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Innovative Medical Cures And Affordability: The Health Care Dilemma

posted by Alicia Caramenico

on May 15, 2015

Today the Partnership for Quality Care held a forum on sustainable prescription drug pricing – something that we need but still don’t have, according to the panelists.

The forum called attention to the difficult balance of promoting access to innovative medical cures and ensuring affordability. Compounding that problem is the fact that the prices for complex medicines have no connection to their development costs, according to Kaiser Permanente CEO Bernard Tyson.

The panelists emphasized the need for greater awareness among the public and policymakers about the challenges of providing access to new breakthrough treatments in the face of out-of-control pricing. Kaiser Permanente’s Anthony Barrueta, SVP of Government Relations, explained how the math of specialty drug pricing just doesn’t add up. In the case of five-figure price tags for drugs like Sovaldi, one of those medications alone would cost a massive $5.1 billion to treat Kaiser Permanente’s members. And that’s more than a billion dollars more than what the organization spends on all drugs in a year.

The forum also featured a new issue brief from Len Nichols, director of the Center for Health Policy Research and Ethics (CHPRE). Nichols points to the monopoly-like market as one of the contributing factors for the explosive increase in prescription drug prices. Nichols argues that market exclusivity, designed to reward and support innovation for drugmakers, cannot be used as an abuse of power.

As economics professor Uwe Reinhardt put it during his keynote address: Innovation is good but that doesn’t mean we have to spend the whole GDP on it.

As ever, health plans welcome dialogue with policymakers, health care thought leaders, industry stakeholders, and drug manufactures that will keep sustainability, access, and innovation at the center of the conversation.-