No Patient Left Behind is pursuing a variety of high-impact research and policy projects to support our proposed reforms. If your team has data, resources, or interest in joining forces with us to solve any of these problems, please contact a member of our Steering Committee.
Branded drugs go generic, making what we pay for them more of a mortgage-like investment than a rent-like expense. Although some health economists recognize that value, hardly any cost-effectiveness models have taken it into account. We’re working with leading academic health economists to redo old math to see how much value has been overlooked.
We've teamed up with health insurance and policy experts to model how insurance plans could be designed if they couldn’t rely on OOP costs for prescribed treatments. So far, our findings suggest it’s possible to eliminate OOP costs while preserving payers’ ability to negotiate with providers and drug companies.
The profitability of the drug industry cannot be judged by measuring its larger and more successful companies and ignoring unknown or struggling competitors. We’re compiling an integrated income statement for the drug industry to determine its overall profitability. So far, our analysis shows that the whole industry is only moderately profitable and that top-down price controls would cut deeply into R&D.
“We like the idea of ensuring that all drugs will go generic without undue delay, but how would that actually work?” We get this question from lawmakers all the time. So we’re drafting a mock bill because it’s always easier to revise a draft than to come up with something from scratch.
We’re not content focusing on theoretical ways to help uninsured patients afford drugs. We support HarborPath, a North Carolina-based non-profit that assists uninsured people by providing their prescription drugs for free. Unlike many patient-assistance charities, HarborPath helps patients even if they are undocumented. Because compassion doesn’t abide bureaucracy.
For Contractual Genericization to work, we need to figure out how to set a price that simulates what an ungenericizable drug’s price might drop to if it were to go generic competitively. We must study the margins and production costs of many types of drugs so that the framework we create can inform both economic models of our proposal as well as the bill that will bring it to life.
How much would the US Government’s go-to team of economists think our proposal would cost the federal government? We’re working with analysts to model Congressional Budget Office scores for each of our key reforms.
We’re modeling the impact of NPLB’s proposal on insurance premiums and taxes, factoring in the higher (appropriate) utilization of drugs on savings from averted healthcare services, industry’s revenues and cost of goods sold (COGS), PBM rebates, and incentives for innovation.
We know how much American patients pay every year in out-of-pocket costs. But that’s not the whole picture. How much isn’t being paid because people abandon prescriptions due to high out-of-pocket costs? The answer to that question informs how much it would cost to actually provide coverage of appropriate care to all Americans.
Would a healthy person really take a cancer drug if it were free? This drug-by-drug analysis examines the degree to which eliminating OOP costs would raise premiums due to over-utilization (not just increased appropriate utilization). Many branded drugs are so unpleasant that it’s hard to imagine why someone would need an OOP cost to deter inappropriate utilization.
Payers, providers, and drug companies employ people to fight amongst themselves in an arms race of bureaucracies and counter-bureaucracies, with patients in the crossfire. If out-of-pocket costs were outlawed, what bureaucracy might be rendered unnecessary? Would hospitals need “surprise billing” departments? Efficiencies could offset the cost of appropriate care and help keep premiums down.
If we eliminated out-of-pocket costs, more patients would be able to access the medications they need. Branded drug volumes would likely go up, but increased drug company margins would make it possible for PBMs to drive further price competition in competitive drug classes, mitigating the impact of eliminating OOP costs on overall societal spending. We plan to model these dynamics.
Anticipating and publicizing when a branded drug is set to enter the public domain achieves two goals. First, we can show innovators that they are appreciated, by telling their drugs’ origin stories and celebrating their contributions to human health. Second, we can appeal to them to let their products go generic with grace. Read more.