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.

 The Professor and Pete reach the most difficult part of their journey: understanding how medicines are sold. It’s a complex system that hurts patients and at times exposes them to paying excessive costs. They also learn that patients who get their prescriptions from a pharmacy don’t really benefit from drug discounts negotiated by pharmacy benefit managers (PBMs) – only PBMs and insurers do....

[vc_row css_animation="" row_type="row" use_row_as_full_screen_section="no" type="full_width" angled_section="no" text_align="left" background_image_as_pattern="without_pattern"][vc_column width="2/3"][vc_column_text css=".vc_custom_1590107672986{padding-right: 40px !important;}"]DOWNLOAD THE PDF In October 2019, the Center for Medical Economics and Innovation at the Pacific Research Institute, under the direction of Dr. Wayne Winegarden, released its second study documenting the savings potential enabled by biosimilars. Biosimilars are medicines manufactured in, or derived from, biological sources that are developed to be similar to FDA-approved reference products. Biosimilars are only approved to compete in nine biologic drug classes in the U.S....

There they go again. In the midst of the race for an effective COVID-19 treatment the Institute for Clinical and Economic Review (ICER) has performed an incomplete analysis of remdesivir in order to produce a cost estimate that is, by definition, precisely wrong. Remdesivir, produced by Gilead Sciences Inc., is an experimental antiviral medication that did not work as hoped to treat Hepatitis C, but is showing promise as a treatment for viruses such as SARS and COVID-19. If ICER’s analysis were...

Expanding “Buy America” rules for prescription drugs and medical supplies would reduce patient access to drugs and further damage the economy, finds a new issue brief released today by the Center for Medical Economics and Innovation at the Pacific Research Institute. Click here to download the brief “As the U.S. fights the coronavirus, policymakers must ensure that life-saving drugs are readily available to America’s patients,” said Sally Pipes, PRI President, CEO, and Thomas W. Smith Fellow in Health Care Studies and the...

SAN FRANCISCO – As prescription drug pricing and accessibility has become a greater topic of discussion during the current coronavirus pandemic, a new series of animated videos launched today by the Center for Medical Economics and Innovation at the Pacific Research Institute aims to guide Americans through the “drug pricing maze”. The new series will educate viewers on how the current drug pricing system is fueled by misguided policies that drive up costs, and how free-market reforms would steer us toward...

Expanding the use of biosimilars to treat serious illnesses like cancer or auto-immune diseases could reduce a patient’s out-of-pocket costs by 17 percent, finds a new issue brief released today by the Center for Medical Economics and Innovation at the Pacific Research Institute. Click here to download the study “Biologics effectively treat very serious illnesses but can often be very expensive and lead to patients incurring significant out-of-pocket costs,” said Dr. Wayne Winegarden, director of PRI’s Center for Medical Economics and Innovation...

Swiss drugmaker Novartis recently launched a lottery-style program to allocate free doses of Zolgensma, its groundbreaking treatment for children with spinal muscular atrophy (SMA), to patients in countries that haven't approved the drug. But with a $2.1 million price tag, Zolgensma is inaccessible to some patients even where it has been approved. The prohibitive cost has been a source of criticism since the drug was approved. In a letter to the U.S. Food and Drug Administration's (FDA) Acting Commissioner last August, five U.S. senators, including presidential...

Trump administration officials keep searching for solutions to rising prescription drug prices, which are increasing faster than inflation. “Drug makers and companies are not living up to their commitments on pricing. Not being fair to the consumer, or to our Country!” President Donald Trump tweeted last year. However, it’s hard to know what “fair” prices are. After all, pharmaceutical research and development is expensive and high risk. Bringing a drug to market may take 10 or more years and costs, on average, more than $2.5...

Drug supply chain, pricing system reforms will slash healthcare costs, says PRI By Jeff Lagasse As the Trump administration pushes for price caps and government controls to address prescription drug prices, a new issue brief released by the Center for Medical Economics and Innovation at the Pacific Research Institute contends that reforming the complex drug supply chain and ending the current drug pricing system that overcharges patients – along with systemwide reforms – are what's needed to lower America's healthcare costs. Many proposals have been...

Twenty-five years ago, the leading cause of death for adults between the ages of 25 and 44 was complications from HIV. At the time, 50,000 Americans were dying from AIDS-related causes a year, with the African American community particularly hard hit – 49 percent of the people dying from AIDS-related deaths were African Americans. Today, thanks to highly active antiretroviral therapies (HAART), along with other medical advances, people with HIV like basketball great Magic Johnson are living longer and healthier lives. And,...

As each new year begins, the increases in the list prices of drugs are announced. And, following these announcements, the political class complains that something must be done. This year, following the price announcements, Speaker Nancy Pelosi tweeted “Enough is enough” while Senator Grassley emphasized that a “call to action” on drug prices is needed. Undoubtedly, there are real problems. Unfortunately, the politicians seem more interested in espousing simple talking points rather than effective actions that would simultaneously promote innovation and...

As Washington pushes for price caps and government controls to address prescription drug prices, a new issue brief released today by the Center for Medical Economics and Innovation at the Pacific Research Institute argues that reforming the complex drug supply chain and ending the current drug pricing system that overcharges patients – along with system-wide reforms – are what’s needed to lower America’s health care costs. “Politicians are promoting drug price caps and increased regulation in a futile attempt to increase...

Biosimilars could generate savings of about $116 million in New Jersey annually—including the state’s Medicaid program and patients with commercial insurance, according to a new issue brief by the Center for Medical Economics and Innovation at the Pacific Research Institute. Nationwide, those annual savings could reach $7 billion. PRI is a San Francisco-based free-market think tank. “We broke it down so you can look at it by state total and then breakout how much is for Medicaid which is directly applicable...

“Three hundred forty-five billion dollars in savings versus the cost of eight to 15 fewer drugs over 10 years, I frankly think it’s worth it.” Rep. Darren Soto (D-FL), hearing before the House Energy and Commerce Committee In the above quote, Representative Soto is defending H.R. 3, the drug price control bill Speaker Nancy Pelosi is advocating. While the Congressman believes that the costs of price controls are “worth it”, patients living with diseases that lack an effective treatment may disagree. While there has...

Despite their abysmal track record, government solutions are back in vogue. Ostensibly, government’s scale, leverage, and freedom from profit will unlock potential health care savings that are beyond the reach of the private sector. At their most extreme, reforms such as “Medicare for all” call for a complete government takeover of the health care system. Proponents of single payer reforms claim that only a complete government takeover of the health care sector can eliminate the health care sector’s inefficiencies and ensure 100 percent...