Drug Pricing
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Generalized Risk Adjusted Cost-Effectiveness (GRACE): A New Healthcare Valuation Model That Puts Patients First
By recognizing that health is worth more to those who have less, GRACE provides a more equitable approach to value assessment and healthcare investments.
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Medicare Coverage of Weight Loss Drugs Could Save the U.S. Billions of Dollars
The new weight loss drugs work, and represent huge value in treating obesity. Even though they are expensive, broader access to them via Medicare would end up saving the U.S. money.
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Medicare Part D Plans Increased Restrictions on Drug Coverage
Medicare Part D plans excluded more compounds from coverage or subjected more of them to review before patients can access treatments, USC researchers found.
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Medicare Part D Plans Greatly Increased Utilization Restrictions On Prescription Drugs, 2011–20
Part D plans became significantly more restrictive over time, rising from an average of 31.9 percent of compounds restricted in 2011 to 44.4 percent restricted in 2020.
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About this section
High pharmaceutical prices may garner headlines, but innovation must be appropriately incentivized to help solve healthcare’s intractable challenges. The Schaeffer Center connects industry, the academy and government to support the scientific and technological creativity that saves and improves lives — and spurs economic growth.
Our Work In Drug Pricing
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Testimony on Pharmaceutical Pricing That Balances Innovation and Affordability for Patients with Rare Diseases
Alice Chen delivered testimony to the House Energy & Commerce Health Subcommittee Hearing pm February 29, 2024.
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Knowing Actual Prices Will Help HHS Set the Maximum Fair Price under the Inflation Reduction Act
Requiring data on actual net costs will improve negotiations over the “maximum fair price” for select drugs under Medicare.
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Ensuring Affordable and Valuable Pharmaceutical Innovation for Americans
Aligning drug prices with the actual value provided to patients stimulates innovation that benefits patients and discourages innovation that does not. Legislation to increase drug price transparency, coupled with better information about value, can help payers and consumers spend their money wisely.
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A Spoonful of Sugar Makes the Medicine Go Down
CVS said its 9,500 pharmacies soon will be reimbursed by health insurers and other payers for the cost of the drugs plus a limited markup. That sounds like a simplification of drug pricing. But for vertically integrated CVS Health, revenue will shift from its pharmacy benefits division (CVS Caremark) to another (CVS Pharmacy). The move may also be an attempt to defuse growing political pressure to regulate the PBM industry.
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Response to Sen. Cassidy’s Request for Information on Improving Americans’ Access to Gene Therapies
Schaeffer experts submitted a comment letter responding to a request for information from stakeholders about improving access to cell and gene therapies for ultra-rare diseases.
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The Inflation Reduction Act’s Harms Go Beyond Drug Pricing — They’re Threatening Your Medicare
The IRA threatens to deliver disaster across the entire innovation, financing and distribution system for prescription drugs.
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