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.

November 3, 2021 Briefs, Price and Costs

Policies that promote biosimilar competition have the potential to save U.S. patients up to $5.8 billion collectively if biosimilars to Humira and Enbrel grow in market share, finds a new brief released today by the Center for Medical Economics and Innovation at the nonpartisan Pacific Research Institute, a California-based, free-market think tank. Click to download “Generating Drug Savings Through Competition” “The significant savings potential that patients and taxpayers alike would realize from introducing biosimilars to Humira and Enbrel to the U.S. market...

October 21, 2021 Briefs, Price and Costs, Studies

Addressing the ongoing problems with the U.S. health insurance system, the Center for Medical Economics and Innovation at the nonpartisan Pacific Research Institute today announced the release of the first paper in the Coverage Denied series, which will analyze and propose reforms to fix the problems in the current system that threaten patient health outcomes and often lead to huge financial risks for patients facing unexpected or chronic health care challenges. Click to download the first paper in PRI’s Coverage Denied...

October 19, 2021 Briefs, Policy Proposals, Price and Costs, Studies

Today, the Pacific Research Institute published an issue brief revealing overwhelming public disapproval for Medicare reforms that Congress is considering as part of its $3.5 trillion spending bill. Click here to read the full issue brief, "Drug Pricing Proposals Threaten America's Most Vulnerable Patients." "It's a relief that Americans oppose Congress's drug pricing proposals once voters learn the true consequences of these misguided reforms," said Sally C. Pipes, the brief's co-author and PRI president, CEO, and Thomas W. Smith Fellow in Health...

October 5, 2021 Briefs, Industry Trends, Price and Costs

DOWLOAD THE PDF In October 2019, the Center for Medical Economics and Innovation at the Pacific Research Institute 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 approved to compete in nine biologic drug classes in the U.S. and are available in seven of these drug classes currently.  Since 2018, biosimilars’ market share has grown appreciably, see Figure...

August 19, 2021 Price and Costs

"Everyday low prices" are coming to health care. Walmart recently launched its own private-label analog insulin, a synthetic form of the hormone that's been genetically modified to be released rapidly or slowly, depending on a per- son's needs. It will be manufactured by pharmaceutical giant Novo Nordisk – but costs 75% less than brand-name analog insulin. The deal is obviously good for people with diabetes, who have long clamored for more affordable insulin. And Wal- mart and Novo Nordisk wouldn't have...

August 16, 2021 Price and Costs

Imagine you’re in the market for a new car. You go to the dealership, take a few models out for a test drive, and ultimately choose the one that has the features and driving experience you’re looking for. But now imagine that there’s no sticker price. You just tell the salesperson you’ll take it — and silently pray that it’s not too expensive. You’ll find out how much you owe in a few weeks, when the bill comes in the mail. Of...

August 3, 2021 Briefs, Price and Costs, Studies, Value

Establishing a two-part drug pricing system quantifying separate values for a drug’s innovation and production would create an efficient market and a more accurate reflection of how patients value a drug compared to those produced by centralized organizations, argues a new report released today by the Center for Medical Economics and Innovation at the Pacific Research Institute. Click to download “Establishing a Two-Part Drug Pricing System to Promote Value-Based Pricing and Innovation” “Some policymakers assume that only a centralized agency can determine...

May 18, 2021 Price and Costs

Proponents from states such as California, Oregon, and Connecticut all claim that “pay for delay” legislation is necessary to rein in the pharmaceutical industry’s anti-competitive practices. If implemented, the bills will impose a high cost on patients by raising the costs of medicines and delaying generic entry into the market. Pay for delay tactics refers to the practice of patented drug manufacturers paying off generic manufacturers for the sole purpose of delaying the launch of competitive products. When successful, such tactics...

