Price and Costs

Home > Issues  > 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.

October 19, 2026 Price and Costs

Congress should therefore require standardized reporting on 340B revenues and how hospitals use them. Clearer eligibility standards and meaningful charity-care requirements for hospital-affiliated outpatient facilities would help ensure the program serves patients rather than simply enriching providers.   Congress established 340B in 1992 to help safety-net hospitals and clinics stretch their resources. The program requires drug manufacturers to sell outpatient medicines at substantial discounts to eligible facilities, which can bill insurers at higher rates and retain the difference. Participating institutions are expected to...

June 30, 2026 Multimedia, Price and Costs

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. ...

June 30, 2026 Price and Costs

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...

June 22, 2026 Innovation, Policy Proposals, Price and Costs

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...

May 21, 2026 Policy Proposals, Price and Costs

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.   ...

January 20, 2026 Briefs, Price and Costs

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...

December 31, 2025 Blog, Price and Costs

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...

December 24, 2025 Blog, Price and Costs

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...

December 17, 2025 Blog, Price and Costs

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...

December 10, 2025 Blog, Price and Costs

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...

October 8, 2025 Blog, Policy Proposals, Price and Costs

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...

October 1, 2025 Briefs, Policy Proposals, Price and Costs, Studies

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...

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...