Unbiased Analysis of Today's Healthcare Issues
This is the title of a recent paper by Jiao et al. (2025). Previous studies (e.g., Goldman et al. 2013, Goldman et al. 2023) have argued for a 3-part pricing model. Under a 3-part pricing model, drugs would come to market quickly under accelerated approval with a relatively lower price. As clinical trials and other…
What options do payers have for setting prices for high-cost drugs? Examples include volume discounts, performance based contracts and coverage with evidence. However, is there a comprehensive taxonomy one can use for defining all these different pricing and payment options? The closest we have come is a new paper by Ardito, Ciani & Drummond (2024).…
The answer appears to be ‘yes’ according to a survey by Mahendraratnam et al. (2019). After surveying subject matter experts that were senior representatives from payer organizations and pharmaceutical manufacturers on value-based pricing arrangements (VBA), they found: More than 70% of VBAs implemented between 2014 and 2017 were not publicly disclosed. Furthermore, although consideration of…
The American Medical Association released a statement yesterday in support of value-based pricing of pharmaceuticals. However, AMA claims that value-based pricing should follow the following core principles. Value-based prices of pharmaceuticals should be determined by objective, independent entities. They also should be evidence-based and the result of valid and reliable inputs and data that incorporate…
A growing number of value-based drug pricing arrangements are tying the price of treatments to outcomes. While these payment models are far from prominent now, is it likely that drug makers will have a greater share of the risks and rewards associated with value-based care moving forward? This is what is written in a feature…
The answer may be yes. One of the big inpediments to value-based pricing of pharmaceuticals was that any discount given to any single organization based on outcomes needed to be reflected in the Medicaid price. Since outcomes are subject to random noise, there will inevitably be health plans that end up getting a low price due to worse than expected…
A Health Affairs post by Dana Goldman and Darius Lakdawalla argues that dose-based pricing for pharmaceuticals is suboptimal. They make a clear distinction between typical goods, where cost and benefits are roughly proportional to quantity consumed, and pharmaceuticals. Buying two bunches of bananas naturally costs twice as much as one bunch. Twice as many bananas can…
Looks likes cuts to UK reimbursement rates for Pharma are on the way: People involved in the PPRS drug pricing talks have told the Financial Times on Tuesday, that drug companies operating in the UK have agreed the drugs bill to the NHS for their patented (but not generic drugs or vaccines) products will fall…