Peter Kolchinsky, Managing Partner at RA Capital Management, discusses the long negotiations for drug pricing that stifle early-stage R&D. John LaMattina, former President of Pfizer Global R&D, highlights how the Inflation Reduction Act reshapes pharmaceutical pipelines and investment strategies. They dive into the disparity in price-setting for small versus large molecules, challenges in patient access, and the implications of stricter regulations on innovation. Both guests emphasize the urgent need for reform to maintain balance in affordability and the advancement of medical therapies.