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Friday, October 28, 2022

Why Are Drugs So Expensive?

It’s Not What You Think


Costly research and development aren’t necessarily why drugs are so expensive.

A multinational team of scientists examined whether high R&D (research and development) expenditures account for high drug prices in the United States in the first known study of its kind.

“There is a presumption that high R&D costs justify high drug prices. If that were true, then we’d see a positive association between the two measures,” said first author Olivier Wouters, Ph.D., assistant professor at the London School of Economics and Political Sciences.

Inmaculada Hernandez, PharmD, PhD, is an associate professor at Skaggs School of Pharmacy and Pharmaceutical Sciences at UC San Diego and senior author of a study that found high drug prices are not associated with the costs of research and development. Credit: UC San Diego Health Sciences

But in a paper recently published in the journal JAMA Network Open, Wouters and colleagues from the University of California San Diego’s Skaggs School of Pharmacy and Pharmaceutical Sciences discovered no such association for 60 new drugs approved by the US Food and Drug Administration from 2009 to 2018.

The researchers compared information on drug pricing and R&D expenditures. They discovered no connection between pharmaceutical corporations’ R&D spending and the prices they charge for new drugs. The therapeutic value of a product was also evaluated by the researchers, but they discovered no link between therapeutic value and price. 

“Our findings provide evidence that drug companies do not set prices based on how much they spent on R&D or how good a drug is. Instead, they charge what the market will bear,” said senior author Inmaculada Hernandez, PharmD, Ph.D., associate professor at Skaggs School of Pharmacy and Pharmaceutical Sciences.

The Congressional Budget Office estimates that the pharmaceutical sector spent $83 billion on research and development in 2019. It is estimated that companies spend between $1 billion and $3 billion on average to bring a single new product to market. According to the database company Statista, the U.S. pharmaceutical industry earned more than $490 billion in sales in 2019, making up close to half of the worldwide pharmaceutical market.

Americans spend more on prescription drugs per capita than citizens in any other country. In 2019, that worked out to more than $1,200 per person. A 2021 Rand Corporation study found U.S. drug prices were 2.56 times higher than those in 32 comparable countries. A Kaiser Family Foundation Health Tracking Poll published earlier this year found that eight in 10 adults said the cost of prescribed medications was unreasonable.

Legislators in Congress have in recent years introduced numerous proposals intended to apply downward pressure on drug prices. Pharmaceutical companies and trade groups have opposed these reforms, arguing that high drug prices are needed to recover R&D investments.

“If this argument is to be used to justify high prices and oppose measures to curb prescription drug costs, drug companies should supply further data to support their claims that high drug prices are needed to recover R&D investments,” said Hernandez.

Reference: “Association of Research and Development Investments With Treatment Costs for New Drugs Approved From 2009 to 2018” by Olivier J. Wouters, Ph.D., Lucas A. Berenbrok, PharmD, MS, Meiqi He, MS, Yihan Li, BS and Inmaculada Hernandez, PharmD, Ph.D., 26 September 2022, JAMA Network Open.
DOI: 10.1001/jamanetworkopen.2022.18623

The study authors acknowledged that the analysis was limited by the small sample size.