By the Numbers: Patients lose when the government sets prices

Learn more about why government price setting is bad policy and better ways Congress could help patients access and afford their medicines.

Nicole LongoJuly 8, 2022

By the Numbers: Patients lose when the government sets prices.

Yet again, Congress is considering harmful drug pricing policies with complete disregard for the negative impact they will have on patients and our economy. At the same time, they are continuing to enable insurers and pharmacy benefit managers (PBMs) to take advantage of the system by shifting more and more out-of-pocket costs to patients. Instead of addressing a broken insurance system, the most recent proposal doubles down on sweeping government price-setting policies that will threaten patient access to future medicines and innovations.

For Tammie, a mother of five who lost her husband to ALS, price-setting policies that may limit new cures would be, in her own words, “absolutely devasting.” This says nothing of the individuals and families suffering from one of the other thousands of rare diseases that exist today – only 5% of which have any available treatments. There are 90 medicines in development for Alzheimer’s Disease. Another 26 for childhood diabetes. And 119 for breast cancer. But all of these developments could stall – sacrificing new medical advances for these and other diseases – if Congress passes misguided price-setting legislation.

Here are some other important numbers to keep in mind when you hear about the supposed benefits of government price setting:

  • Nearly 1/5: That’s how much research and development (R&D) investment could be lost by 2039 if these price setting proposals are implemented, according to a 2021 study. For parents like Emily, that means "less hope" for their kids living with rare diseases. Learn how government price setting leaves behind families counting on new medicines.

  • 10-15 years: On average, that's how long it takes to bring a new, breakthrough medicine to market. It’s a long and challenging process that would likely be made even more difficult if the United States implemented price setting policies. Read more about how government price setting could threaten potentially lifesaving cures for patients.

  • $2.6 billion: That's the average cost to develop just one new medicine. And that doesn't include post-approval R&D that can often lead to new uses for a treatment. Learn how the current price setting proposal could discourage this crucial innovation.

  • 90%: That’s how many new medicines launched globally since 2011 are available in the United States. Compare that to the 50% available to patients in other countries like France and Canada. Read more about ensuring Americans have access to the treatments they need.

  • >$200 billion: That's the total rebates, discounts and price concessions that brand drug companies provided in 2021 alone. Read why shortsighted price-setting policies won't stop PBMs and insurers from continuing to shift costs to patients.

Not only does the current drug pricing proposal weaken some improvements aimed at addressing patient cost concerns from previous versions of the proposal, but it makes a broken system worse by disincentivizing the research and development needed to find new treatments and cures. Make no mistake, government price setting could mean fewer new medicines in the coming years. Rather than proceed with proposals that jeopardize patient access to lifesaving treatments, Congress should focus on bipartisan solutions that would meaningfully address out-of-pocket costs for patients.

Learn more about why government price setting is bad policy and better ways Congress could help patients access and afford their medicines.

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