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Prices For Common Cardiovascular Drugs In The US Are Not Consistently Aligned With Value.

Jonathan D Campbell1, Vasily Belozeroff2, Melanie D Whittington3

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US drug prices are not consistently linked to their cost-effectiveness. Cardiovascular drug pricing may be influenced by factors beyond value, necessitating a reevaluation of how value-based evidence informs US healthcare decisions.

Keywords:
cardiovascular drugshealthtechnology assessmentsvaluevalue-based price benchmarks

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Area of Science:

  • Health Economics
  • Pharmacoeconomics
  • Health Policy

Background:

  • International healthcare reimbursement agencies use cost-effectiveness for drug coverage.
  • Value-based pricing is expected by manufacturers in many countries.
  • The US system's approach to value-based drug pricing requires examination.

Purpose of the Study:

  • To assess if US drug prices reflect cost-effectiveness.
  • To determine the range of cost-effectiveness for common cardiovascular drugs in the US.

Main Methods:

  • Extrapolation of data from randomized controlled trials.
  • Calculation of lifetime quality-adjusted life-years (QALYs) and payer costs.
  • Determination of incremental cost-effectiveness ratios (ICERs) for 30 cardiovascular drugs.

Main Results:

  • ICERs varied widely, from cost-saving to increased costs with decreased QALYs.
  • Drug pricing in the US does not appear consistently influenced by demonstrated value.
  • Potential masking of value influence by factors like undisclosed price discounts.

Conclusions:

  • US drug pricing is not consistently aligned with cost-effectiveness.
  • There is a need to redefine and utilize value-based evidence for US coverage decisions.
  • Further debate is required on incorporating value into US drug reimbursement.