番茄社区

As part of 番茄社区's occasional series on healthcare clinicians running for office, Washington Editor Joyce Frieden spoke with oncologist Prasanth Reddy, MD, a Republican who is running for a U.S. House seat in Kansas. Reddy's opponent is incumbent Rep. Sharice Davids (D).

The interview, which was conducted via phone with a press person present, has been edited for length and clarity.

Tell us about your background and how you ended up becoming a physician.

Reddy: I was born in South India and immigrated to Manhattan, Kansas with my parents at the age of 5. I knew from a young age the importance of education, and I was always interested in becoming a physician. I had the opportunity to [spend time at] Berkeley and the Lawrence Livermore National Laboratory, and that program kind of sealed the deal for me about my deep interest and desire to understand molecular biology and biotechnology, and how we can use those disciplines to help patients.

After high school, I went to Kansas State University, got a microbiology and psychology dual-major Bachelor of Science degree, and then completed my MD at the University of Kansas Medical School. I went on to do my internal medicine residency there and then a research [fellowship] at the Midwest Veterans' Biomedical Research Foundation, looking at high-risk prostate cancer biology and also prostate cancer imaging, specifically nuclear medicine for PET.

I was convinced I was going to stay in academics, but as it turned out, I finished off my clinical fellowship in hematology and medical oncology -- as well as my master's in public health through the NIH -- and it just didn't quite work out to stay in academics. So I left to join a private practice.

How did you decide to run for Congress?

Reddy: I've always been about service, and so, certainly, medicine is an important way to serve the community. But 9/11 happened, and I was actually in Dallas doing an externship. I asked myself, "What are you going to do about it?" And so I joined the Air Force Reserves and have continued to serve as an Air Force physician for nearly 20 years. I'm a lieutenant colonel and very proud of the service.

And politics is another form of service. Politics has become a dirty word, unfortunately, but political service should be the highest form of public service. And I just want to continue to give back to the community and hopefully contribute to making the world a better place.

How has your healthcare experience qualified you to legislate on healthcare issues?

Reddy: I've had the unique medical history of serving both in academics as well as private practice, and then also in managed care. After 5 years of private practice, I took over the service line leadership for cancer medicine for one of the larger hospital systems in the Kansas City metro area, and I did that for 3 years.

[Later I went] to the Harvard Business School's equivalent of an executive MBA program, and I completed that program over several years. And that led me to going to industry for a handful of years as well. That experience has given me a full view of the entire healthcare ecosystem, from the clinical end to healthcare implementation science, but then also understanding how payers and healthcare systems and pharma biotech fit into that kind of ecosystem, along with providers and patients. Patients are always the core of everything we should be doing.

How do you feel about the proposed cuts to the Medicare Physician Fee Schedule?

Reddy: The Medicare fee schedule -- a chronic issue several decades old -- is a problem, and we need to have a better solution. We need to think about value-based care and how we assess value in healthcare.

There are a lot of ways we can improve the efficiency of healthcare while still innovating, and a lot of that has to start with healthcare implementation science to make sure all those patients are getting the benefit of those innovations that we're smack dab in the middle of.

Can you give an example of the healthcare innovation you're talking about?

Reddy: When I was getting my business school training, I actually took a position at a company called Foundation Medicine, which spun out of Dana-Farber, the Broad Institute, and a venture capital company called Third Rock Ventures. The goal of that company was to ensure that ... we find the right drug for the right patient at the right time using genomics -- to make sure that we're understanding why an individual patient's cancer is behaving like it is, and whether we can use that information to inform prognosis as well as therapy selection. My personal opinion is that personalized and precision medicine is the best way to take care of a patient at the individual level.

OK, and getting back to the Medicare fee schedule, would you vote for a bill to reverse pay cuts to physicians?

Reddy: Yes, I'd be very interested in thinking through how do we not always hurt physicians, and look for other inefficiencies in the healthcare ecosystem, and how do we improve using technology for some of those inefficiencies. When I think about the role of government, it can sometimes get unwieldy, but there are clearly areas where only government can help with solutions through public/private partnerships.

One of those things is, I think the federal government has failed in its ability to increase access to clinical trials no matter where you live. And by having access to clinical trials, you're addressing some of these issues with social determinants of health, whether you live in the state of Kansas or, frankly, anywhere in the country where maybe you can't fly to Mayo Clinic or MD Anderson or Memorial Sloan Kettering or even a regional academic center. So we have to think about these public policies to improve access to medical care in a thoughtful way. And, for me, one of those ways is to increase access to clinical trials.

