RealTalk MS – Episode 437: Remembering David Mitchell

Host: Jon Strum
Date: January 12, 2026

Brief Overview

This episode of RealTalk MS is dedicated to remembering David Mitchell, founder of Patients for Affordable Drugs, a passionate advocate for lowering prescription medication prices in the United States. Jon Strum recaps recent developments in MS research, highlights how artificial intelligence and telehealth are transforming care, and then shares a moving interview with David Mitchell from 2018 to honor his legacy following his recent passing.

Key Discussion Points & Insights

1. Progress in MS Research: Pathways to Cures (00:28–05:39)

• Pathways to Cures Roadmap Update:
  • Three Pathways in MS Research:
    • STOP: Halt disease activity from the point of diagnosis
    • RESTORE: Repair damage to the central nervous system and regain lost functions
    • END: Prevent new cases of MS
  • Quote:
    “The STOP pathway is focused on halting disease activity from the point that an individual is diagnosed with MS. The RESTORE pathway is about repairing the damage... and the END pathway is dedicated to preventing new cases of MS.” – Jon Strum (00:40)
• Recent Funding Review:
  • Out of 2,346 MS projects funded globally, only 6% focused on prevention.
• International Workshop:
  • Sponsored by MS Canada and MS Australia in 2024 to develop a global research agenda for MS prevention.
• Research Paper:
  • Emphasizes timing in prevention:
    • Primary Prevention: Addressing modifiable risk factors like obesity and smoking, and preventing Epstein-Barr virus.
    • Secondary Prevention: Early detection and intervention before clinical symptoms develop.
  • Next steps include improved biomarkers and cost-effective screening.

2. The Rise of Artificial Intelligence in Healthcare (05:45–10:00)

• AI’s Role in MS:
  • Tools like ChatGPT now detect MS subtypes and support clinicians.
• Public Use of AI:
  • 40+ million people ask ChatGPT health questions daily; 60% of Americans have used AI for health queries in the past 90 days.
  • Quote:
    “Nearly one in three Americans said they would delay or avoid seeing a doctor if an AI tool labeled their symptoms as low risk.” – Jon Strum (07:29)
• AI and Health Equity:
  • AI tools offer key support in “hospital deserts” (rural areas far from hospitals).
• Health Insurance Questions & Parity:
  • Millions use AI to navigate insurance issues while insurers themselves use AI to approve/deny claims.
• Launch of ChatGPT Health:
  • Securely connects with medical records for personalized responses—“the launch of a new era in healthcare.”

3. Telehealth Policy & Access (10:00–13:00)

• Pandemic’s Silver Lining:
  • Huge surge in telehealth usage among Medicare enrollees and beyond during COVID-19.
• Benefits for the MS Community:
  • Increases access, reduces no-shows, vital for rural patients.
• Pending Legislation:
  • Telehealth waivers are set to expire; the AMA urges Congress to make these expansions permanent.
  • Quote:
    “Telehealth has virtually erased these obstacles.” – Jon Strum (12:30)
• Persistent Challenge:
  • High cost of MS medications—“obscenely high,” including older drugs.

Remembering David Mitchell: Advocacy for Affordable Medications

Introduction to David Mitchell (13:49–14:39)

• Diagnosed with multiple myeloma, drug regimen costs $450,000 per year.
• Founder and president of Patients for Affordable Drugs—accepts no funding from the pharma industry.

Notable Quote:

“For drugs to be fully effective, people have to be able to afford them.”
— Jon Strum (13:52)

David Mitchell Interview Highlights

Why the Fight? (14:51–15:51)

• Personal experience with prohibitively high drug prices inspired founding the organization.
• Saw a gap: very few patient groups advocating for lower drug prices.
• Quote:
  “The experience of fighting the cancer and doing it through these expensive drugs was really searing for me.” – David Mitchell (14:54)

The Scale of the Problem (15:51–16:30)

• Healthcare costs for MS patients nearly doubled from 2006–2015; rising drug pricing is the biggest cause.
• Example: MS drugs went from $16,000 (2004) to $84,000 (2017).
• Systemic issue: “The whole system is set up to benefit the people who make money on it...” (16:48)

Solutions: Policy & Advocacy (16:30–18:35)

• Let Medicare Negotiate Drug Prices:
  • “We’re the only developed country that doesn’t negotiate directly with drug companies.”
  • This would ripple across the system and lower prices—first, critical step.

State vs. Federal Action (18:35–20:14)

• States are enacting drug price transparency bills; more activity at state than federal level.
• Acknowledges these aren’t a complete solution but important progress.

Legal & Political Obstacles (20:14–22:35)

• Pharmaceutical industry uses their financial clout to challenge reforms.
• Recent Supreme Court decision (Oil States) upheld consumers' ability to challenge weak patents—incremental wins can add up.
• Quote:
  “It’s a Long March. There’s no doubt about that.” – David Mitchell (20:42)

The Power of Advocacy (22:35–24:50)

• Pharma spent $3.5 billion on lobbying in two decades—“They spend more on lobbying than any other industry in the world.” (22:35)
• Success requires collective voices and votes; major patient and consumer groups are uniting.

How to Get Involved (24:50–27:02)

• PatientsForAffordableDrugs.org:
  • Share your story—stories are critical tools for policy change.
  • No donation required—focus is on amplifying patients' real experiences.

Memorable Moment (Final Thanks) (27:28)

• Quote:
  “Your leadership and its impact extends beyond the multiple sclerosis community because you’re a voice that is speaking out in a way that will help all of us.” – David Mitchell to Jon Strum (27:28)

Notable Quotes (with Timestamps)

• “For drugs to be fully effective, people have to be able to afford them.”
  — Jon Strum (13:52)
• “The experience of fighting the cancer and doing it through these expensive drugs was really searing for me.”
  — David Mitchell (14:54)
• “The whole system is set up to benefit the people who make money on it.”
  — David Mitchell (16:48)
• “It’s a Long March. There’s no doubt about that.”
  — David Mitchell (20:42)
• “They spend more on lobbying than any other industry in the world.”
  — Jon Strum (22:35)
• “The way we beat them, I honestly believe, is with our voices and our votes.”
  — David Mitchell (23:57)
• “Telehealth has virtually erased these obstacles.”
  — Jon Strum (12:30)
• “Your leadership and its impact extends beyond the multiple sclerosis community because you’re a voice that is speaking out in a way that will help all of us.”
  — David Mitchell (27:28)

Important Segment Timestamps

• Pathways to Cures and Prevention Focus – 00:28–05:39
• AI in MS Care & ChatGPT Health – 05:45–10:00
• Telehealth Access & Pending Legislation – 10:00–13:00
• Remembering David Mitchell & Interview – 13:49–27:49

Summary & Reflection

This episode blends the latest MS research developments—especially the shift toward prevention—with timely discussion of how emerging technologies (like AI and telehealth) are reshaping patient care. Most powerfully, it pays tribute to David Mitchell’s tireless advocacy for affordable medications. Through the replayed interview, listeners are reminded that the struggle for access, innovation, and justice in health care is not only ongoing, but deeply personal for millions. Mitchell’s advice to mobilize, share stories, and demand accountability offers a concrete call to action for all affected by chronic diseases like MS.

Resources and links mentioned throughout the episode are available in the show notes at realtalkms.com/437.