Over a year into the COVID-19 pandemic, we are living in a unique time where the world is noticing the impact of vaccines and therapeutics, and the overall contributions so many are making toward ending the pain and suffering of the pandemic. Now more than ever, the public is aware of what the biopharmaceutical industry is doing to help solve these huge global health challenges, with new medicines playing a key role.
We’re also facing health policy debates in the United States that are fueled by misunderstandings about what it takes to bring life-changing medicines to market, about where our health care dollars can provide the most return on public health, and how to balance pricing in a system that rightly rewards innovation but does not always guarantee patient protections for affordability. Despite the many advantages of the U.S. drug discovery, development, and delivery system, comparisons to policies from health systems abroad are frequently pointed to as silver bullet solutions for American patients. But solid solutions should stem from first identifying real problems. As such, we ought to address these misunderstandings in three key ways:
- Offer a thorough explanation of the differences in reimbursement and pricing systems in other countries to better inform the current discussion, which is vastly oversimplified.
- Thoughtfully discuss the tradeoffs other countries make when they implement pricing systems that differ from the U.S.
- Analyze what it could mean for patients in the U.S., in terms of the development of new medicines and their access to them, if the U.S. adopted a different system.
Amidst this backdrop, my chairmanship of the National Pharmaceutical Council could not have come at a more challenging – or more important – time. I’m honored to take on this leadership role of this evidence-based, research-focused organization and work with their staff and a broad range of health care stakeholders to address these issues.
We should remember that here in the United States, we have almost immediate and sustained access to the most innovative medicines on the market, which is a direct reflection of the priorities of the American people.
Outside of the United States, reimbursement policies often delay, or even preclude, patient access to effective new treatments in areas of unmet need. For example, in the case of several innovative cancer medicines, access for patients in Europe has not been secured until years after regulatory approval in those jurisdictions, and in some cases, patients are still waiting for access to new medicines, even though regulators have approved them.
The approach of other countries reflects their unique economic, political, societal and cultural values. But importing their pricing approach to the U.S. would ignore the vastly different U.S. health care structure and patient population.
Adopting the approach of other countries could jeopardize the rewards the American system offers, which in turn fuels new research and health innovation. The work to date around COVID-19 medicine development is in part a result of these rewards: the quick investment in COVID-19 treatments and vaccines, a robust ecosystem of expertise in medicine development and manufacturing, and the safe delivery of approved treatments and vaccines to the American public and the world.
NPC has a unique role to play in fostering a better understanding not only about the harmful impact of delayed or restricted patient access to innovative medicines can have on both overall outcomes and the future of innovation, but also about the role of social determinants of health on the wellbeing of populations. The Going Below The Surface initiative launched in 2018 by NPC sparked numerous research initiatives aimed at identifying the root causes of health care spending in the U.S. and how best to optimize spending without negative effects to patient care and next-generation health care innovation. Outputs like these bring a data-driven perspective to important discussions that are too often shaped by oversimplified talking points.
Work like this will continue to bring important information to the debate about the value of medicines and how to improve access and outcomes for patients, a debate that will only grow in importance this year and beyond. Along with the experts at NPC, we have the opportunity to inform these critical conversations as we work toward a system that successfully balances rewarding innovation and protecting patient access and affordability.
Michael L. Ryan is Senior Vice President, Worldwide Value, Access, Pricing & Health Economics and Outcomes Research at Bristol Myers Squibb. He also is NPC's Chair of the Board of Directors for 2021.