High drug prices are the result of the increasing cost and complexity of drug development but also arise in large part from the approach the United States has taken to the granting of government-protected monopolies to drug manufacturers, combined with restriction of price negotiation at a level not observed in other industrialized nations. Opportunities to address these problems include paying greater attention to potentially unjustified granting and extension of patent exclusivity, enhancing competition by ensuring timely generic drug availability, providing greater opportunities for price negotiation by governmental payers, generating more evidence about comparative cost-effectiveness of therapeutic alternatives, and actively educating physicians and patients about such choices to promote more value-based decision making. There is little evidence that such policies would hamper innovation, and they could even drive the development of more valuable new therapies rather than rewarding the persistence of older ones. Medications are the most common health care intervention and can have a major benefit on the health of individuals, as well as of populations, but unnecessarily high prices limit the ability of patients and health care systems to benefit fully from these vital
products.

ABSTRACT | INTRODUCTION | BRAND-NAME VS GENERIC DRUGS | SOURCES OF HIGH DRUG PRICES IN THE UNITED STATES | JUSTIFICATIONS FOR HIGH DRUG PRICES | CLINICAL CONSEQUENCES OF HIGH DRUG PRICES | POSSIBLE SOLUTIONS | CONCLUSIONS | ARTICLE INFORMATION | REFERENCES