00:00:00
Speaker 1: If you have one family of five that have a genetic disorder that requires a very specialized drug, that family could be a multimillion dollar family on the healthcare side. But there's things in the drug side that we should be paying attention to, and one of them is the role of pharmacy benefit managers and what role they play in driving up the cost of drugs. And joining me now to talk about it the president of Three Access Advisors and a guy who loves to ferret out waste in the drug industry, Antonio Chacia.
00:00:29
Speaker 2: Welcome to the show. Antonio, Hey, great to be with you. Well, first of.
00:00:35
Speaker 1: All, let's start at the very beginning. What is a pharmacy benefit manager and how did they come to be?
00:00:44
Speaker 3: I know your listeners are very excited to learn about what a PBM is. A pharmacy benefit manager. That's what everybody woke up today wanted to know about. In a world of bloated and inflated prescription drug prices, we rely on PBMs as an inner mediary to negotiate on behalf of all of us to essentially drive down the underlying costs of medicines in a world of loaded prices.
00:01:09
Speaker 2: So to start at the very beginning.
00:01:11
Speaker 3: Drug companies have very poor incentives to compete by lowering the actual sticker prices. They sell drugs to wholesalers who have poor incentives to compete on lowering sticker prices, and pharmacies who buy the drugs from wholesalers also have poor incentives to compete by lowering the sticker prices. As a result, we rely on pharmacy benefit managers or PBMs as the intermediary is working on behalf of government programs or employer programs to ultimately negotiate lower costs from medicines.
00:01:42
Speaker 2: So it sounds great, right, Why would there be a problem with.
00:01:45
Speaker 3: PBMs if ultimately they're taking on the bad guys of high drug prices.
00:01:51
Speaker 2: Well, that's where conflicts of interest come in.
00:01:53
Speaker 3: PBMs ultimately use their position in the middle to buy low sell high at every turn. They are large, publicly traded companies, they're Fortune fifty companies, and they are actually larger than the drug companies and the pharmacies they were hired to control.
00:02:12
Speaker 1: How did that happen? I mean that cannot be how it initially started out. So was it just a process of ongoing consolidation in that industry that led us to this place.
00:02:23
Speaker 3: It was largely driven by a few things. First, let's not forget our good friends and government, who, in their never ending wisdom, decided back in the nineties that rather than paying the full list price of drugs, they would demand via law, that they would get discounts off the list prices of drugs.
00:02:42
Speaker 2: Now, I'm sure to a lay person that.
00:02:43
Speaker 3: Sounds great, right, who wouldn't want the government getting bigger discounts on drugs, but understand that a discount essentially means that the list price will be a lie. And so when government demanded to get bigger and bigger rebates than discounts for the medicaid program in the three forty B program, that essentially communicated a law to drug companies, charge whatever prices you want, because we only care about the discounts. Shortly thereafter, PBMs and drug companies got exemptions to federal anti kickback laws, which meant that drug companies could essentially put money in the pockets of PBMs in exchange for the PBMs to prefer the drug company's medicines on the curated list of drugs that are covered under our benefits plans.
00:03:27
Speaker 2: We call it a formulary.
00:03:29
Speaker 3: So Pfizer in this instance, as an example, can pay a bunch of money to Express Scripts a PBM, and in exchange, express Scripts will say, hey, Pfizer, we'll make sure that the patients under all of our benefit plans get your drugs and not somebody else's. That conflict of interest, where the PBM gets paid by the drug company who they're supposed to be controlling, becomes a huge part of the disconnect and why drug prices continue to go up.
00:03:56
Speaker 1: Now, Antonio, I'm just a talk show host, so maybe I'm missing this, but what you're describing sounds awfully like a bribe.
00:04:04
Speaker 3: Well, that's what kickbacks are intended to the prohibitions and kickbacks are intended to be. So if you get an exemption to federal anti kickback laws to do something, well, by definition, that something would otherwise be a kickback if not for the exemption.
00:04:21
Speaker 2: How did that occur?
00:04:22
Speaker 1: I'd love to know who, like Loft, did that legislation and how do you get that pass? Where they're really I mean part of these kind of I admire the just sheer ballsiness of the move when you get right down to it, I mean, as they went and said, yeah, we want to be able to bribe the people that are going to be negotiating the prices on behalf of the government.
