Price, Value, and Access

PORTAL researchers study the high cost of prescription drugs in the US and around the world, and how to ensure essential medicines reach the patients who need them.

Price, Value, & Access

Correlation Between Changes in Brand-Name Drug Prices and Patient Out-of-Pocket Costs

Rome BN, Feldman WB, Desai RJ, Kesselheim AS | JAMA Network Open (2021)

From 2015 to 2017, list prices for brand-name drugs increased by a median of 16.7%, net prices increased by 5.4%, and out-of-pocket (OOP) spending increased by 3.5%, with changes in list prices showing weak correlation with overall out-of-pocket spending but moderate correlation among patients with deductibles or coinsurance. Policies regulating list price increases may be necessary to reduce out-of-pocket spending for patients with high-deductible or coinsurance-based plans, as manufacturer rebates do not appear to translate into reduced patient costs.

Read More

Recent Work in Price, Value, & Access

Talk bubble graphics representing commentary and opinion.

Deeming Doesn’t Deliver: Reliance on Foreign Regulators Targets the Wrong Stage of Canadian Drug Access

Eisenkraft Klein D, Kesselheim AS - Health Policy

  • Price, Value, and Access
  • Regulation and Clinical Evidence
Simple graphic of magnifying glass examining papers to signify reviewing research publications.

Prescription Drugs Affected by an Expanded Rare Disease Carve-Out from Medicare Price Negotiation

Rome BN, Mooney H, Kesselheim AS - Journal of General Internal Medicine

  • Innovation Incentives and Competition
  • Price, Value, and Access
The One Big Beautiful Bill Act (OBBBA) expanded exemptions from Medicare drug price negotiation to include drugs approved for multiple rare diseases and delayed negotiation timelines for drugs first approved for a rare disease. The authors identified 22 drugs, collectively accounting for $18 billion in 2023 Medicare spending, that would be exempted or delayed from negotiation under these new provisions. Congress should consider more targeted approaches, such as setting a higher spending eligibility threshold for rare disease drugs, to preserve savings while maintaining protections for rare disease products.
View Source
Talk bubble graphics representing commentary and opinion.

Skinny Labels at the Supreme Court—Generic Competition, Patent Inducement, and Affordable Medicines

Tu SS, Tessema FA, Kesselheim AS - JAMA

  • Innovation Incentives and Competition
  • Price, Value, and Access
The skinny label pathway, which allows generic manufacturers to enter the market by omitting patented indications from their labels, is under threat following Federal Circuit decisions in GlaxoSmithKline v. Teva and Amarin v. Hikma, which expanded induced infringement liability to include truthful, FDA-aligned statements and contributed to a sharp drop in skinny labeled generic entries. With Amarin now before the Supreme Court, the authors recommend ways the Court can clarify the skinny label safe harbor, warning that failure to do so risks undermining a cornerstone of the Hatch-Waxman Act and prolonging brand-name drug monopolies.
View Source