Quantifying the Wrong Value: Pete continues to have questions about drug pricing – especially ICER’s work in determining a medication’s value. Watch as the Professor shows Pete that there is a lot of value in the medication he takes because it makes him feels better. He also points out the many flaws in ICER’s analyses.
As they approach the end of the Drug Pricing Maze, the Professor and Pete explore reforms to fix a broken system and encourage the use of cheaper biosimilars that can help patients and the health care system save big. They also learn what can be done to make very expensive gene therapies that provide a lot of value for patients more affordable and accessible.
The Professor and Pete must collect 3 keys to finally escape the drug pricing maze. The first key involves reforms to increase drug affordability for patients who buy their drugs at a pharmacy. The Professor shows Pete that these reforms should ensure that prices are transparent, easy to understand, and help patients benefit from the large discounts that are being paid.
The Professor explains to Pete that some of the claims that he’s heard on TV about drug price controls are just spin. He shows Pete that whatever name you call them, drug price controls will reduce innovation and threaten people’s access to life-saving medicines.
The Professor and Pete go to the movies to learn why there is a drug affordability problem. After watching a scary thriller about list prices and net prices, an adventure on the prescription escalator, and a movie on biosimilars, they learn that a) specific patient populations are impacted by the drug affordability problem; and b) these issues can be fixed with targeted reforms to achieve innovation and affordability.
The Professor and Pete learn how infusion drugs – drugs that you have to go to a doctor’s office, clinic or hospital to take – are sold and how the complex pricing environment encourages the use of higher cost drugs rather than lower cost alternatives like biosimilars.
The Professor and Pete reach the most difficult part of their journey: understanding how medicines are sold. It’s a complex system that hurts patients and at times exposes them to paying excessive costs. They also learn that patients who get their prescriptions from a pharmacy don’t really benefit from drug discounts negotiated by pharmacy benefit managers (PBMs) – only PBMs and insurers do.
Sage the Detective Dog digs up clues on biologics and gene therapies – drugs that offer tremendous value for patients but are some of the most expensive drugs. Along the way, the Professor and Pete Paystoomuch learn that there are many distinct challenges to develop markets for competition and lower drug costs for each unique class of drug.
Listen to Dr. Henry Miller, PRI senior fellow in health studies, discuss the move by the WHO to pause hydroxychloroquine trials for Coronavirus treatment on the nationally-syndicated Lars Larson Show.
Prof. Salvare and Pete Paystoomuch join Sage the Detective Dog in searching the Drug Pricing Maze for clues about why drug prices are so different. Along the way, they learn that drug prices vary because there are so many different types of drugs, and how we make orphan drugs that treat patients with rare diseases affordable and accessible.
Professor Salvare and Pete Paystoomuch watch government, the private sector, universities, and foundations pass the baton in a research relay race that is ultimately anchored by private companies that finish the race to develop new medicines that treat illnesses and create cures for devastating diseases.