00:04:41
Speaker 3: Well, totally, and again government was the original sin here because the second day essentially told drug companies that the list prices don't matter and that the discounts will matter. Well, drug companies had poor incentives to compete by lowering prices. So essentially, if Medicaid and medicare get these big, big discounts and the prices are disconnected from reality, well then everybody in the employer space reasonably says, well, we want discounts too. Well, again, in order to get them, you have to create exemptions to anti kickback laws. So essentially that allowed the drug company to pay off the people we're supposed to be controlling efficient utilization of medicines.
00:05:19
Speaker 1: Okay, so obviously this system is extremely corrupt and broken.
00:05:24
Speaker 2: But how do we fix it?
00:05:26
Speaker 1: Because I mean, do you have an example, By the way, I wanted to ask if there was a specific drug that you knew of that you know that the price had dramatically increased, because it sounds to me that if the government only cares about discounts and I'm selling a drug for one hundred bucks and I'm a drug company, And then I can come back and say, well, the government only cares that I give them thirty percent off the list price. Well, I'm going to charge two hundred bucks to everybody else, and then the government still pays one seventy, right, or a little math is bad, but you get the drift.
00:05:55
Speaker 3: Yeah, you got it right, like, and this is exactly the calculus that drug companies are making. Right, everybody thinks that drug companies are big, bad, villainous creatures, and let's give them credit. Let's say for the sake of this discussion that they are. Well, if the government says we care about the discount, we don't. Necessarily we aren't going to control anything about your price. Well, if I'm a drug company, okay, well I'm just going to raise the price more and more and more in order to make more money. And so, while the government has insulated themselves from those problems with their own mandatory discounts and rebase, employers across the country are left grappling with these bloated and inflated prices without any sort of insulation from them other than using PBMs to negotiate big discounts on their behalf. The PBMs are more than happy to essentially have a captive market because you can't achieve rational pricing and an insurance based world without them. That's why trump Orex is making all these headlines because they're essentially working around the PBMs and insurance companies in order to get the true low list price products from manufacturers to directly to the patients at the pharmacy counter.
00:07:02
Speaker 1: Antonio, we've seen recently with the rise of golp ones exactly what happens when the free market decides when it comes to drug prices. Because insurance companies said, there's no way I'm going to pay twelve hundred bucks in fat America every single month so everybody can lose weight, so they didn't cover them. And what's happened is the price of those drugs has absolutely collapsed over the last three years. How is there any way in the drug market, specifically, when we're talking about drugs that people have to take every month for various conditions for the rest of their lives for us to inject the same sort of free market levers to put pressure on those drugs, Because I think it sounds like that's almost what the PBM was designed to do. But now it's been it's turned into Frankenstein's monster, and it's turned into exactly what it was designed to prevent.
00:07:55
Speaker 3: Yeah, so you know, jlp ones are used for a number of issues, but most specifically diabetes. And so let's look at diabetes and the predecessor to glp ones, insulins.
00:08:06
Speaker 2: You asked for an example of marketplace dysfunction.
00:08:08
Speaker 3: Let's look at insulin, where the list price to the drug and a competitive environment was around four hundred dollars a vial of insulin, but when the manufacturer discounts and rebates and legalized kickbacks are tabulated, the actual amount that drug companies were bringing in was anywhere from thirty five to fifty dollars. So out of a four hundred dollars list priced drug, we're saying that the drug company brought in thirty five to fifty bucks. This is all back by Senate Finance Committee investigations.
00:08:33
Speaker 2: That were released a few years ago.
00:08:34
Speaker 3: So the why is that, Well, because the PDM successfully negotiated massive discounts on those medicines, good for them, but the rub became that they got to take a piece of the action, and they ultimately got to make sure that the patient went up to the pharmacy counter, paid four hundred dollars for that for that insulin, take the three hundred and fifty dollars rebate and not share it with the patient. So we're taking advantage of the patient right under this rebating scheme, requiring them to overpay for the medicine the pharmacy counter to generate a discount that doesn't actually go back to them.
00:09:06
Speaker 1: Oh my god, this is infuriating. This is so infuriating. How do we fix this, Antonio? What has to happen here?
00:09:14
Speaker 2: Well, you just named it.
