Price and Costs

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.

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In the Health Policy Podcast episode featuring Wayne Winegarden from the Pacific Research Institute, the discussion centers on the 340B Drug Pricing Program. Winegarden critiques the program's lack of transparency and its unintended consequences, which have led to large hospital systems profiting at the expense of smaller institutions and patients. He advocates for reforms, including improved transparency and a shift in funding models to better serve the intended vulnerable populations. ...

California economist: 'The transparency is nonexistent' in federal 340b drug discount program By A.R. Baird A California healthcare economist is calling for greater transparency in the federal 340B Drug Pricing Program, arguing that lawmakers, taxpayers and even participating hospitals lack sufficient reporting to determine whether billions of dollars in drug discounts are being used as Congress intended. Speaking on the Health Policy Podcast, Wayne Winegarden, senior fellow in business and economics and director of the Center for Medical Economics and Innovation at the...

International drug price comparisons often create more confusion than clarity. One reason: they ignore the large drug access problems that exist in the comparator countries, such as Canada and the U.K. Lost access to drugs raises other health spending and reduces health outcomes. Another fundamental problem is these comparisons rely on U.S. medicines’ gross (or list) price. But list prices do not account for the complex U.S. drug supply chain, where manufacturers receive only a portion of the gross price and...

If a charity organization collected billions of dollars with little evidence that needy people benefited, regulators and the public would quickly demand answers. Yet many large hospital systems participating in the federal 340B Drug Pricing Program are quietly doing just that—extracting billions in drug discounts with scarce oversight and no obligation to prove vulnerable patients benefit.   ...

A new issue brief released by the Center for Medical Economics and Innovation at the nonpartisan Pacific Research Institute finds that innovative drug manufacturers earn some of the lowest risk-adjusted returns in the U.S. health care system, despite making the largest investments in research and development. The findings challenge the central claim used to justify government drug price controls. The brief examines financial data from more than 1,200 publicly traded U.S.-based companies across five major health care sectors between 2022 and...

Recently, PRI President, CEO and Thomas W. Smith Fellow in Health Care Policy Sally C. Pipes was in Fort Worth, TX at the American Legislative Exchange Council (ALEC) 2025 States and Nation Policy Summit for a discussion about the push for drug price controls and themes of her recent book The World’s Medicine Chest (Encounter Books).  The title of her talk was, “Balancing Access, Affordability and Innovation: The Hidden Costs of Drug Price Controls.”  This week, we present the latest post in...

Recently, PRI President, CEO and Thomas W. Smith Fellow in Health Care Policy Sally C. Pipes was in Fort Worth, TX at the American Legislative Exchange Council (ALEC) 2025 States and Nation Policy Summit for a discussion about the push for drug price controls and themes of her recent book The World’s Medicine Chest (Encounter Books).  The title of her talk was, “Balancing Access, Affordability and Innovation: The Hidden Costs of Drug Price Controls.”  This week, we present the latest post in...

Recently, PRI President, CEO and Thomas W. Smith Fellow in Health Care Policy Sally C. Pipes was in Fort Worth, TX at the American Legislative Exchange Council (ALEC) 2025 States and Nation Policy Summit for a discussion about the push for drug price controls and themes of her recent book The World’s Medicine Chest (Encounter Books).  The title of her talk was, “Balancing Access, Affordability and Innovation: The Hidden Costs of Drug Price Controls.”  This week, we present the latest post in...

Recently, PRI President, CEO and Thomas W. Smith Fellow in Health Care Policy Sally C. Pipes was in Fort Worth, TX at the American Legislative Exchange Council (ALEC) 2025 States and Nation Policy Summit for a discussion about the push for drug price controls and themes of her recent book The World’s Medicine Chest (Encounter Books). The title of her talk was, “Balancing Access, Affordability and Innovation: The Hidden Costs of Drug Price Controls.” This week, we begin a series...

Sen. Sanders and President Trump are reading from the same playbook. They are trying to address a real problem – the U.S. spends way too much on healthcare – but their playbook misdiagnoses the causes. Consequently, their cures will only worsen the problem. Whether it is Sanders vilifying pharmaceutical companies or Trump’s emphasis on imposing price controls, they both allege that drug spending is a primary driver of the nation’s rising healthcare costs. Even a cursory look at the data demonstrates...

SACRAMENTO – As California prepares to restrict access to proven private health insurers for dual eligible Medicare and Medi-Cal patients, the Center for Medical Economics and Innovation at the Pacific Research Institute – the nonpartisan, California-based, free market think tank – today released a new brief showing that expanding competition—not imposing new government restrictions—is the best way to lower costs, expand access, and improve patient outcomes. Download the new brief at www.medecon.org “California mistakenly believes that reducing health care choices will save...

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...

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...

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...

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...

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...

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...

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...

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....