Price and Costs

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On this page, you’ll find the Center’s research on the complex world of pharmaceutical pricing. Our focus will be breaking down current pharmaceutical pricing structures and processes and potential reforms to improve efficiency and innovation; evaluating the impact of regulatory-created inefficiencies such as Pharmacy Benefit Managers (PBMs) and the 340B program; and analyzing how policy proposals such as price controls and drug importation would undermine competition.

July 30, 2025 Innovation, Price and Costs

The flaws driving up costs across the broader health care landscape are also driving up the costs for innovative drugs. After all, pharmaceuticals are an integral component used in combination with the broader healthcare system. As a result, spending on medicines both influences and is influenced by the spending on all other healthcare services. Evaluating the total amount of spending on drugs as a share of total healthcare spending provides important perspective, consequently. As Drug Channels notes, “total net drug spending...

July 23, 2025 Price and Costs

The government explicitly grants innovators temporary market exclusivity to provide an opportunity for groundbreaking pharmaceutical companies to recover the costs of capital associated with developing novel treatments. This was one of the express purposes of past federal reform legislation, such as the Hatch-Waxman Act signed in 1984 and the Biologics Price Competition and Innovation Act of 2009 (BPCIA). The reality that, since 2000 alone, 750 new medicines have been developed, demonstrating that these acts are achieving their stated purpose. The pharmaceutical...

July 16, 2025 Price and Costs

Recently, the Federal Trade Commission (FTC) held its first of three listening sessions on the pharmaceutical market. The goal was to discuss reforms that will improve drug affordability by increasing “generic and biosimilar availability” and promoting “competition”. Achieving these goals is essential. The flaw of the first listening session is its focus on the ill-founded claims of “anticompetitive practices” by incumbent manufacturers. This focus demonstrates an inherent misunderstanding of the strengths and flaws of the current pharmaceutical market. Consequently, it will...

May 27, 2025 Price and Costs

A recent executive order from the Trump administration directs the government to implement policies that will lead to U.S. drug prices being pegged to the lower drug prices available in other developed countries. It's hard to imagine a more destructive plan. Importing foreign price controls on prescription drugs would reduce access to existing treatments for everything from rare diseases to cancer. To understand why, consider two recent pieces by Michael Baker for the American Action Forum's "Reality Check-Up: The Truth About...

May 22, 2025 Blog, Price and Costs

To Improve Drug Affordability Congress Should Fix the Payment System President Trump has issued an Executive Order (EO) demanding that drug prices in the U.S. equal the lowest price among comparable industrialized countries. This EO fails to understand the complex drug payment system and threatens to harm patients. Demanding that drug prices in the U.S. equal overseas prices is akin to demanding that the price of all expensive handbags should equal the prices for the knockoffs that people purchase from street vendors. Of...

May 20, 2025 Blog, Price and Costs

President Trump and former President Biden don't agree on much. But they appear to have found common cause in calling for government price controls on prescription drugs. Patients will pay dearly, as Michael Baker and Douglas Holtz-Eakin explain in two recent pieces for the American Action Forum's "Reality Check-Up: The Truth About Single-Payer Systems. Biden signed the Inflation Reduction Act into law in 2022. It directs the feds to "negotiate" prices for a steadily increasing number of prescription drugs through Medicare. But...

May 7, 2025 Innovation, Issues, Price and Costs

Read comments submitted to the U.S. Department of Commerce by Sally C. Pipes, PRI President, CEO, and Thomas W. Smith Fellow in Health Care Policy, arguing against the imposition of tariffs on pharmaceuticals as part of the Department's examination of pharmaceutical imports and their relevance to U.S. national security interests. Click here to download a copy of Pipes' comments Thank you for inviting public input on the Department's Section 232 examination of pharmaceutical imports and their relevance to U.S. national security interests. As...

April 24, 2025 Issues, Price and Costs

In an interview this month, Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr., appeared open to the idea of Medicare covering drugs like Ozempic and Wegovy for beneficiaries with obesity. "Ideally, over the long term, we’d like to see . . . those drugs available for people after they try other interventions," he said. Delaying coverage of these breakthrough weight-loss medications is not the right approach. Read the entire op-ed here....

April 23, 2025 Issues, Price and Costs

At the top of the new executive order’s priorities for pharma is the pill penalty, which Trump said threatens innovation and favors biologics. Currently, small molecule drugs are eligible for price negotiations sooner than biologics — nine years versus 13 years — and critics have said the law disincentivizes small molecule R&D. The order asks Kennedy to work with Congress to end “the distortion that undermines relative investment in small molecule prescription drugs.” “We’re already seeing it where research is being skewed...