00:09:15
Speaker 3: The GLP one space is a great example where because you're buying it outside of insurance, manufacturers have to take a more sober approach to the setting of those list prices because if it's not going to be a negotiated amount, that means the manufacturer has to price it all in. We see the same thing happening with generic drugs, where Mark cuban costplus drug company, is saving anywhere from twenty thirty to forty percent on generic drugs relative to the rest of the supply chain.
00:09:45
Speaker 2: So it is not just a PBM problem.
00:09:48
Speaker 3: Understand that it is the PBM in the insurance company and their intersection with the drug companies, wholesalers and pharmacies that results in this unholy stew of garbage where prices go up, up, up up up in order to create more and more discounts. What a GLP one show us, and what Mark Cuban shows us is that if you price it to sell as is, rather than sell it as a starting point for a negotiation, voila low prices arise.
00:10:17
Speaker 1: What is the incentive for any of the people that are currently working this grift to do that.
00:10:23
Speaker 3: Well, that's the challenge, right because what I just said is the entire distribution channel relies on high drug prices, and the government has essentially cemented it as fact and essentially a goal through the direction of their public policy. Lawmakers love saying that they love low prices for drugs.
00:10:40
Speaker 2: Bogus, It's not true.
00:10:42
Speaker 3: What they want our big discounts off increasingly inflated prices. So until we track tackle the pricing problem, then we need to go through the PBM toll booth in order to pay for medicines through our insurance plans. Otherwise we have to disregard our insurance and it essentially waste the premium dollars that we're passing along to insurers and buy our medicines outside of this convoluted and inflated system.
00:11:06
Speaker 1: Why can't we cut out all the middlemen? Why can't the drug? Why can't we have a drug? Let's just say, man Docks is the new drug that just came out, and we're going to charge one hundred bucks for mandocks. We're not going to charge anybody higher. We're not going to charge anybody less. That's how much the drug costs. I mean, why can't we just move to a more direct system. Is it just because there are too many fingers in the pie?
00:11:29
Speaker 3: I think what you're seeing are cracks starting to form, right, And part of this is our own fault as consumers. We are not very good shoppers. We've been We've been essentially primed to buy everything through our insurance, and we assume that when we do so, it will.
00:11:43
Speaker 2: Yield a better price. What we see.
00:11:46
Speaker 3: Time and time again is that insurance is providing massive discounts on high priced products. But again, the second you move outside of that insurance world, low prices actually can beat the negotiator to discounts that insurance is providing Trump RX, Mark Cuban, and some of these more direct consumer programs are relatively new over the last couple of years. So it'd argue that the ground is starting to shake a little bit and the GLP ones are really greasing things a little bit more. I think you're seeing a marketplace that's more responsive or interested in the design that you just laid out.
00:12:25
Speaker 1: Well, I mean, we'll see, but this is so, this is something I've been aware of for a very long time. Before Medicare Party, I worked with a company that helped poor seniors get either access to Canadian drugs or signed up for the free drug programs, and then Obamacare completely blew all that up and killed our pipeline to get Canadian drugs, which are far cheaper because they capped the amount that they can charge in Canada. But it's like, why can't we fix this here, because some of these designer drugs that are one hundred and fifty thousand dollars a year and they're keeping people alive.
00:13:00
Speaker 2: These are not, you.
00:13:01
Speaker 1: Know, unnecessary drugs, but you look at it's like, how in the world can you justify one hundred and fifty thousand dollars a year, and they justify it because no one's actually.
00:13:10
Speaker 2: Paying that.
00:13:13
Speaker 3: Exactly right, Right, They set the list price as a goal.
00:13:17
Speaker 2: Right.
00:13:17
Speaker 3: The list price that the drug company sets is essentially the most that they'll be able to obtain, and it's the starting point for negotiations. So if the government says, hey, we're going to demand that you give let's say, a fifty percent discount on your drug, well, okay, I guess they better double the price to make the money that I would have otherwise.
00:13:34
Speaker 2: Made if I didn't have to give the discount.
00:13:37
Speaker 3: So when I talk about incentives, I mean you have to abandon You cannot have a system of high discounts and low prices simultaneously. You can have a system of low prices and no discounts, but you can't have low prices and big ones.
00:13:53
Speaker 1: Antonio Chachia, thank you for your time today. I really appreciate it. It's infuriating, but I guess it's another thing we all need to know.
