Value-based pricing aligns prescription drug prices to their clinical benefits, leading to lower spending and better health outcomes.

Introduction and summary
In the United States, pharmaceutical companies are able to set the price of a prescription drug at whatever they believe the market will bear. As a result, the prices of prescription drugs are not tied to the value those drugs provide to patients, as they are in many of our peer nations. Countries such as Germany and Australia use value-based pricing, ensuring that the price of a drug is based on the benefit provided to patients in terms of quality of life or efficacy; this pricing approach makes their drugs cheaper and more valuable to the patients taking them.
Because of the pharmaceutical industry’s ability to set prices largely unchecked, drug prices in the United States are much higher than they are in peer nations. Multiple recent studies have arrived at this conclusion. A 2021 study by the RAND Corporation compared prices for prescription drugs in the United States with those in 32 other countries, including the United Kingdom, Germany, and Australia; the authors ultimately found that prices in the United States were an average of 156 percent higher than prices in the comparison countries.1 Even after adjusting for rebates and other discounts in the United States, prices were still nearly twice as high.2 The U.S. Government Accountability Office found similar results: A 2021 report found that U.S. drug prices were two to four times higher than the prices for those same drugs in Australia, Canada, and France.3
In addition to starting at a higher price, prescription prices have risen for several decades at an unsustainable rate, higher than inflation.4 A 2020 study conducted by researchers at the University of Pittsburgh found that the average list price for brand-name drugs increased by more than 150 percent from 2007 to 2018.5 A Kaiser Family Foundation analysis of Medicare Part D drugs found a similar result: Half of Part D drugs had list price increases above inflation in 2019, and nearly 15 percent of Part D drugs had list price increases of more than 10 percent.6 These trends have continued into 2021. According to GoodRx, drug companies increased the prices of 832 drugs by an average of 4.5 percent in January 2021 and 67 drugs by an average of 3.5 percent in July 2021.7
These high prices and price increases have a real impact on patients: Nearly 3 in 10 American adults reported not taking medicines as prescribed in 2019 due to cost.8 American taxpayers also bear the burden of high drug prices, with Medicare and Medicaid spending nearly $290 billion on prescription drugs in 2019.9 As a result, there has been considerable discussion at both the state and federal level on how to lower both overall










