Will Cost-Effectiveness Save the Day in the USA?

With the 2016 election campaign season fast approaching, conversations about high and rising pharmaceutical prices are moving to the forefront.  This topic, which has always been part of presidential politics — for those of us old enough to remember — has been supercharged of late by concerns over price gouging and downright greed.

The focus has been on individual medications, such as Daraprim, whose price increased from $13.50 per pill to $750 (Wall Street Journal, September 29, 2015), and the market more generally, with prices increasing by 76% from 2010 through 2014 for the top 30 products (WSJ, October 5, 2015). While some newspaper editorials have pointed to the value of innovation, which price controls will presumably stifle, there is surprisingly little discussion of value-for-money.

The privately-funded Institute for Clinical and Economic Review is playing a key, but perhaps less heralded role, in providing guidance on drug pricing through economic analysis, most notably for the new PKSC9 inhibitors for high cholesterol.  While the ICER methods still need refinement, its more rational, value-based approach to drug pricing is clearly better than arbitrary price controls or delisting drugs from formulary altogether.

Perhaps we’ve finally reached the point where economic analysis and value-based purchasing can supplant hyperbole and help turn down the temperature in an overheated election season.

There’s much more to come between now and next November’s election, so stay tuned, and enjoy our newly rebranded newsletter!

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