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Comment & Response
December 13, 2016

Factors Influencing Prescription Drug Costs in the United States

Author Affiliations
  • 1Atlanta VA Medical Center, Atlanta, Georgia
JAMA. 2016;316(22):2430-2431. doi:10.1001/jama.2016.17290

To the Editor Dr Kesselheim and colleagues stated that the United States spends more on prescription medicines than other countries.1 However, the solutions they proposed are unlikely to fix the problem, but may stymie US-based innovation instead.

First, the authors suggested the US Patent and Trademark Office should play a greater role in lowering health care costs. The current mission of this office is to assess novelty of an invention, not superiority over previous inventions. The Patent and Trademark Office is understaffed, leading to long delays in assessing inventions.2 The criterion of assessing superiority is unclear and difficult to implement. For example, a compound might be a potent inhibitor of an enzyme involved in cancer but a poor drug for other reasons. This type of information is not present in patent applications and often is discovered long after a patent is granted. Patenting minor improvements does not mean higher prices. The value of a patent is assigned by the market, not by the existence of the patent per se. If a minor improvement is patented, a company still must invest in developing the improvement and bringing it to market. The market decides whether the minor improvement is worth paying for.

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