single thing that really stands out sets healthcare communications apart from anything else is the conservative nature. And I don’t mean that politically. I mean that kind of philosophically, if you look at the biopharma industry, it’s very heavily lawyered, for a good reason, but that tends to tamp down people’s ability to really kind of be loud and be enthusiastic and be expansive when they talk about topics. There’s always this sense that because of the publication process, because the sense that things have to be vetted by the FDA or kind of well-established in the scientific literature before you can really bang pots and pans together, communications has always been a little bit more limited. And so, I get really excited when I see these really interesting PR efforts being made in other industries. So, I watched the pop tart bowl and saw all of the interesting things, right, with the pop tart mascot and the going down in the toaster and all of this stuff. And all I could think is like, if this was happening in an FDA regulated industry, there would be concerns about, well, the pop tart mascot didn’t truly represent what an actual pop tart is because of this or that. And you’d have a bunch of lawyers saying, “well, you can’t do that with your pop tart mascot”, even though no one is seeing that as an actual avatar of the, what comes wrapped in the aluminum foil stuff. So, there’s this real sense that the conservative nature of this makes for a much more limited and I think restricted and sometimes self-censored communications landscape, which in some ways makes it much more interesting, but in some ways, makes it much more frustrating to really be able to do, you know, a Pop Tart bowl.

Mel Whittington: A pop tart bowl, right? Well, maybe we need to do that.  I completely agree with what you’re saying, and I have felt that struggle in my own communication and my own dissemination of things of that there is this kind of conservative and I’m going to say kind of boring way that we communicate findings. I was certainly trained to write peer reviewed literature and it’s not digestible. It’s not a fun read. And so that’s one of my areas of development is to how can I be a better communicator to different audiences and to get people engaged? I recently received some advice from somebody saying, “don’t be boring. Like, Mel, stop being boring. You’re not a boring person. Why are you writing in such a boring way?” You know, it’s an uncomfortable thing to try to be creative, but I think our field does need to be more creative. And I wonder if we were a little bit more creative and a little bit more passionate and a little bit less conservative, would there be more, you know, excitement and appreciation for biotech?

Brian Reid: I think the short answer there is yes. And the long answer is we need to have more people experimenting with that sort of thing. We need to normalize the idea that talking about these issues is good and natural. We ought to be doing more of it, and there ought to be more practice, and we ought to be doing a better job of promoting it. And we can be explicit about the caveats and the limitations, but I think there’s a real sense that this is a hard thing to get people interested in and so we probably don’t make the effort and time on task is the key to anything. And as an industry, as a group of thinkers, we just don’t have much time on the task of how can we make conversations about the fundamental economics of healthcare interesting. Those who have spent a lot of time doing it and, and you can certainly list a, it’s not a big list, but the list of people who do it, you know, have figured out how to do it well. And I think we can probably make that even broader.

Mel Whittington: So, something that is not boring is your newsletter, the Cost Curve. So, I want to spend some time talking about that. I am a daily avid reader, as I feel every single person I talk to is also a daily avid reader of your newsletter. I did pick up on at the beginning of this podcast, you said you spend the first three hours of the day writing and, I’m filled with jealousy that it’s only taking you three hours to put out one of those newsletters. I’m new to the newsletter game, but it certainly, and I only do one a week, not one per day like you do. And I certainly, it takes me much longer than three hours. So, I’d love to hear from you of like, how did the cost curve, what was the origin of that? What do you think makes it so wildly successful?

Brian Reid: Well, I’m flattered that you think it’s wildly successful.  I mean, at the end of the day, I’m filling, I’m filling a gap that existed, and when I started thinking about this stuff, started writing about this stuff, it’s the publication I wish I had. There’s not a great place, on a daily basis, to see that kind of curation and commentary, and I’m super gratified that there’s a community that’s growing up that goes well beyond Cost Curve of people who are digesting, discussing, hosting conversations about this, you and Bill Sorrell and John O’Brien and Adam Fine, and we’re beginning to get this sense of these are issues that people are out there digesting. They’re tossing back and forth. There’s an intersection with again, the peer reviewed literature. And so, Cost Curve is just trying to be a part of that. Ultimately, it’s a tool for me to make sure that I wake up in the morning and digest what’s out there. And the writing is just a way of kind of clarifying that and making sure that we’re all basing our thinking for the day on the same shared reality and because the honest truth is if you don’t have that, you’ve got a lot of folks who are not necessarily dealing with the most, up to date view of what’s going on. So, my hope is that in having this out there, people can at least have a sense of what they should be thinking about and talking about on any given day.

