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VIDEO: Bringing value-based medicine pricing, access to the U.S.
LOS ANGELES — In this exclusive video from GI Outlook 2019, James C. Robinson, PhD, MPH, professor of health economics at the University of California Berkeley, discusses the steps needed to bring true, value-based medicine to the United States.
“New drugs that come through need to be assessed not only by the FDA on their safety and efficacy compared to placebo or to the standard of care, but to one another,” he told Healio Gastroenterology and Liver Disease. “We need comparative clinical assessments of each new drug relative to the other state-of-the-art treatments for that condition or that therapeutic class. I’m not saying it’s easy, but it has to happen.”
Robinson said drug pricing needs to be based on the incremental benefit of the drug compared with existing drugs. That means if a new drug is no better than existing drug, its price cannot be higher. He said this kind of model has had success elsewhere in the world and gives an incentive for companies to develop better new drugs.
Additionally, Robinson said the criteria for coverage has to be transparent. The different protocols for payers are often so complicated, even doctors have trouble navigating them.
For breakthrough drugs with no comparator, Robinson said something needs to be done to ensure that drug prices remain fair.
“There has got to be a maximum that drug companies can charge for this. They cannot charge so much that they are going to break the bank, if you will, and put undue pressure on the nation’s ability to pay,” he said. “If they will charge fair, evidence-based pricing, the quid pro quo is that the payers cannot impose the kind of arbitrary and onerous prior authorization, step therapy and consumer cost sharing that we are struggling with right now.”
Disclosures: Robinson reports no relevant financial disclosures.