Who sets a drug’s price, and how do we know it’s fair?

What can physicians do in their hospitals and communities to advocate for fair drug prices? What questions should we ask our patients to assess for financial toxicity? In the final episode of the season, we discuss the steps doctors can be taking now to help solve the drug pricing problem.

If we only look at the benefits that a drug provides to those patients who take it, we may underestimate its value by ignoring the benefits it provides to the broader healthcare system. In episode 7, we reveal some of the other reasons that can make a drug more valuable than first meets the eye.

If a “fair” price rewards the benefit a drug provides, how do we quantify those benefits—both to the patient and, more broadly, to society? Cost-effectiveness analysis is the tool we can use to quantify a drug’s benefit in a way that can be compared across treatments.

In episode 5, we review the variety of approaches one might take to settle on what the “fair” price of a drug should be. The most logical solution to this problem is to price the value—set a drug’s price commensurate with the clinical benefits it provides.  

What motivates a drug manufacturer to create a drug in the first place? How do firms stretch the limits of these incentives? In episode 4, we discuss how  the “ecosystem” of drug development in the US has led to truly remarkable innovation but also runaway drug prices.

Drugmakers, pharmacies, wholesale distributors, physicians, pharmacy benefit managers—the world of prescription drugs can seem extraordinarily complex. In episode 3, we disentangle this spider’s web and answer the question: who decides how much our patients pay at the pharmacy?

Whenever we choose to spend on one thing instead of another, we pay an opportunity cost. And, just like in life, healthcare is an either/or decision. Patients face decisions about how to spend their money on healthcare, just like insurance companies and governments must decide how to spend their finite dollars on healthcare.

In the first episode of the series, we discuss the problem of skyrocketing drug prices and the harmful effects they have on our patients. Not only must patients decide what their medications are worth to them, but payers introduce barriers that limit patients’ access to care. More broadly, we also review the ways that drug prices affect all of our society, via rising insurance premiums and taxes.

In a new podcast series from the Institute for Clinical and Economic Review (ICER), neurologist Dr. Jason Crowell sits down with ICER’s President Dr. Steve Pearson to pry open the black box of US drug pricing and to wrestle with each of the financial and ethical tensions that undergird our current medical infrastructure. A must-listen for physicians, patients, and policymakers who are concerned that prescription drugs not only can have health side effects, but financial side effects, too.