Briefs
NEW BRIEF: Broken System Imposes Higher Out-of-Pocket Costs on Patients, Puts Interests of Government and Insurers First
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...
The Flawed Third-Party Payer System Drives the Drug Affordability Problem
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...
The Fundamental Flaws of the Third-Party Payer System
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...
NEW BRIEF: 340B Hospitals More Profitable, Provide Less Charity Care, Receive Unwarranted Subsidies
So-called 340B hospitals whose mission is to help the vulnerable are more profitable and provide less charity care, 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....
NEW BRIEF: U.S. Patients Could Save Up to $5.8 Billion Through Competition from Humira and Enbrel Biosimilars
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...
New PRI Series to Show How Flawed U.S. Health Insurance System Inflates Costs, Decreases Quality and Reduces Health Outcomes
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...
NEW BRIEF: Focus Groups Overwhelmingly Disapprove of Government “Negotiated” Drug Pricing
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...
The Biosimilar Opportunity: Quarterly Update No. 4 – October 2021
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...
NEW BRIEF: Creating Two-Part Drug Pricing System Would Ensure Prices More Accurately Reflect How Patients Value Drugs
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...
ISSUE BRIEF: ICER Analyses Are Flawed, Undervalue Life-Saving Medicines, and Are Biased Toward Price Controls
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...
NEW BRIEF: Tearing Down Drug ‘Rebate Walls’ Would Save Patients, Improve Health Care Outcomes
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...
NEW BRIEF: Counterfeit Drugs Harm Patients, Economy, Innovation
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...
NEW BRIEF: Mandating that Drug Rebates Benefit Consumers Will Help Patients with High Out-of-Pocket Drug 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...
NEW BRIEF: Impact of California’s Surprise Medical Billing Law: Lower Quality Care, Reduced Access, Higher System 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...
NEW BRIEF: Expanding “Buy America” Rules Would Hurt U.S. Patients and Economy, Hinder Development of Coronavirus Vaccine
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...
New Issue Brief: Expanding Biosimilars Use Could Save Patients, Reduce Out-of-Pocket Costs By 17 Percent
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...
New Issue Brief shows that Reforming Supply Chain & Drug Pricing System Will Lower Health Care Costs
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...
New Biosimilars Issue Brief Shows Massive State and Taxpayer Savings Possible by Expanding Biosimilars Market
[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...
New Issue Brief: Increased Use of Biosimilars Could Bring Billions in Savings for Patients, Providers, Taxpayers
Biosimilars have the potential to realize billions in savings for the health care system if reforms are enacted to incent their market share to grow, according to a new issue brief issued today by the Center for Medical Economics and Innovation at the California-based, free-market think tank, the Pacific Research Institute. “Biosimilars are innovative medications that can treat patients at lower costs,” said Dr. Wayne Winegarden, director of PRI’s Center for Medical Economics and Innovation and author of the issue brief. ...