April 22, 2025 Issues, Price and Costs

More than 4 in 5 Americans blame the pharmaceutical industry’s profits for the high prices of prescription drugs. It’s little wonder, then, that roughly the same share supports placing price controls on prescription drugs through Medicare. The logic is straight out of Robin Hood. Our leaders should take from the “rich” drug companies and give to the “poor” patients. Read the op-ed here....

April 2, 2025 Issues, Price and Costs

A new paper by the America First Policy Institute, a think tank with close ties to the Trump administration, has revived the debate over global drug pricing. The paper points out that patients in the United States tend to pay considerably more for brand-name prescription drugs than those in most other wealthy nations. The think tank argues that the Trump administration should find ways to force other countries to pay more for drugs — and thus pick up a more equitable...

March 31, 2025 Issues, Price and Costs

The U.S. Senate last week confirmed former Johns Hopkins surgeon and professor Dr. Marty Makary to lead the Food and Drug Administration. During his confirmation hearing, Makary said his goals for the agency were "more cures and meaningful treatments for Americans." Throughout the hearing, he offered insight on how he would achieve those goals, including leveraging artificial intelligence and making other regulatory changes to streamline the drug review process. That's great news for patients. Read the entire op-ed here....

March 24, 2025 Blog, Innovation, Price and Costs

An analysis by the American First Policy Institute released today correctly notes that the drug price controls most OECD countries impose on innovative medicines jeopardize future innovations. Yet, while correctly diagnosing their high cost, the authors still recommend that price controls should be imposed on U.S. patients. Adopting such a policy will worsen health outcomes while potentially raising overall healthcare spending even more. The cost of capital for developing a new drug is $2.9 billion, including post approval research and development costs. Meanwhile, the...

February 27, 2025 Briefs, Price and Costs, Studies

SACRAMENTO – Nevada taxpayers could face millions in new bureaucratic costs and patients will likely see less access to life-saving drugs if state government mandates so-called “Maximum Fair Price” price controls on prescription drugs, finds a new brief released today by the Center for Medical Economics and Innovation at the nonpartisan, California-based, free-market think tank, the Pacific Research Institute. “Some Nevada lawmakers want to enact government price controls on prescription drugs in the name of lowering costs for patients,” said Dr....

February 5, 2025 Briefs, Innovation, Price and Costs, Studies

READ THE PDF A California appellate court invented out of whole cloth a new and troubling theory of tort liability. Specifically, the court held that drug companies have a duty to develop and bring to market drugs that are supposedly safer and more effective than another, FDA-approved drug the company sells already. The claim rested on factual premises contradicted by all publicly available information, the acceptance of which could seriously disrupt the FDA approval process. This disruption gives rise to an...

January 29, 2025 Issues, Price and Costs

On Jan. 17, just days before leaving office, the Biden administration announced the next 15 prescription drugs dispensed through Medicare Part D that will be subject to price controls on Jan. 1, 2027, under the terms of the Inflation Reduction Act. Among them is the blockbuster semaglutide, a prescription medication sold by Novo Nordisk under the brand names Ozempic, Wegovy, and Rybelsus for the treatment of Type 2 diabetes and obesity. The IRA required the federal government to publish the list...

January 29, 2025 Issues, Price and Costs

On this Wednesday and Thursday, two powerful Senate committees will hold confirmation hearings for Robert F. Kennedy Jr., President Trump's nominee to lead the Department of Health and Human Services. RFK Jr. is no stranger to controversy. But his most radical policy position may be one that relatively few people are talking about. Politico recently reported that RFK Jr. has "expressed openness" to seizing drug companies' patents and relicensing them to generic manufacturers—a move that would effectively implement roundabout price controls on...

January 27, 2025 Issues, Price and Costs

Just three days before President Biden left office, his appointees tried to tie incoming Trump staffers' hands on a health policy decision that affects millions of Americans and tens of billions in federal spending. On January 17, the Centers for Medicare & Medicaid Services announced a new list of 15 drugs under Medicare Part D that will be subjected to price controls under the Inflation Reduction Act on January 1, 2027. The list was announced this month despite the IRA not...

January 24, 2025 Issues, Price and Costs

California State Senator Scott Wiener, D-San Francisco, recently introduced a bill aimed at reining in pharmacy benefit managers (PBMs), the middlemen largely responsible for the dysfunction plaguing our nation’s prescription drug market. Wiener’s effort should attract the support of lawmakers on both the left and right. By cracking down on the activities of PBMs, they can deliver real savings for patients at the pharmacy counter. Read the op-ed here....