Q&A with Faculty Scholar Rachel Sachs

Rachel Sachs, associate professor, School of Law, is a scholar of innovation policy whose work explores the interaction of intellectual property law, food and drug regulation, and health law and identifies potential problems and solutions that lie at the intersection of these fields.

We recently checked in with Professor Sachs to see what she’s currently working on and what thoughts she has regarding the current administration’s efforts to repeal the Affordable Care Act.

Q: Tell us about any public health research you’re currently working on, and anything you have planned for this year.

I am currently working on two sets of projects. The first set focuses on the relationships between different health-related administrative agencies and the ways in which they can work together to promote both innovation in new healthcare technologies and access to those technologies. More specifically, how do – and how can – the National Institutes of Health, Food & Drug Administration, and Centers for Medicare and Medicaid Services work together along these two axes? I have projects exploring these questions more generally as well as applied to particular health technologies.

The second set of projects focuses on new technologies and the ways in which existing law does or does not account for their existence. When a new technology emerges, how does the FDA decide how to regulate it – and does the patent system necessarily reach the same conclusion? What happens when different institutional actors reach different outcomes here?

This year, I am hoping to add some more scholarly work on drug pricing under the first set of projects, considering how the link between FDA approval and CMS reimbursement affects the price of drugs and what, if anything, should be done about it.

Q: What are some of your work highlights/favorite projects? 

It’s hard to pick a favorite project! I’m really passionate about all of the different projects I am working on, and this is an exciting (if busy!) time to be working in these fields.

I do really enjoy the opportunity to present my work in a range of different settings. This past semester, I presented some of my projects at traditional legal scholarship workshops, but I also presented some of my work to economists and to public health scholars. Getting the views of scholars who study these same issues but who have deep expertise in other methodologies is incredibly important to the work that I do, and Wash U has given me a number of opportunities in this area.

Q: Several of your posts/articles of late have focused on President Trump and the Affordable Care Act. What do you see as happening next? 

It is difficult to predict what will happen over the next few months with the Republican party’s effort to repeal the Affordable Care Act. The Senate is now crafting its own bill, which may then need to go back through a conference committee. Repeal is definitely possible, but at this point it is far from certain.

Much more worrisome, though, is the degree of uncertainty the administration is stoking in the individual health insurance markets. Insurers are deciding now whether and how to file their plans for 2018. If they don’t know what the rules of the market will be, both because repeal work is ongoing and because the administration is unwilling to provide clear answers to insurers on a number of ACA requirements, how can we expect them to stay in the markets? Due to this uncertainty, regardless of what happens with repeal, there may be areas of the country without individual insurers in 2018.

Q: Has any of your recent work involved collaboration with other faculty scholars or community partners from other areas of expertise?  If so, how has this multi-disciplinary approach impacted your process/findings?

I have recently collaborated with physicians and economists, and I hope to engage in more collaborations of this type in the future. Much of the research I do in law and policy can benefit greatly from working with physicians, to understand how medical professionals are affected by changes in the law, or with economists, to understand how market forces work with (or against) the law in shaping incentives for innovation. Working with scholars in other disciplines has enriched my work, as I’m able to explore more fully the empirical implications of my work and to consider its effects more broadly. As I’m just finishing my first year here at Wash U, most of my existing collaborations predate my arrival on campus, but I’m looking forward to meeting potential Wash U collaborators going forward.