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Reforming Drug Price Regulation: Using Tools That Work
Deborah Williams1, Steven C Zima2, Brian J Miller3,4
1Health Policy Insights LLC, Greer, SC, USA.
Summary
Government regulation on drug pricing fails to improve affordability and creates hidden costs. A shift towards market-based reforms and reduced regulatory burden is proposed to lower drug costs for all stakeholders.
Area of Science:
- Health Economics
- Pharmaceutical Policy
- Regulatory Analysis
Background:
- Historical drug pricing reform has prioritized regulation and administrative pricing for public programs.
- These regulatory approaches have not effectively driven affordability and have introduced unintended system costs.
Purpose of the Study:
- To examine the consequences of regulatory-driven drug pricing strategies.
- To propose a new paradigm for drug pricing reform focused on market-based interventions.
Main Methods:
- Analysis of existing regulations impacting government drug payments, including the Medicaid Drug Rebate, Inflation Reduction Act Maximum Fair Price, and Medicare Part B Average Sales Price.
- Evaluation of private market policies such as co-insurance reform, private formularies, specialty pharmacies, and value-based contracting.
Main Results:
- Regulated prices do not ensure affordability and generate hidden costs within the drug market.
- Existing government programs create systemic inefficiencies when viewed from a total market perspective.
Conclusions:
- A shift from programmatic affordability views to understanding the total regulatory impact on drug costs is essential.
- Reducing regulatory burden and fostering competition through market-based reforms will ultimately improve drug affordability for payers, employers, and consumers.
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