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Comment & Response
September 10, 2019

Proposals to Lower Medication Costs

Author Affiliations
  • 1Acorda Therapeutics Inc, Ardsley, New York
  • 2Ovid Therapeutics Inc, New York, New York
  • 3Alnylam Pharmaceuticals Inc, Cambridge, Massachusetts
JAMA. 2019;322(10):982. doi:10.1001/jama.2019.10391

To the Editor In their Editorial, Dr Califf and Mr Slavitt proposed several ideas with the aim of lowering drug costs.1 Unfortunately, several of the proposals would disrupt patients’ access to treatments and reduce incentives for innovation.

For example, in praising the use of an international price index in Medicare as a “positive step,” the authors appeared to be endorsing a policy that would import foreign drug price controls from single-payer health care systems without any considerations of the negative effects that such price controls have in these countries. Patients in the United States presently enjoy unrivaled access to new treatments. One analysis found that nearly 90% of newly launched medicines were available in the United States, while just two-thirds were available in the United Kingdom, half in Canada and France, and one-third in Australia.2 Similarly, the authors supported direct government negotiation, as in the US Veterans Health Administration, without noting that substantially fewer of the drugs available to Medicare beneficiaries are on the VA national formulary.3

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