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Thread: JAMA: Government Granted Monopolies Cause High Cost of Prescription Drugs

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    JAMA: Government Granted Monopolies Cause High Cost of Prescription Drugs

    August 23/30, 2016, Vol 316, No. 8 >

    Special Communication | August 23/30, 2016
    The High Cost of Prescription Drugs in the United StatesOrigins and Prospects for Reform

    Aaron S. Kesselheim, MD, JD, MPH1; Jerry Avorn, MD1; Ameet Sarpatwari, JD, PhD1
    [+] Author Affiliations
    JAMA. 2016;316(8):858-871. doi:10.1001/jama.2016.11237.
    ABSTRACT


    ABSTRACT | INTRODUCTION | BRAND-NAME VS GENERIC DRUGS | SOURCES OF HIGH DRUG PRICES IN THE UNITED STATES | JUSTIFICATIONS FOR HIGH DRUG PRICES | CLINICAL CONSEQUENCES OF HIGH DRUG PRICES | POSSIBLE SOLUTIONS | CONCLUSIONS | ARTICLE INFORMATION | REFERENCES




    Importance The increasing cost of prescription drugs in the United States has become a source of concern for patients, prescribers, payers, and policy makers.
    Objectives To review the origins and effects of high drug prices in the US market and to consider policy options that could contain the cost of prescription drugs.
    Evidence We reviewed the peer-reviewed medical and health policy literature from January 2005 to July 2016 for articles addressing the sources of drug prices in the United States, the justifications and consequences of high prices, and possible solutions.
    Findings Per capita prescription drug spending in the United States exceeds that in all other countries, largely driven by brand-name drug prices that have been increasing in recent years at rates far beyond the consumer price index. In 2013, per capita spending on prescription drugs was $858 compared with an average of $400 for 19 other industrialized nations. In the United States, prescription medications now comprise an estimated 17% of overall personal health care services. The most important factor that allows manufacturers to set high drug prices is market exclusivity, protected by monopoly rights awarded upon Food and Drug Administration approval and by patents. The availability of generic drugs after this exclusivity period is the main means of reducing prices in the United States, but access to them may be delayed by numerous business and legal strategies. The primary counterweight against excessive pricing during market exclusivity is the negotiating power of the payer, which is currently constrained by several factors, including the requirement that most government drug payment plans cover nearly all products. Another key contributor to drug spending is physician prescribing choices when comparable alternatives are available at different costs. Although prices are often justified by the high cost of drug development, there is no evidence of an association between research and development costs and prices; rather, prescription drugs are priced in the United States primarily on the basis of what the market will bear.



    Conclusions and Relevance

    High drug prices are the result of the approach the United States has taken
    to granting
    government-protected monopolies to drug manufacturers,
    combined with
    coverage requirements imposed on government-funded drug benefits.



    The most realistic short-term strategies to address high prices include enforcing more stringent requirements for the award and extension of exclusivity rights; enhancing competition by ensuring timely generic drug availability; providing greater opportunities for meaningful price negotiation by governmental payers; generating more evidence about comparative cost-effectiveness of therapeutic alternatives; and more effectively educating patients, prescribers, payers, and policy makers about these choices.



    For full article see:


    www.sci-hub.bz
    www.sci-hub.cc
    Last edited by presence; 09-14-2016 at 08:14 AM.

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  3. #2
    At first I was impressed but not after reading the full text. The abstract sounded like they were going to completely blast the FDA and patent offices, even attack the concept of govt-granted patent monopolies entirely. Instead they just detailed all the little issues within the mess and blamed that for the high prices.

    So they're saying the problem isn't the patents and monopolies per se, just how they're managed.

    So the "pay for delay" problem is solved giving the FDA/govt more power and stopping it. And if generics are delayed by FDA inefficiency, just expand the FDA to make up for it.

    Same stuff every statist says about government- need to make it work better, police this, improve that, etc...
    Last edited by Murray N Rothbard; 09-24-2016 at 11:04 PM.



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