Mel Whittington: You’re very humble, I will toot your horn of that. I think the content that you cover is so great, but what I take away from your writing, I’ve heard this from others is how you write and how you deliver it is so effective. An example of that as we recently wrote at 88-page best practice report about generalized cost effectiveness analysis, and we’ll get to that here in a little bit. That was an 88-pager. I knew it was getting ready to be published and like how can the Center for Pharmacoeconomics put out something a little bit more digestible that people actually read and so we came up with this two-page methods primer, I was really proud of it. I’m like, “Okay two pages. That’s pretty digestible.” And then I read your newsletter, and you covered the GCEA best practice report. Thank you for that. And you had like one or two paragraphs of the most effectively communicated summary of our report. And I was just like, dang it. That was so much better than what we came up with.

Brian Reid: Well, I have the pressure of like, “Oh my God, I gotta get, I gotta kick something out here so I can get onto my actual real paying client work.” So sometimes, panic is a good motivator for these sorts of things. But I mean, that was a great piece of work. And honestly, if we can kind of turn the compliment cannon back at you, the visual for that, the GCEA visual I think was incredibly compelling and that creates, I think a foundation where you’ve distilled from 88 pages down to two, but really you captured it incredibly well in this one visual. And it’s one of the things my wife asked for Christmas this year was a PowerPoint presentation explaining what I do all day. And so, one of the slides was, you know, hey, look, I helped drug companies explain the value of medicines and to illustrate that I put up the GCEA flower and my wife said, “This is fantastic. Like, why doesn’t everyone use this?” I said, “Well, that’s just it. Like, this is a great product. tool to begin to get into some of those concepts and the ability to go from 88 pages.” And again, it’s not just that 88 pages, it’s years and years and years of kind of research that that is built upon, you know, and to distill that down into that one graphic is, you know, is a skill as well. But the question becomes, and we can talk about this more, is how do you make sure that that idea then gets out into the world more broadly?

Mel Whittington: Right. Yeah. And we’ll spend some time talking about that. And that graphic, I think has, so many people have contributed to making that graphic, what it is. And there’s been a lot of iterations from is for value flower and then no patient left behind created a more updated. graphic, and now we’re continuing to see iterations of that. And I hope we are moving from, all right, now we have our foundation of the science is there. Now let’s actually move this into implementation. Before we talk a little bit more about GCEA and what we hope to do at the Leerink Center for Pharmacoeconomics, you are also recently a senior fellow with the Seaver Group at Tufts Medical Center.

Brian Reid: I’m so thrilled to get to work with you, frankly, and with Peter and Josh and the rest of the crew there. Because again, talk about people who have really focused on the right questions. without fear or favor. I love it that there was a great New York Times op ed a couple of days ago that said in a truly effective advocate, you should agree with 73 percent of the time. If you agree with someone 100 percent of the time, you’re probably just speaking to their preconceived biases. And I think Peter is great because he, everything that comes out of Seaver is something that I think 73 percent of people should agree with, and it’s that additional 27 percent that’s going to provide great conversation and debate that’s going to get us closer. So, I’m just, I’m thrilled to be working with folks who are asking the right questions in the right way.

Mel Whittington: Yeah, I agree. And that was something that drew me to that group as well of, I think that group in particular has done a phenomenal job being open to different opinions, being open to evolving methodologies and kind of developing new methods and following the evidence to figure things out. And I’m honored to be part of that group and I’m so glad that you are part of that group now as well. So, let’s pivot to the Leerink Center for Pharmacoeconomics, because I hope you can help us in ways to achieve our mission. I want us to be effective. And I mentioned at the beginning of this podcast, we want to communicate the impact of healthcare innovations. And we all have a role in paying for healthcare innovation, whether that’s through our taxes or premiums, we are all contributing to the payment of healthcare innovations. And there’s been a lot of critiques around paying for healthcare innovations and some rightly so. I guess I’m coming from the standpoint of if we understand what our money is being used for, could we appreciate health care innovation more? And I think this goes back to what you were saying about the field being so conservative. I think we’ve lost a lot of passion. I think we’ve lost a lot of excitement. And to be honest, I think healthcare innovations are really exciting and can do amazing things. And so, at the Leerink Center for Pharmacoeconomics, we want to add to that dialogue and ideally inspire people to see things that healthcare innovations do for patients, for caregivers, for the health system, for society. And so, you know, when people ask me like, “what do you hope to achieve at CPE?” I’m like, “I want to get people excited about innovation again.” I want when a new drug gets approved for people to be like, “Wow, this is exciting and maybe move less about critiques around pricing and more about like how, wow, we have this new innovation that’s available for folks.” So, my destined to fail here, any tips on helping us communicate and get people passionate about healthcare innovation?