00:14:00
Speaker 2: Hey, thanks for having me
Speaker 1: If you have one family of five that have a genetic disorder that requires a very specialized drug, that family could be a multimillion dollar family on the healthcare side. But there's things in the drug side that we should be paying attention to, and one of them is the role of pharmacy benefit managers and what role they play in driving up the cost of drugs. And joining me now to talk about it the president of Three Access Advisors and a guy who loves to ferret out waste in the drug industry, Antonio Chacia.
00:00:29
Speaker 2: Welcome to the show. Antonio, Hey, great to be with you. Well, first of.
00:00:35
Speaker 1: All, let's start at the very beginning. What is a pharmacy benefit manager and how did they come to be?
00:00:44
Speaker 3: I know your listeners are very excited to learn about what a PBM is. A pharmacy benefit manager. That's what everybody woke up today wanted to know about. In a world of bloated and inflated prescription drug prices, we rely on PBMs as an inner mediary to negotiate on behalf of all of us to essentially drive down the underlying costs of medicines in a world of loaded prices.
00:01:09
Speaker 2: So to start at the very beginning.
00:01:11
Speaker 3: Drug companies have very poor incentives to compete by lowering the actual sticker prices. They sell drugs to wholesalers who have poor incentives to compete on lowering sticker prices, and pharmacies who buy the drugs from wholesalers also have poor incentives to compete by lowering the sticker prices. As a result, we rely on pharmacy benefit managers or PBMs as the intermediary is working on behalf of government programs or employer programs to ultimately negotiate lower costs from medicines.
00:01:42
Speaker 2: So it sounds great, right, Why would there be a problem with.
00:01:45
Speaker 3: PBMs if ultimately they're taking on the bad guys of high drug prices.
00:01:51
Speaker 2: Well, that's where conflicts of interest come in.
00:01:53
Speaker 3: PBMs ultimately use their position in the middle to buy low sell high at every turn. They are large, publicly traded companies, they're Fortune fifty companies, and they are actually larger than the drug companies and the pharmacies they were hired to control.
00:02:12
Speaker 1: How did that happen? I mean that cannot be how it initially started out. So was it just a process of ongoing consolidation in that industry that led us to this place.
00:02:23
Speaker 3: It was largely driven by a few things. First, let's not forget our good friends and government, who, in their never ending wisdom, decided back in the nineties that rather than paying the full list price of drugs, they would demand via law, that they would get discounts off the list prices of drugs.
00:02:42
Speaker 2: Now, I'm sure to a lay person that.
00:02:43
Speaker 3: Sounds great, right, who wouldn't want the government getting bigger discounts on drugs, but understand that a discount essentially means that the list price will be a lie. And so when government demanded to get bigger and bigger rebates than discounts for the medicaid program in the three forty B program, that essentially communicated a law to drug companies, charge whatever prices you want, because we only care about the discounts. Shortly thereafter, PBMs and drug companies got exemptions to federal anti kickback laws, which meant that drug companies could essentially put money in the pockets of PBMs in exchange for the PBMs to prefer the drug company's medicines on the curated list of drugs that are covered under our benefits plans.
00:03:27
Speaker 2: We call it a formulary.
00:03:29
Speaker 3: So Pfizer in this instance, as an example, can pay a bunch of money to Express Scripts a PBM, and in exchange, express Scripts will say, hey, Pfizer, we'll make sure that the patients under all of our benefit plans get your drugs and not somebody else's. That conflict of interest, where the PBM gets paid by the drug company who they're supposed to be controlling, becomes a huge part of the disconnect and why drug prices continue to go up.
00:03:56
Speaker 1: Now, Antonio, I'm just a talk show host, so maybe I'm missing this, but what you're describing sounds awfully like a bribe.
00:04:04
Speaker 3: Well, that's what kickbacks are intended to the prohibitions and kickbacks are intended to be. So if you get an exemption to federal anti kickback laws to do something, well, by definition, that something would otherwise be a kickback if not for the exemption.
00:04:21
Speaker 2: How did that occur?
00:04:22
Speaker 1: I'd love to know who, like Loft, did that legislation and how do you get that pass? Where they're really I mean part of these kind of I admire the just sheer ballsiness of the move when you get right down to it, I mean, as they went and said, yeah, we want to be able to bribe the people that are going to be negotiating the prices on behalf of the government.
