Briefs

SACRAMENTO – Biosimilars competition saves patients and the health care system over $11 billion annually and could generate even more savings if the broken drug pricing system were reformed, finds a new issue brief released today by the Center for Medical Economics and Innovation at the nonpartisan Pacific Research Institute. “Patients living with cancer, autoimmune diseases, osteoporosis, and other illnesses are receiving revolutionary treatment from biologics,” said Dr. Wayne Winegarden, the Center director and the study’s author. “As our research shows,...

CLICK HERE TO READ THE BRIEF Establishing an Efficient Health Insurance Market Cultivating an efficient health insurance market requires reforms that empower patients over payers, which can be achieved by: Making health expenditures and health insurance expenditures tax deductible;  Broadening the availability and usability of tax-free saving accounts to help patients cover the deductibles and out of pocket expenses that could arise should they require costly healthcare services; and Promoting price transparency and insurance competition to enable a more competitive pro-patient healthcare...

America’s broken third-party healthcare payment system prioritizes government and insurance companies as the largest payers, leaving patients with higher out-of-pocket costs, greater exposure to healthcare financial risk, and reduced access to care - finds the latest paper in the Coverage Denied series released today by the Center for Medical Economics and Innovation at the nonpartisan Pacific Research Institute. Click here to read the brief “The healthcare marketplace should prioritize the needs of patients, but our broken third-party payment system caters to insurers...

READ THE REPORT The problem of drug affordability is caused by the perverse incentives created by the third-party payer system that have disempowered patients in favor of insurers and other supply-chain intermediaries. The insurance flaws have created pricing systems that inequitably transfer a disproportionate share of drug costs on to patients. This arrangement inappropriately imposes a drug affordability problem on patients who require expensive medicines. The insurance flaws also incent benefit design policies that create additional affordability burdens and unnecessarily increase...

BY WAYNE WINEGARDEN AND CELINE BOOKIN Part 1 of the Coverage Denied series documented how distortions in the U.S. healthcare system turned the important financial risk management service of health insurance into a barrier to care and an important driver of health care inflation. The insurance industry’s adverse impact on costs is ironic given its current focus on implementing cost control measures.  Unfortunately, the problems of increasing obstacles to care and decreasing health care affordability are the expected outcomes from the current...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...