May 16, 2021 Innovation, Issues, Price and Costs

[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_1621192674245{padding-right: 40px !important;}"]DOWNLOAD THE PDF In October 2019, the Center for Medical Economics and Innovation at the Pacific Research Institute 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 approved to compete in nine biologic drug classes in the U.S., and are available in seven of these drug...

March 17, 2021 Briefs, Price and Costs, Studies

A commonly-used analysis to determine a medicine’s value is based on flawed methodologies that would diminish innovation and access, finds a new report released today by the nonpartisan Center for Medical Economics and Innovation at the Pacific Research Institute. “Cost effectiveness reports may provide precise estimates, but there is no reason to believe that these estimates accurately reflect the value of medicines,” said Dr. Wayne Winegarden, the brief’s author.  “The documented biases in their value assessments should raise serious concerns that...

December 9, 2020 Briefs, Price and Costs

Tearing down drug “rebate walls” that increase patient costs and block access to cheaper and often more effective medications would increase competition, lower out-of-pocket costs, and improve health outcomes, finds a new brief released today by the Center for Medical Economics and Innovation at the nonpartisan Pacific Research Institute. Click to download the brief “America’s patients are harmed because they do not benefit from large, fast-growing rebates when purchasing their medicines,” writes the brief’s author, Dr. Wayne Winegarden, director of PRI’s Center...

October 13, 2020 Briefs, Innovation, Price and Costs

A new brief released today by the Center for Medical Economics and Innovation at the nonpartisan Pacific Research Institute shows that counterfeit drugs put patients in harm’s way, hinder drug innovation, and lead to job losses. Proposals like drug importation or price controls, if implemented, would exacerbate the problem and result in more health and economic consequences. Click here to download the brief “Counterfeit drugs expose patients to potentially lethal contaminants, and may also increase public health risks by failing to effectively...

September 29, 2020 Briefs, Price and Costs

A new brief released today by the Center for Medical Economics and Innovation at the Pacific Research Institute found that reforms mandating drug rebates benefit patients rather than payers would lower overall health care costs and help patients with expensive out-of-pocket drug costs. Click here to download the brief “Ironically, the current drug concession system is raising patient costs,” write the briefs authors, Wayne Winegarden and Robert Popovian. “Mandating that all drug concessions must benefit the patients purchasing the medicines is a...

September 3, 2020 Price and Costs

Title: AB 72 brief analyzes impact of medical billing reform law that's had bad consequences for patients and practitioners By Sarah Downey, Northern California Record A new policy brief about the impact of California AB 72 finds that the law – designed to alleviate surprise medical billing – while well-intentioned also has unintended consequences that have increased medical costs and affected quality of care. The Pacific Research Institute (PRI) brief, “The Menace of Medical Rate Setting: The Case of California’s AB 72,” is...

August 26, 2020 Infographics, Multimedia, Price and Costs

As they approach the end of the Drug Pricing Maze, the Professor and Pete explore reforms to fix a broken system and encourage the use of cheaper biosimilars that can help patients and the health care system save big. They also learn what can be done to make very expensive gene therapies that provide a lot of value for patients more affordable and accessible....

August 19, 2020 Briefs, Price and Costs

SAN FRANCISCO – California’s surprise medical billing law (Assembly Bill 72) – which imposes price controls on the rates out-of-network physicians can charge at in-network facilities – is hurting patients with lower quality care, reduced access, and higher health care system costs, finds a new brief released today by the Center for Medical Economics and Innovation at the Pacific Research Institute. Click here to download the brief “California’s surprise medical billing law has created unintended consequences that are increasing healthcare costs and...

August 12, 2020 Infographics, Multimedia, Price and Costs

The Professor and Pete must collect 3 keys to finally escape the drug pricing maze.  The first key involves reforms to increase drug affordability for patients who buy their drugs at a pharmacy.  The Professor shows Pete that these reforms should ensure that prices are transparent, easy to understand, and help patients benefit from the large discounts that are being paid....

July 31, 2020 Issues, Price and Costs

[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_1596236774320{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.,...