00:04:41
Speaker 3: Well, totally, and again government was the original sin here because the second day essentially told drug companies that the list prices don't matter and that the discounts will matter. Well, drug companies had poor incentives to compete by lowering prices. So essentially, if Medicaid and medicare get these big, big discounts and the prices are disconnected from reality, well then everybody in the employer space reasonably says, well, we want discounts too. Well, again, in order to get them, you have to create exemptions to anti kickback laws. So essentially that allowed the drug company to pay off the people we're supposed to be controlling efficient utilization of medicines.
00:05:19
Speaker 1: Okay, so obviously this system is extremely corrupt and broken.
00:05:24
Speaker 2: But how do we fix it?
00:05:26
Speaker 1: Because I mean, do you have an example, By the way, I wanted to ask if there was a specific drug that you knew of that you know that the price had dramatically increased, because it sounds to me that if the government only cares about discounts and I'm selling a drug for one hundred bucks and I'm a drug company, And then I can come back and say, well, the government only cares that I give them thirty percent off the list price. Well, I'm going to charge two hundred bucks to everybody else, and then the government still pays one seventy, right, or a little math is bad, but you get the drift.
00:05:55
Speaker 3: Yeah, you got it right, like, and this is exactly the calculus that drug companies are making. Right, everybody thinks that drug companies are big, bad, villainous creatures, and let's give them credit. Let's say for the sake of this discussion that they are. Well, if the government says we care about the discount, we don't. Necessarily we aren't going to control anything about your price. Well, if I'm a drug company, okay, well I'm just going to raise the price more and more and more in order to make more money. And so, while the government has insulated themselves from those problems with their own mandatory discounts and rebase, employers across the country are left grappling with these bloated and inflated prices without any sort of insulation from them other than using PBMs to negotiate big discounts on their behalf. The PBMs are more than happy to essentially have a captive market because you can't achieve rational pricing and an insurance based world without them. That's why trump Orex is making all these headlines because they're essentially working around the PBMs and insurance companies in order to get the true low list price products from manufacturers to directly to the patients at the pharmacy counter.
00:07:02
Speaker 1: Antonio, we've seen recently with the rise of golp ones exactly what happens when the free market decides when it comes to drug prices. Because insurance companies said, there's no way I'm going to pay twelve hundred bucks in fat America every single month so everybody can lose weight, so they didn't cover them. And what's happened is the price of those drugs has absolutely collapsed over the last three years. How is there any way in the drug market, specifically, when we're talking about drugs that people have to take every month for various conditions for the rest of their lives for us to inject the same sort of free market levers to put pressure on those drugs, Because I think it sounds like that's almost what the PBM was designed to do. But now it's been it's turned into Frankenstein's monster, and it's turned into exactly what it was designed to prevent.
00:07:55
Speaker 3: Yeah, so you know, jlp ones are used for a number of issues, but most specifically diabetes. And so let's look at diabetes and the predecessor to glp ones, insulins.
00:08:06
Speaker 2: You asked for an example of marketplace dysfunction.
00:08:08
Speaker 3: Let's look at insulin, where the list price to the drug and a competitive environment was around four hundred dollars a vial of insulin, but when the manufacturer discounts and rebates and legalized kickbacks are tabulated, the actual amount that drug companies were bringing in was anywhere from thirty five to fifty dollars. So out of a four hundred dollars list priced drug, we're saying that the drug company brought in thirty five to fifty bucks. This is all back by Senate Finance Committee investigations.
00:08:33
Speaker 2: That were released a few years ago.
00:08:34
Speaker 3: So the why is that, Well, because the PDM successfully negotiated massive discounts on those medicines, good for them, but the rub became that they got to take a piece of the action, and they ultimately got to make sure that the patient went up to the pharmacy counter, paid four hundred dollars for that for that insulin, take the three hundred and fifty dollars rebate and not share it with the patient. So we're taking advantage of the patient right under this rebating scheme, requiring them to overpay for the medicine the pharmacy counter to generate a discount that doesn't actually go back to them.
00:09:06
Speaker 1: Oh my god, this is infuriating. This is so infuriating. How do we fix this, Antonio? What has to happen here?
00:09:14
Speaker 2: Well, you just named it.
