The Right Price A Value-Based Prescription for Drug Costs

The US prescription drug business is a $500 billion industry whose rising prices carry profound consequences for patients, caregivers, employers and taxpayers across the nation. In the United States, average prices of leading brand-name drugs are two to four times higher than prices charged in other wealthy countries, raising questions as to what Americans are getting for the extra expense. On the other hand, healthy industry returns have arguably fueled life-saving innovation. With the advent of ever more targeted and powerful treatments, including cell- and gene-based therapies with multi-million-dollar price tags, the need for sensible drug pricing policies will only intensify.

The Right Price sheds light on the controversial topic of drug pricing by providing an accessible guide on pharmaceutical markets and analytic techniques used to measure the value of drug therapies. It illustrates the need for value-based pricing through real-life stories of patients and their experiences with the drug industry, and explains why simple solutions like price controls and the importation of cheaper drugs from other countries will not work. This volume describes how researchers and policy makers have pursued drug valuation efforts in the past, and lays out a series of recommendations, based on years of shared author experience serving on national drug policy platforms, for how to further improve pharmaceutical value assessment in the United States.

With unique industry insights and clear narrative, The Right Price unveils why the pricing of drugs continues to be so challenging and how public and private officials can create more informed policies to achieve the right balance between drug pricing and value.

Peter J. Neumann, ScD, is Director of the Center for the Evaluation of Value and Risk in Health (CEVR) at the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center, and Professor of Medicine at Tufts University School of Medicine. Dr. Neumann is also a member of the editorial advisory board of Health Affairs and the health policy advisory board for the Congressional Budget Office.

Joshua T. Cohen, PhD, is Deputy Director of the Center for the Evaluation of Value and Risk in Health (CEVR) at the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center, and Research Associate Professor of Medicine at Tufts University School of Medicine.

Daniel A. Ollendorf, PhD, is Director of Value Measurement and Global Health Initiatives at the Center for the Evaluation of Value and Risk in Health (CEVR) at the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center, and Research Assistant Professor of Medicine at Tufts University School of Medicine. Prior to joining CEVR, he spent ten years as the Chief Scientific Officer for the Institute for Clinical and Economic Review (ICER).

Acknowledgments
Preface

PART 1: THE ECONOMICS OF PRESCRIPTION DRUGS

Chapter 1: Introduction
Chapter 2: The prescription drug market
Chapter 3: Proposed solutions for rising drug prices
Chapter 4: Measuring the value of prescription drugs

PART 2: EXPERIENCES MEASURING A DRUG'S VALUE IN THE US AND ABROAD

Chapter 5: Measuring drug value: Whose job is it anyway?
Chapter 6: Institute for Clinical and Economic Review (ICER)
Chapter 7: Other US value assessment frameworks
Chapter 8: Do drugs for special populations warrant higher prices?

PART 3: GETTING TO VALUE-BASED PRICING FOR DRUGS

Chapter 9: Improving value measurement
Chapter 10: Aligning prices with value
Chapter 11: The path forward

Index