#Pathological fear of fruit plus
In Massachusetts, Gov Charlie Baker has spearheaded legislation to limit annual price increases for drugs with average annual costs of $50 000 or more to inflation plus 2%.
1 Bills in both the House and the Senate in 2019-2020 proposed to penalize drug manufacturers when the average manufacturer’s price for a Medicare-covered drug increased by more than the rate of inflation, requiring them to pay rebates to Medicare equal to the excessive portion of the increase. The UPI concept has found expression in both federal and state bills, as well as in then-candidate Biden’s health care proposals. State proposals apply to units of product sold, dispensed, or delivered in the state. Because of the difficulty of obtaining information about net prices of drugs after discounts and rebates, the UPI laws typically reference a drug’s wholesale acquisition cost, which approximates the drug’s list price. Proposals addressing UPIs vary in which drugs are covered by the price-increase cap, with some specifying drugs with annual costs over a particular threshold, and others relying on work by the Institute for Clinical and Economic Research for identifying drugs with large price increases that are unsupported by new evidence of clinical value. Therefore, they should not increase much over time in real terms, absent some extenuating circumstance.
#Pathological fear of fruit free
The underlying logic of UPI laws is that because drug companies are essentially free to set the base or launch price for a new drug at whatever the market will bear, base prices represent a fair return on companies’ investment in research and development. If they cannot, most of the revenue generated from the disallowable portion of the price increase is taxed. Companies are given the opportunity to justify large price increases-for example, by presenting new evidence about the drug’s clinical value or by showing that an ingredient became more expensive. Laws addressing UPIs impose a tax or penalty when a drug’s price increases by more than a specified percentage (such as the rate of general inflation) over a defined period. Among the most promising policy options not yet widely adopted is legislation regulating excessive or unsupported price increases (UPIs). States have been highly energetic in passing a range of laws aimed at drug prices, from price transparency requirements to drug affordability boards. Therefore, it is likely that states will continue to be the major players in prescription drug affordability reforms. 1 None of the political barriers to far-reaching reform that surfaced during the Trump administration have vanished, and the prevailing partisanship and Democrats’ razor-thin Senate majority limit the range of realistic possibilities. But despite signs that Congress recognizes drug costs as a priority, federal reforms that significantly ease costs face steep odds. Many potentially useful measures are under consideration in Congress, including repeal of the Medicaid rebate cap.
Notwithstanding the new balance of power in the US Senate, making big strides in addressing drug costs at the federal level remains challenging.
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