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“Take away our rebates? We’ll just up premiums.” This is the threat from pharmacy benefit managers (PBMs) and insurers if rebates are passed back to seniors in Medicare. PBMs determine the formularies for Medicare beneficiaries, thus controlling what drugs they can get, where they can get them and how much they will pay for them. Ideally, placement on the preferred formulary should be based on efficacy, safety and lowest list price. However, preferred status is determined by highest price concessions from manufacturers in the form of rebates and administration fees. (Madelaine Feldman, 3/18)

Innovative new drugs can be miraculous, often representing quantum advances in health. Recent examples include the unprecedented benefits of antiviral drugs to treat hepatitis C, gene therapy, checkpoint inhibitors and CAR T-cells for cancer. Many drug developers are working on complementary products and technologies to make these recent advances even better, as well as new innovative approaches. Often, however, they are monumentally expensive, with a course of treatment running into the hundreds of thousands of dollars per patient. (Jacob J. Gottlieb and Joseph Gulfo, 3/18)

The generic drug industry should cause prices for medications to drop. But lately it has been engaging in price gouging and making it difficult to obtaining some vital medications. You’ve heard the stories: a 5,000 percent increase by Turing Pharmaceuticals for one tablet of generic pyrimethamine, which is used to treat toxoplasmosis, a rare infection; a 2,800 percent price increase in a single year for digoxin, a commonly prescribed heart medication. (Marc Harrison, 3/14)

Alice, a preteen with newly diagnosed leukemia, and her parents were understandably distraught when she was diagnosed with cancer. As I sat down to discuss treatment options with Alice’s parents, I was glad I had something positive to share with them: A recent clinical trial showed that adding the drug nelarabine to standard chemotherapy led to a significant improvement in survival for children with Alice’s form of leukemia. Unfortunately, a national shortage of nelarabine meant that for Alice — I’ve used a pseudonym — the chances for a cure were suddenly less clear. (Yoram Unguru, 3/19)

For a country whose GDP per capita is only 15 percent that of the U.S., consumers in China are paying remarkably high drug prices. The U.S. isn’t famed for its low-cost pharmaceuticals – but prices of generics are on average only 55 percent of those in China, according to a recent Credit Suisse Group AG report. For instance, Jiangsu Hengrui Medicine Co.’s Docetaxel, a chemotherapy medication that treats a number of cancers, costs one-third less in the U.S. Or consider Levamlodipine, a cardiovascular drug. If CSPC Pharmaceutical Group Ltd. charged prices similar to those prevailing in the U.S., it would see 5 percent of its annual revenue gone. (Shuli Ren, 3/18)

In the ongoing debate about value in health care, the narrative in the media, political campaigns, and congressional hearings has consistently focused on the relatively narrow issue of drug pricing.We are squandering time and resources trying to find a neat answer to “what is value?” by focusing on the cost of drugs without tackling other hard questions at the heart of measuring value across health care interventions. (Jennifer Bright and Mark Linthicum, 3/14)