Dr Clifford Goodman on Possible Drug Pricing Solutions Adapted From Abroad

Though no country has a drug pricing system that would work perfectly in the United States, there are many components that could potentially be adapted for use here, like strengthened price negotiation abilities, said Clifford Goodman, PhD, moderator at the ACO Coalition spring live meeting in Scottsdale, Arizona, and senior vice president and director at the Center for Comparative Effectiveness Research at the Lewin Group.

Transcript (slightly modified)

Are there models in other countries that the United States can adopt or adapt to address high drug prices?

With regard to high drug prices in the United States and the extent to which we might learn from other countries, there’s no single other country that has the perfect paradigm for direct adaptation here in the United States, but there are some things we can learn about how drug prices are handled in other countries that are of benefit to us and frankly we are already learning.

To the extent that, for example, in the UK what the National Institute for Health and Care Excellence is looking at things quite specifically, like cost per quality adjusted life year gained, you may have some concerns about the methodology but the point is that’s a healthcare system that operates within a budget and they are having to make difficult choices. When they’re having to make difficult choices, they’re trying to come up with a rubric, a paradigm, an approach to try to be clear about assumptions and their results. That clarity and the definition of a problem is something from which we can learn.

Also, we can consider the extent to which we might have more price negotiation here in the United States. Now, price negotiation won’t go quite as far as some advocates think, because we’re already doing a lot of price negotiation anyway through our PBMs and through market leverage. The list price that you often see for a drug or biologic isn’t the true market place, so there’s a disconnect there. At the same time, there are advantages to offering or shall I even say maybe threatening stronger price negotiation that might bring about some changes to the market.

Finally, to the extent that we can use assessments of value and what we’ve learned from value frameworks, many of which were developed based on programs from outside the United States, the information from value assessment and value frameworks can be brought to the negotiation table and can be brought to bear into the marketplace, to try to help to manage drug prices.

That’s very real in the United States, and even the work thus far by ICER and some of the cancer-oriented organizations and others that bring this information to bear, that information is being used by payers, PBMs, and others to try to arrive at better prices. I think that there’s plenty to be gained there. Let’s not stop looking, though; with the experience of other countries, there’s always something to learn.