It is finally starting to happen. The first gene therapy to treat an inherited disease is out of the gate. But my, that price tag: $850,000. Many more gene therapies are on their way. How can they be priced to hit the sweet spot of affordability, access, and innovation? Outcomes-based pricing doesn’t really do the trick.
Despite standardization, advocates for various industries and certain patient needs continue to propose changes in coverage rules. Much of the advocacy is occurring at the state level with a focus on pharmaceutical coverage, such as equalizing cost sharing between oral and infused oncology drugs or setting limits on cost sharing for prescriptions.
Too many Americans are skipping prescribed medications because they find them too expensive. That foretells trouble for payers—and for patients. On this page, you’ll find several relevant facts and numbers.
Even the most effective drug is useless if people don’t take it because it’s so expensive. Today’s high prices are pushing more and more patients into nonadherence. It’s a prescription for trouble for us all.
The industry has been criticized for lack of transparency—and worse. Some see ‘a ton of sense’ in the proposed mergers with insurers and retailers. Others see a risk of even higher drug prices and a need for oversight.