Studies

Home > Resources  > Studies

January 7, 2025 Briefs, Innovation, Price and Costs, Studies

READ THE PDF Executive Summary Reforms that will strengthen the biosimilar market and expand savings opportunities include: Reforming (ideally repealing) the Inflation Reduction Act’s price control measures. Improving the incentives underlying the current buy-and-bill system to better align the financial incentives of providers, payers, and patients. Promoting greater transparency to the opaque drug rebating system including addressing the rebate wall problem through comprehensive reform or prohibiting the anti-competitive rebating practices that are generally outlawed in other markets. Given biosimilars’ demonstrated ability to...

December 2, 2024 Briefs, Innovation, Price and Costs, Studies

READ THE PDF Executive Summary The Inflation Reduction Act’s price controls discourage biosimilar development. Payment system inefficiencies, such as the buy-and-bill payment system and rebate walls, disincentivize the use of lower cost biosimilars. Despite the savings biosimilars have already enabled, there are barriers to further progress. First, the price controls from the Inflation Reduction Act (IRA) disincentivize biosimilar development. Second, the convoluted pricing system discourages greater use of lower cost alternatives. How the payment system disincentivizes their use varies depending on whether...

October 28, 2024 Briefs, Innovation, Price and Costs, Studies

READ THE PDF Executive Summary Since 2019, biosimilars have obtained a majority share of most markets where they compete. The combination of lower prices (both biosimilar and originator) and rising market share could have generated up to $35 billion in savings in 2024 dollars compared to an all-originator baseline based on PRI’s latest analysis. These savings demonstrate that, just like with small molecule medicines, biosimilars strike a beneficial balance between incentivizing innovation and promoting affordability. Lower-cost Biosimilars Are Gaining Market Share The share...

October 1, 2024 Briefs, Innovation, Studies

READ THE PDF Executive Summary In the competitive biologic markets, biosimilars have reduced average prices by 56 percent. The lower prices have reduced total expenditures by 51 percent in the competitive biologic markets even though total use is higher. Developing biosimilars is a long and costly endeavor that can take up to 9 years and $300 million. Market conditions should encourage uptake and appropriate reimbursement for physicians and manufacturers. Biologics – innovative medicines made, or derived, from biological processes – treat devastating...

July 25, 2024 Briefs, Studies

SACRAMENTO – A new brief released today by the Center for Medical Economics and Innovation at the nonpartisan Pacific Research Institute finds that artificially low reimbursement rates used by Medicare to contain costs are threatening patient care, and reform is needed to prevent future doctor shortages. Click to download the brief “Price controls used by government-run health care systems globally to contain costs lead to delays, lower quality, and worse health outcomes,” said Dr. Wayne Winegarden, director of PRI’s Center for Medical...

June 11, 2024 Briefs, Innovation, Resources, Studies

A new brief released today by the Center for Medical Economics and Innovation at the nonpartisan Pacific Research Institute provides the latest evidence that biosimilar competition is saving patients billions – and additional competition would increase savings even more. Click to download the brief From 2019-2023, patients saved $15 billion from biosimilar competition.  Had there been competition during the same period for two other biologics, Humira and Enbrel, patients would have saved another $13 billion, for a total of $28 billion. “The growing...

February 7, 2024 Briefs, Studies

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,...

September 26, 2023 Briefs, Coronavirus-Alternate2, Issues, Resources, Studies

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...

August 28, 2023 Multimedia, Studies

Watch as the Professor buys a bike for Penny to show how the broken health care payment system hurts Medicare patients. They explore that by creating a support program based on income, we can help Medicare patients buy private insurance instead of being stuck with poor government care. READ THE STUDY   https://www.youtube.com/watch?v=rvlwyvVGcNY...

August 4, 2023 Briefs, Multimedia, Studies

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...

June 20, 2023 Briefs, Studies

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...

January 4, 2023 Briefs, Studies

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...

November 16, 2022 Briefs, Price and Costs, Studies

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...

October 10, 2022 Briefs, Price and Costs, Studies

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...

August 22, 2022 Briefs, Industry Trends, Price and Costs, Studies

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,...

July 25, 2022 Briefs, Price and Costs, Studies

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...

April 28, 2022 Briefs, Price and Costs, Studies

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...

March 1, 2022 Briefs, Policy Proposals, Price and Costs, Studies

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...