Brian Reid: I mean, the reality is that early on, we’re probably destined to fail because we don’t have a whole lot of experience doing this. There’s not a foundational set of principles or language. Especially for communicating to groups that aren’t necessarily swimming in this soup, whether that’s patients or advocates or policymakers or even to a certain extent, investors, but we’ve got to start somewhere. And I think the issue is that we have basically not made this attempt by and large to tell an innovation story outside of a very narrow scientific context. So, you go to the press room at ASCO, it’s full. People can’t wait to write breakthrough cancers treatment stories. That’s great. We have a wonderful system to talk about scientific innovation. What we don’t have is a system for talking about anything outside of that. If you want to talk about phase three data, that’s great. If you want to talk New England Journal publications, that’s fantastic. But when you start looking at the broader impact of this innovation on society, all of the components that go into GCEA, we start to fall down. So, if you look, we’re spending less per patient to treat heart disease than we were 25 years ago, yet we’re getting substantially better outcomes. That’s absolutely every bit as amazing as something you’ll see at a medical conference. That we as a nation have taken one of the leading killers, made it cheaper to treat and more effective. That’s an incredible magic trick in a system that, a healthcare system that’s just getting more and more expensive and more and more convoluted. But we’ve got these incredible successes. What we don’t have is a good template for talking about them.

Mel Whittington: Why do you think the template doesn’t exist? Is it that a lot of these benefits are so long term and we’re more short-term thinkers? Is it that a lot of the impact happens to other people besides ourselves or why does the template not exist?

Brian Reid: I think the template doesn’t exist in part because, A, it’s hard to figure out who should be telling those stories. Again, if you go to ASCO, it’s very clear who’s pushing, who’s creating those narratives and they’re not illegitimate. But there’s folks who believe it’s their job to tell those stories. When it comes to telling stories about, again, all of the other elements of the value flower, it’s really hard to figure out who owns that. And again, this is why I think the work at Tufts is great. The work you’re doing at Leerink is great. We’re starting to see this contingency of people who believe it’s their job to talk about it. And again, if you roll the tape back five years ago, 10 years ago, there wasn’t anyone really in academia, elsewhere in the ecosystem who said, “you know what? Look, it’s my job to help explain how these innovations have these cascading effects through the health care system.” And I think the number of people who are taking ownership of that and the way that’s changed is a good sign, but the reality is we do not have the infrastructure to tell these stories in the same way there is an infrastructure to tell more traditional scientific innovation, clinical endpoint stories.

Mel Whittington: That’s fair. And I think this goes back to, again, something you mentioned at the beginning of being a little bit more creative. And I think we have followed the status quo or how things have been done and that’s something we want to do here is shake things up a little bit. I think that’s certainly things that you’ve done throughout your career. Shake things up a little bit and say, “well, why not? Why can’t we try? Let’s at least try to tell those stories.” So, I am not trained in communications, and that’s probably abundantly clear. But I am trained in economic modeling, and I love building economic models. My husband didn’t ask for this, but he should have asked for, Christmas an economic model and for me to walk him through how beautiful and absolutely delightful economic models are. I think economic models are very cool tools that are underutilized for storytelling. And economic models can synthesize all sorts of evidence and extrapolate it. And so, you can have this phase three trial that says, “Oh, there’s no significant weight gain.” Well, what does that mean? Well, an economic model can tell you, it can say, “well, this is what it means for heart disease. This is what it means for diabetes. This is what it means for quality of life, patient productivity, caregiver impact.” And I think the storytelling aspect of an economic model has not been implemented in that way. And so that’s something we hope to do is let’s use an economic model to tell a story and so I find that exciting and that’s what we’re trying to accomplish here. I guess I get stuck on the dissemination aspect of it, of okay, I can build this really fun, and pretty and helpful model that extrapolates and synthesizes evidence. But then what do you do with it? Publish it in a peer reviewed journal that nobody even reads or very few people have access to? Release it in a white paper that’s at least publicly available? But do you have advice for us on how we can better communicate and disseminate these findings in a way that all sorts of people can understand and access?

