It’s Health Care, Stupid: Where do the Candidates Stand on Drug Prices

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If you read the news and listen to the politicians, you’ll come away thinking that Americans are irreparably divided. The upcoming presidential debate will surely focus on important issues like race and the pandemic upon which people genuinely disagree. However, Pew Research shows that Americans’ top concerns are healthcare and the economy – issues which go right to the heart of all Americans’ desire to feel safe and take care of their loved ones. 

As the media and both parties focus on where Joe Biden and President Donald Trump disagree, both candidates are pushing drug price controls that will harm tens of millions of Americans. President Trump threatened executive action in July that came to fruition earlier this month to tie drug prices to those in other countries, while Biden’s healthcare plan includes pinning price growth to the rate of inflation and limiting prices based on international averages. Neither of these approaches is sustainable, and both risk reducing innovation and access to treatments just as the pandemic looks like it might pick up again.

Given that the U.S. spent twice the OECD average on prescription drugs as of 2015, having the government simply mandate lower prices can seem like a tempting solution. However, price controls don’t address the factors that drive up costs. Supporters of the approach cite other countries’ lower drug prices, but the truth is that Americans enable price controls in the rest of the world. When other countries’ citizens pay less, they essentially pass on the costs to free-market countries. 

In the long term, though, neither American nor foreign patients benefit. According to ISPOR, a leading professional society for health research, price controls hurt the development of new drugs. The U.S. leads the world in medical innovation, but has lost ground to Europe and Asia in recent years. Imposing price controls will reduce the incentive for pharmaceutical companies to innovate, accelerating this decline. Americans will feel the consequences, as will people all over the world, who on average get access to only about half of the treatments available to Americans as it is.

It’s not clear that Trump, the supposed master of the deal, can convince the rest of the developed world to ditch price controls, but there are a few things he could do to expand drug access and reduce prices without increasing government interference in drug innovation. In a February 2018 report, his own Council of Economic Advisors recommended reforming the Food and Drug Administration’s drug approval process, which adds an average of 16 months on top of multiple years of clinical trials.

Trump has made some positive drug policy changes. His administration’s FDA is making more drugs available over the counter and approving record numbers of generic drugs. It’s a more streamlined process, but not a shortcut – generic and over-the-counter drugs still undergo a thorough approval process. The FDA should continue giving businesses the opportunity to make medication cheaper and easier to access whenever it’s safe to do so.

Chris Wallace is a competent and ethical journalist who will surely push both candidates on the issues people care most about. He should hold both Biden and Trump accountable on Main Street pocketbook issues, forcing both candidates to focus on economic and healthcare policies that will benefit all Americans. Unfortunately, the drug pricing solutions that both candidates offer right now will cause more harm than good, at the worst possible time to reduce healthcare innovation.

Dr. Gianoli is a neuro-otologist at the Ear and Balance Institute and a clinical associate professor at Tulane University School of Medicine.


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