Medicare Drug Price Negotiation in the United States: Implications and Unanswered Questions |
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| Institution: | 1. The CHOICE Institute, School of Pharmacy, University of Washington, Seattle, WA, USA;2. Department of Health Policy, London School of Economics and Political Science, London, England, UK;1. Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA;2. Department of Medicine, Tufts University School of Medicine, Boston, MA, USA;1. Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia;2. School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University;3. Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia;4. QIMR Berghofer Medical Research Institute, Herston, QLD, Australia;5. Metro North Mental Health Service, Herston, QLD, Australia;6. Child and Adolescent Mental Health Services Barwon Health, Geelong, VIC, Australia;7. Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia;8. Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia;9. Royal Children’s Hospital, Melbourne, VIC, Australia;10. Murdoch Children’s Research Institute, Melbourne, VIC, Australia;11. Child and Youth Mental Health Service, Eastern Health, Melbourne, VIC, Australia;12. School of Population Health, Curtin University, Perth, WA, Australia;13. Caring Futures Institute, Flinders University, Adelaide, SA, Australia;14. Children’s Health, Queensland Hospital and Health Service, University of Queensland, Herston, QLD, Australia;15. Centre for Health Economics Research and Evaluation, Faculty of Health, University of Technology, Sydney, NSW, Australia;1. Office of Health Economics, London, England, UK;2. Biogen, Maidenhead, England, UK;1. Center for the Evaluation of Value and Risk in Health, Health at the Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA;2. Pharmaceutical Outcomes Research and Policy Program, University of Washington School of Pharmacy, Seattle, WA, USA;3. The International Society for Pharmacoeconomics and Outcomes Research, Lawrenceville, NJ, USA;1. Evidence Synthesis and Decision Modeling, PRECISIONheor, Vancouver, BC, Canada;2. Worldwide Health Economics and Outcomes Research, Bristol Myers Squibb, Uxbridge, England, UK;3. Health Economics and Outcomes Research, Bristol Myers Squibb, Rueil-Malmaison, France;4. Global Biometric Sciences, Bristol Myers Squibb, Boudry, Switzerland;1. Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia;2. School of Health and Related Research, University of Sheffield, Sheffield, England, UK;3. Department of Economics, University of Sheffield, Sheffield, England, UK |
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| Abstract: | The United States is a relatively free-pricing market for pharmaceutical manufacturers to set list prices at the product launch. Few drug price controls exist, and federal price negotiation as a policy has historically been politically untenable. After decades of debate on whether the federal government, specifically the Medicare program, should more actively manage drug prices, the US Congress passed legislation authorizing Medicare to directly negotiate prices with manufacturers. The purpose of this article is to describe elements and implementation of the price negotiation provisions and then comment on the potential impacts on payers, innovations, and the pharmaceutical industry. While impacting only a few drugs each year in the beginning, price negotiation in the Medicare program will have secondary and long-term effects in the US market and beyond. It is clear that in the United States, the Medicare market for drugs will no longer be a free-pricing environment in the industry. |
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| Keywords: | drug pricing Inflation Reduction Act Medicare price negotiation |
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