Brian Reid: It’s hard, Mel, to talk about this with you because I think in a lot of ways, you’re doing this right. You’re trying to apply best practices. And I think when you look at the field more holistically, you’re out on one edge of the bell curve and that’s appreciated because I think they’re overlapping, I don’t want to call them points of failure, but let’s call them overlapping missed opportunities. There’s a lot of really good thinking, really good economic modeling, especially that’s coming from industry that never sees the light of day. It informs strategic decision making. It may inform negotiations with business partners. It doesn’t percolate out into, to the ether at all. And so, you’ve got this missed opportunity there where you’ve got this data, you’ve got this information that’s probably going to be important to the broader external debate, but it just never enters the conversation. And then at one level up, you’ve got white papers that are fantastic that begin to check that box of having things out in the public domain, but because they’re not part of the peer reviewed literature, they don’t have quite the same foundational impact, right?  They don’t get built upon, they don’t get cited in Senate reports. They don’t necessarily create their own momentum. And then you’ve got a lot of the, I think what you were talking about, a lot of the really good and thoughtful peer reviewed publications that don’t get the publicity they deserve and what can we do, I think, to amplify the attention there. Is that a matter of doing more social media? Is that a matter of finding the journalists who will talk about it and making sure it gets in front of them? Is that a matter of emailing Brian over a Cost Curve and making sure that he’s going to give you at least two paragraphs? These are the conversations we need to be having because I think it every stage we could level up and make a bigger deal about it. But again, because there’s oftentimes not a communications person at any point in that production cycle there’s probably opportunities to just, again, we don’t need to turn things up to 11, but right now we’re at like two and a half. And if we can get to four, that would be great.

Mel Whittington: Okay, I like that. I like the level up aspect and that’s something that we’re going to try to do. And I am sure I will email you and ask for two paragraphs.

Brian Reid: I am here for it.

Mel Whittington: Okay, one thing you did give two paragraphs to is the GCEA best practices report. So, as you are aware, there’s been a lot of recent methodological advances in the field of economic evaluation. Essentially, more of an emphasis on the broader societal impacts of healthcare treatments rather than the maybe more traditional emphasis on the healthcare system. This expanded framework is often referred to as GCEA or generalized cost effectiveness analysis. It’s gaining some traction. You’ve covered it in your newsletter. We’re trying to implement those best practices here at the Center for Pharmacoeconomics. In your opinion, what place, if any, could GCEA have in the US?

Brian Reid: Oftentimes when I hear about GCEA discussed, it’s very much in this lens of like, “Oh, well, what will payers think? And is this a legitimate way of doing health economics? What about the methodology here or there?” And I feel like that’s taking too narrow a look at it. And of course, I’m coming at this not as a market access guy, not as a health economist, but as a communicator. I think that these are probably good discussions to be had. But again, to get back to that level up phrasing, what can we do to make sure that that GCEA is informing not just that conversation, but I think this this even broader conversation that we had talked about before. So again, when we talk about innovation, it’s usually in this very kind of narrow and clinical, what’s the impact of intervention X on your six-minute walk test or your CDASB Score. And that’s really not necessarily capturing the full impact of a given intervention. And so that’s where GCEA comes in, is it gives us this roadmap as communicators to say, not just what’s the clinical impact, but does this have an impact on caregivers? Does it have an impact on productivity? Is there a value of hope thing? Is there an option value thing? And these are not easy concepts necessarily to explain, but GCEA gives us this opportunity to start looking at those and saying, Is the data there? Is there a way of talking about the way it’s been modeled? That’s going to be informative to a patient, to a provider, to a policymaker who’s trying to decide is this a good deal? So, in a lot of ways, I feel like the structure there might not have been built for communication, but wow, what a resource we have to really begin to look at this as a way of telling those broader stories.

Mel Whittington: I love that. And I’ve certainly heard those reservations as well for innovators and those reservations, they’re all fair, why invest in the evidence for this or why invest in applying this when maybe HTA groups might not look at them or payer negotiations might not might not look at them and there are still some methodological questions about, what threshold should we use or what percent of societal surplus should go to the manufacturer versus society? And all of these things are fabulous questions and noble goals and hard questions. But I think we’re a little bit too far in the weeds and a little bit too focused on how things have been done in the past. And let’s just think about telling a story and let’s think about communicating and let’s thinking about doing things for even purposes beyond HTA negotiations and payer negotiations. And let’s just get people excited about what this drug could do. And so that’s where I see GCEA being kind of an outline to a story of and helping explain what an innovation does. We’ve released a few CPE exclusives, which is where we apply kind of a GCEA framework to a healthcare innovation. And my favorite part of the CPE exclusive is this like, long, very ugly table. I think it’s 24 value elements, and it just tells you, “Hey, here’s the value elements of, you know, household production.” And then we provide a number of, and we think this drug could give you this many more hours of household production. And. I really like that. I get excited about that, of how can we just provide new pieces of evidence to help maybe inform decision making, but also more to just communicate what it might do to take it from a six-minute walk to something that people can actually digest.

