A: ONE NEW IDEA IS TO SHARE REBATES with patients at the point of sale. Under our current system, a patient may be required to shoulder a 30 percent (or higher) coinsurance burden based on a fictional list price that is heavily reduced by rebates. Similarly, insurance plans are increasingly adopting so-called “co-pay accumulators,” which are really just another means of raising patients’ out-of-pocket costs, effectively denying access to care. These should be eliminated.
Easing barriers to value-based pricing also can help lower costs. We need to clarify the FDA’s off-label promotion restrictions to allow payers and drug innovators to more freely enter into detailed pre-approval discussions.
Medicaid’s “Best Price” requirements should also be reformed to encourage creative, value-based arrangements that will drive smarter spending.
RON COHEN, M.D.
Ron is president, CEO, and founder of Acorda Therapeutics, a public biotechnology company developing therapies for spinal cord injury, MS, and other nervous-system disorders.