Putting Americans First: Importing European prices means importing European systems and values

European countries don’t just pull prices for medicines out of thin air. The prices that those governments set are based on specific sets of assumptions about their citizens and their economies. That creates an issue around proposals that seek to tie U.S. prices to those in other countries. After all, the assumptions about health care in the United States can be very different.

Other countries generally have a lower willingness to pay for health gains than the United States does.

• In some cases, this is because the economies in those countries are weaker, putting out of reach the kind of care that Americans take for granted.
• In other cases, foreign governments are willing to put a lower price on what they are willing to spend to improve and sustain the health of their citizens.
• The UK is a classic example of this unwillingness to invest in the health of its citizens; the country sets a “willingness to pay” threshold for new medicines of about $40,000. That number hasn’t changed in a quarter century and may help explain why the UK lags peer nations when it comes to cancer survivorship.

These differences are not purely philosophical. There are real-world impacts on access when a country decides that it is unwilling to pay a fair price for the health of its citizens. That’s part of what is driving the mammoth access disparities between the U.S. and European countries.

Other countries often use metrics to restrict care that Americans have rejected as discriminatory, most notably the quality-adjusted life-year, or QALY, which tends to lessen the value attributed to interventions aimed at the elderly or those with disabilities.

Indeed, U.S. law forbids the use of QALYs in certain circumstances, and adopting international pricing norms would provide a back-door way to force inflexible European attitudes toward value onto Americans in ways that have already been explicitly rejected by the American people and U.S. policymakers.

BIO’s View: American issues deserve American solutions. There is a careful balance of innovation, pricing, and access in the United States. Rebalancing that system requires a deep look at the values and expectations of the American people, not the values and constraints of countries that are far more willing to allow patients to go without.

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