Two of the nation's leading advocates for pricing drugs based on value have issued a new menu of cost-control options for policymakers, insurers and healthcare system pharmacists.
Their goal: Force drugmakers to price their products "in alignment with the benefits to patients and sensitive to the potential budget effect on the entire health care system," wrote Dr. Peter Bach of Memorial Sloan Kettering Cancer Center and Dr. Steven Pearson of the Institute for Clinical and Economic Review. The viewpoint appears in the latest issue of JAMA.
Among the steps they say will bring drug prices under control:
- Create more expensive tiers for patient co-payments on overpriced drugs. If the drug price reflects the actual medical benefit as measured by lengthened lives or improved health status, give it a minimal co-pay. If it is higher, give the patient a "large co-insurance burden."
- Set a value price on the drug (not its market price), and then incorporate that amount into the inpatient and outpatient Medicare payments. That will allow hospitals and doctors to either negotiate a fair price or look for cheaper alternatives.
- When a company sets an exorbitant price on a new drug, allow the Food and Drug Administration to give priority review to any company that comes to market with an equal or more effective drug that is priced closer to its true medical value.
- Extend the patent exclusivity period for drugs that are priced based on actual medical value, and shorten the patent life of overpriced drugs.