And what are your thoughts on government regulation of drug prices -- for example, capping Medicare beneficiaries' out-of-pocket costs at $2,000 per year, or capping insulin prices for Medicare beneficiaries at $35 per month? Are these good ideas?

Reddy: Well, like most things in the world, the truth is somewhere in between. And so what is that? Price caps and price controls are going to have an impact on innovation. And so I think we have to be thoughtful.

The biggest costs for payers tend to be end-of-life care and therapeutic costs. If people go on clinical trials, that therapeutic cost gets defrayed back onto pharma. But instead of putting price controls on pharma, [by expanding clinical trials] that innovation pipeline is allowed to be robust, and more patients get access to the best care. And then pharma will recoup some of that by getting more drugs into the marketplace that are actually helping patients.

Now the caveat there is generics, and so if you have a drug that's been in the marketplace for a number of years that already should be off patent, we shouldn't allow loopholes like, say, mode of delivery as being a mechanism to extend patent life.

Speaking of pharma, there was a that discussed your $651,000 in drug company investments, $78,000 in consulting fees from pharmaceutical companies, and the $400,000 you've raised for your campaign from interests aligned with pharmaceutical companies. Does any of that represent a conflict of interest?

Reddy: [Those stock purchase and consulting fee numbers are] somewhat misleading because they weren't over a year, they were over the course of a career. Honestly, that was hard work. One thing that I firmly believe in is that there should never be insider trading -- it doesn't matter who you are. That's the key, ensuring that you're not taking information you shouldn't be having. And from a conflict-of-interest perspective, it should always be about patients and delivering better healthcare both to improve quality of life, and of course morbidity and mortality outcomes.

I believe in healthcare companies, and I believe in innovation. But you should be very careful that you're not making policy decisions based on stock ownership alone, and in almost all of these instances, if you have any material ownership of stock, you have to disclose that.

Speaking of controversies, abortion is another contested issue in the election landscape this year. What are your feelings on abortion?

Reddy: I start where all doctors should start from: a place of empathy. Sometimes these decisions are incredibly challenging, and you should understand that your ultimate responsibility is to the patient.

As it relates to the state of Kansas, the voters here have made their will known with this by continuing to support state law keeping abortion legal, and [in 2022 to outlaw abortion], and I'm fully supportive of that. And at the end of the day, I do believe in exceptions, like rape, incest, and life of the mother.

I believe abortion is a states' rights issue; I don't believe in a national ban -- I would never vote for that. And then lastly, I would say other issues like in vitro fertilization and contraception, which are adjacent issues, I am fully supportive of those.

So would it be fair to say you're pro-life but you believe in some exceptions?

Reddy: That's fair, but again, in the state of Kansas, the voters have made their will clear and I support the will of the voters.

What about the Affordable Care Act? Would you like to see it repealed?

Reddy: I think the current systems in place are inadequate, and we need to think through new solutions. The details around what those solutions should be are unanswered still. And I would like to get into office, fully understand the detailed numbers, and then be able to come back and think through ways that we could use public/private partnership to improve healthcare delivery and other ways we can reduce the overall cost of healthcare, while still maximizing healthcare outcomes to be as positive as they can be.

On a more personal note, is there anything you'd like to tell us about your family and your outside interests?

Reddy: For sure! I'm very blessed -- both my parents are in their 70s. They live with me here. Unfortunately, they both have illnesses, and I help take care of them, and I'm very grateful for what they've done in my life. I also have a sister and a brother-in-law who live in Chicago, and certainly they're an important part of my support system.

As for hobbies, I'm in a clinical fellowship for Complementary and Alternative Medicine run by the University of Arizona and Andrew Weil, MD. I wanted to look at both Western medicine and Eastern medicine not in a vacuum, but I think that there's a lot of untapped potential and ways to improve quality of life, looking at the role of natural therapeutics -- complementing and augmenting what we do in Western medicine in a systematic, thoughtful way, following the scientific method. I think we've undervalued whole body medicine and systems biology for way too long.

It's part of my journey of lifelong learning -- I'm always improving on what I know. And the only way you can do that is to talk to other people, to have dialogue and say, "Wow, I didn't think about it that way." I'm interested in learning for the rest of my life.

Do you know of a non-incumbent physician, nurse, or other clinician who is running for a U.S. House or Senate seat? We would like to interview them! Please email Joyce with the information and we will be in touch.

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