Briefs

The current federal regulatory process to develop monoclonal antibodies to treat mutating strains of COVID-19 imposes unnecessary hurdles that hinder the creation and approval of effective treatments for the immunocompromised, 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 “Monoclonal antibodies provided benefits to vulnerable populations and six different ones were authorized to treat COVID-19,” said Dr. Wayne Winegarden, director of PRI’s Center for Medical Economics...

SACRAMENTO – Fixing the current broken system that incentivizes pharmacy benefit managers (PBMs) to enact policies that benefit themselves and insurers at the expense of patients would lead to lower patient drug costs, 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 “The current system incentivizes PBMs to implement policies that benefit insurers and themselves, while making drugs less affordable and available,” said Dr. Wayne Winegarden,...

SACRAMENTO – States that had more invasive COVID-19 restrictions saw small reductions in COVID-19 infection and mortality rates, but saw large negative impacts on employment, economic growth, and children’s education 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 “Looking at the data, states with stricter COVID-19 public health policies did see small health benefits from reduced infections and mortality rates – but at the...

Watch as Penny is unhappy that she has to enter the geography bee instead of the science fair due to bureaucratic rules at school. The Professor explores how, much in the same way, eliminating unnecessary barriers can produce a more efficient and productive health care system. To learn more, read the Coverage Denied series at www.medecon.org   https://www.youtube.com/watch?v=RmLoJWQ935M...

Providing cash-based support to the vulnerable to purchase private health insurance would increase access to quality healthcare at roughly the same per enrollee costs as Medicaid programs - 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 to download the brief “Tens of millions are stuck in a flawed government-run healthcare system that provides sub-par care to patients, imposes huge taxpayer costs, and harms the...

DOWNLOAD THE BRIEF   Executive Summary Declining productivity growth in the delivery of healthcare is not innate to the sector. It simply reflects the current policy environment. Incentivizing a more productive and cost-effective healthcare provider sector is possible but requires comprehensive policy reforms that eliminate the obstacles blocking progress. These reforms include: Implementing the insurance reforms discussed in Part 5 that, from a provider perspective, will incentivize the creation of innovative payment models. New payment models create opportunities to better align the incentives...

SACRAMENTO – The broken 340B program, designed to provide affordable care for at-risk patients, creates massive profits for providers without necessarily improving patient health outcomes and should be reformed, finds a new issue brief released today by the Center for Medical Economics and Innovation at the nonpartisan Pacific Research Institute. Click here to download a copy of the brief “The 340B program is growing unsustainably and isn’t improving health outcomes for at-risk patients,” said Dr. Wayne Winegarden, the Center’s director and the...

CLICK HERE TO READ THE BRIEF In addition to the reforms to the health insurance system, which will help address the problems of drug affordability, reforms tailored to the pharmaceutical sector are necessary. These reforms should eliminate drug supply chain inefficiencies and include: fostering a patient-controlled generics market, creating price transparency through reforms that ensure patients directly benefit from all discounts when purchasing their medicines,  fixing the drug formularies’ systemic biases against low-cost medicines, and encouraging contracting innovations that could create...

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...