00:09:15
Speaker 3: The GLP one space is a great example where because you're buying it outside of insurance, manufacturers have to take a more sober approach to the setting of those list prices because if it's not going to be a negotiated amount, that means the manufacturer has to price it all in. We see the same thing happening with generic drugs, where Mark cuban costplus drug company, is saving anywhere from twenty thirty to forty percent on generic drugs relative to the rest of the supply chain.
00:09:45
Speaker 2: So it is not just a PBM problem.
00:09:48
Speaker 3: Understand that it is the PBM in the insurance company and their intersection with the drug companies, wholesalers and pharmacies that results in this unholy stew of garbage where prices go up, up, up up up in order to create more and more discounts. What a GLP one show us, and what Mark Cuban shows us is that if you price it to sell as is, rather than sell it as a starting point for a negotiation, voila low prices arise.
00:10:17
Speaker 1: What is the incentive for any of the people that are currently working this grift to do that.
00:10:23
Speaker 3: Well, that's the challenge, right because what I just said is the entire distribution channel relies on high drug prices, and the government has essentially cemented it as fact and essentially a goal through the direction of their public policy. Lawmakers love saying that they love low prices for drugs.
00:10:40
Speaker 2: Bogus, It's not true.
00:10:42
Speaker 3: What they want our big discounts off increasingly inflated prices. So until we track tackle the pricing problem, then we need to go through the PBM toll booth in order to pay for medicines through our insurance plans. Otherwise we have to disregard our insurance and it essentially waste the premium dollars that we're passing along to insurers and buy our medicines outside of this convoluted and inflated system.
00:11:06
Speaker 1: Why can't we cut out all the middlemen? Why can't the drug? Why can't we have a drug? Let's just say, man Docks is the new drug that just came out, and we're going to charge one hundred bucks for mandocks. We're not going to charge anybody higher. We're not going to charge anybody less. That's how much the drug costs. I mean, why can't we just move to a more direct system. Is it just because there are too many fingers in the pie?
00:11:29
Speaker 3: I think what you're seeing are cracks starting to form, right, And part of this is our own fault as consumers. We are not very good shoppers. We've been We've been essentially primed to buy everything through our insurance, and we assume that when we do so, it will.
00:11:43
Speaker 2: Yield a better price. What we see.
00:11:46
Speaker 3: Time and time again is that insurance is providing massive discounts on high priced products. But again, the second you move outside of that insurance world, low prices actually can beat the negotiator to discounts that insurance is providing Trump RX, Mark Cuban, and some of these more direct consumer programs are relatively new over the last couple of years. So it'd argue that the ground is starting to shake a little bit and the GLP ones are really greasing things a little bit more. I think you're seeing a marketplace that's more responsive or interested in the design that you just laid out.
00:12:25
Speaker 1: Well, I mean, we'll see, but this is so, this is something I've been aware of for a very long time. Before Medicare Party, I worked with a company that helped poor seniors get either access to Canadian drugs or signed up for the free drug programs, and then Obamacare completely blew all that up and killed our pipeline to get Canadian drugs, which are far cheaper because they capped the amount that they can charge in Canada. But it's like, why can't we fix this here, because some of these designer drugs that are one hundred and fifty thousand dollars a year and they're keeping people alive.
00:13:00
Speaker 2: These are not, you.
00:13:01
Speaker 1: Know, unnecessary drugs, but you look at it's like, how in the world can you justify one hundred and fifty thousand dollars a year, and they justify it because no one's actually.
00:13:10
Speaker 2: Paying that.
00:13:13
Speaker 3: Exactly right, Right, They set the list price as a goal.
00:13:17
Speaker 2: Right.
00:13:17
Speaker 3: The list price that the drug company sets is essentially the most that they'll be able to obtain, and it's the starting point for negotiations. So if the government says, hey, we're going to demand that you give let's say, a fifty percent discount on your drug, well, okay, I guess they better double the price to make the money that I would have otherwise.
00:13:34
Speaker 2: Made if I didn't have to give the discount.
00:13:37
Speaker 3: So when I talk about incentives, I mean you have to abandon You cannot have a system of high discounts and low prices simultaneously. You can have a system of low prices and no discounts, but you can't have low prices and big ones.
00:13:53
Speaker 1: Antonio Chachia, thank you for your time today. I really appreciate it. It's infuriating, but I guess it's another thing we all need to know.
00:14:00
Speaker 2: Hey, thanks for having me