Brian Reid: I think that’s exactly right. It starts allowing us to tease out what I think, especially patients really value, because I think that’s often lost, that’s often not baked into traditional HTA because at the end of the day, it’s not necessarily all about the clinical outcomes. There’s a whole lot of other elements here that may be important, but we have not traditionally captured them or tried to explain them. I mean, I love what Meng Li over at Tufts is doing around option value that the reality is if you can just get a little bit more benefit maybe that’s the bridge to the next breakthrough and patients can put a dollar value on “will this get me to the next thing?” And again, maybe that’s really important and maybe it’s not, but until we have the framework for discussing that, we have this lost opportunity to really figure out what’s important to patients because it does not always the stuff that shows up in the NEJM abstract.

Mel Whittington: That’s right. That’s right. I agree completely. And I think that’s the exciting part about GCEA and the best practice report that I’m clearly biased about, but it provides that framework. It moves us from talking about it to let’s actually implement. Let’s get some evidence out there. Let’s get some application out there and let’s talk about it. And so, I hope the field does embrace it and, and thinks about novel ways to embrace it, even beyond the more traditional ways that they may typically think of value demonstration or value assessment. Well, Brian, you’ve been so gracious with your time. I appreciate you. We always end our episodes with one final question, and that is what is the best piece of advice you have ever received?

Brian Reid: So, when I was a freshman in college, they round up everyone and you have to go to convocation where some mid-level Dean gives you a speech on how you should think about college. But it turns out that that this had really, she, her name was Franny Lucas Toucher. I still remember this, even though I remember almost nothing else I learned in college and part of her schtick, I ended up being a freshman residence hall leader for three years. So, I actually heard the same speech four times. One of her points was, you need to go and do everything, you need to see everything you can, you need to read everything you can, you’re only in college once, you really need to experience the broadest range of things. And the kicker was, she said this is a piece of advice that had been given to her by her father, who told her, “you need to go to everything, even if it’s just a monkey dancing on a stick, just go.” So, it’s the monkey dancing on a stick line that’s always stuck with me, but I think that there’s a real sense that following your curiosity, trying to figure out, trying to take in the largest possible swath of stuff, even if it’s just a monkey dancing on a stick. That’s turned out not to be a bad guiding philosophy.

Mel Whittington: I love that. I would love to go see a monkey dancing on a stick.

Brian Reid: To each their own, but uh, but you know, I think, I think the idea, and again, maybe a monkey dance on a stick doesn’t sound that interesting, and you know, quite frankly, maybe figuring out productivity scores doesn’t sound that interesting, but it doesn’t mean it’s, it doesn’t mean it’s not important, and it doesn’t mean that it’s not a worthwhile undertaking, and it’s gotten me to where I am, and it sounds like it’s gotten you to where you are, so uh, not bad advice.

Mel Whittington: Well, I love it. Not bad advice at all. Thank you for sharing that. Before we close, is there anything else that you want to talk about or say in closing? And then if not, if you could tell everyone how we can access the great content you put out, I’d appreciate it.

Brian Reid: So, the social network of choice is LinkedIn. So, it’s Brian Reid on LinkedIn. And then if you want to subscribe to Cost Curve, the easiest way, even easier than remembering URLs, just to Google Brian Reid Cost Curve, and that should pop it right up. as with anything else, the strength of that comes down to the strength of the feedback I get, if I’m wrong, if I’m missing stuff, I really love hearing from folks. If you’ve got something you want to promote, I think to get to your broader point, Mel, if there is something that needs to be inserted out in the universe, you know, I can’t claim to have a giant influential, uh, world changing readership. But I think the more we get things out there, the more we can start a conversation. We don’t have to be big. We just have to start somewhere. So, I am here for your tips and for your promotion and for anything else you need.

Mel Whittington: Oh, Brian, thank you so much. This has been a pleasure. And, uh, I hope everybody subscribes. Although they probably already are already subscribers and, uh, I look forward to your content every day.

Brian Reid: So appreciative that you had me.

Mel Whittington: Thank you.

Thank you for listening to this episode of Perspectives.  If you’re interested in participating in future podcasts or would like to learn more about the Leerink Center for Pharmacoeconomics , please email cpe@medacorp.com.