President Joe Biden celebrated a milestone today—but American patients have no reason to cheer.
The White House announced the first 10 prescription drugs that, starting in 2026, will be subject to price controls authorized by the Inflation Reduction Act.
Democrats laud these price controls, which they glibly dub "negotiations," as a way to lower drug costs for seniors on Medicare. But in the not-too-distant future, people of all ages may look back and rue this day—as the beginning of the end of America's medical golden age.
These so-called negotiations are more akin to a mugging. Medicare officials will essentially dictate prices. Drug companies can theoretically take them or leave them. But if manufacturers leave them, they must pay a 95% excise tax on their total nationwide sales of the drug in question. This will be each company's punishment for refusing to do things Uncle Sam's way.
Since Medicare is America's largest insurer, its bureaucratically fixed prices for cutting-edge drugs will slash drug manufacturers' revenues severely. Since approximately one quarter of drug makers' revenue underwrites research and development, price controls will limit how much these companies can spend on R&D.
Consequently, they will invent and market fewer new drugs for real diseases that ail real people. This includes everything from cancers to neurodegenerative diseases like Alzheimer's to autoimmune disorders like multiple sclerosis. University of Chicago researchers warn that price controls could prevent the development of 135 new drugs by 2039.
The estimate tracks with statements from pharmaceutical executives since the IRA became law in August 2022. In January, 78% of drug-company executives surveyed expect to cancel early research into new drugs.
Also, 95% plan to develop "fewer new uses for medicines" because drug "negotiations" can begin just nine years after FDA approves certain drugs. Many treatments are initially developed and approved for one indication—such as advanced lung cancer—and only later approved for other cancers or earlier stages of the disease, after years of additional testing. Price controls could make such follow-on research financially unviable.
Small-molecule drugs are in particular peril. These simple pills make up 90% of the drug market. The IRA imposes price controls on small-molecule drugs nine years after FDA approval, rather than 13 years for biologics—a type of drug grown from living cell cultures and administered by doctors via injections or infusions.
Major pharmaceutical manufacturers already indicate that they will shift focus to developing biologics, since they can be sold for four more years beyond the price-control deadline for small-molecule medications. In one survey, 63% of companies said they would shift their investments away from these easier-to-use drugs.
It's laudable that lawmakers want to reduce out-of-pocket drug prices for seniors. But the tradeoffs inherent in price controls make them a brutal way to achieve this goal. Without access to recently approved medicines or R&D dollars to bring miracle drugs to market, U.S. patients who otherwise would survive, instead will die. And all thanks to the IRA's price controls. Today's announcement is nothing to celebrate.
Sally C. Pipes is president, CEO, and the Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute
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