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.

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...

Influenza — the flu — is more than a bad cold. Seasonal outbreaks mean not only misery but increased hospital admissions and deaths. The last flu season, from October 2018 until May 2019, caused up to 42.9 million illnesses, up to 647,000 hospitalizations and up to 61,200 deaths, according to preliminary numbers from the Centers for Disease Control and Prevention. Those figures are slightly higher than the average over the last decade. What can we expect this year? Australia’s flu season, which...

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[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][vc_empty_space][qode_button_v2 target="_self" font_weight="500" hover_effect="" gradient="no" text="DOWNLOAD THE PDF" link="https://medecon.org/wp-content/uploads/2019/10/BiosimilarSavings_web.pdf" color="#ffffff" hover_color="#ffffff" background_color="#a21e2c" hover_background_color="#000000" font_family="arial"][vc_empty_space height="12px"][vc_column_text]Biosimilars have the opportunity to bring significant savings to state Medicaid programs and consumers with commercial insurance according to a new study released today by Pacific Research Institute. “Every state would experience significant savings in the state Medicaid programs from expanding the use of biosimilars compared to the more expensive originator biologics,” said Dr. Wayne Winegarden, director of PRI’s Center...

When it comes to determining value, the U.S. health care system faces unique challenges. Without a better approach, the twin goals of continued innovation and broad-based drug affordability will be difficult, if not impossible, to maintain. Value assessment models are quickly becoming the approach du jour to overcome these challenges. However, value assessment models suffer from several flaws, but perhaps most importantly, as applied, these models assume that there is one number that accurately portrays the value of a medicine to all patients. Such an...

Much of the medical progress in the past half-century has involved expensive, high-tech diagnostic tests and therapies. But it would be a mistake to gainsay the value of inexpensive, low-tech innovations. Consider the problem of falls, which are both a cause and effect of declining health in the elderly. They are the leading cause of injury-related visits to U.S. emergency rooms and of accidental deaths for Americans over 65. Preventing falls or reducing their impact would help millions of people and...

San Diegans and all Californians will pay a high price should a bill introduced by Assemblyman Jim Wood, a Democrat from Santa Rosa, become law. Proponents claim the bill is necessary to rein in anti-competitive practices by the pharmaceutical industry, but in reality, it will delay generic entry and raise the costs of medicines for Californians. The ostensible rationale for Assembly Bill 824 is to stop “pay-for-delay” tactics. “Pay-for-delay” refers to the practice of patented drug manufacturers paying off generic manufacturers for the sole...

Making medicines more affordable for patients promises to be a top policy priority for Congress when it returns from its August recess. Achieving this goal does not require new, elaborate, government programs or regulations. It requires reforms that will empower biosimilars to more effectively compete against originator biologics. To see why a little background is needed. Consider that the growth in spending on drugs that includes all discounts and rebates grew 3.5% annually between 2009 and 2018 according to IQVIA’s annual review of...

The Trump Administration on July 31 announced steps that could lead to the importation of prescription drugs from Canada, where prices are lower. This strategy is favored by President Trump but has long been opposed by many Republicans. Health and Human Services Secretary Alex Azar said that the policy would enable Americans to “get the benefit of the deals that pharma themselves are striking with other countries.” The fate of this initiative is uncertain after the failure of the administration’s last two proposals...