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Appendix B: A Minority Perspective - Rena Conti, Stacie Dusetzina, Martha Gaines,Rebekah Gee, Victoria Hale, Peter Sands, and Alan Weil
Pages 179-182

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From page 179...
... The committee's report shines a powerful spotlight on the myriad ways in which actors within the biopharmaceutical development, production, and distribution system exploit information asymmetries, misaligned incentives, and market power to maximize profits, often to the detriment of individual patients or society as a whole. Even as the biopharmaceutical industry delivers enormous benefits through the development of new drugs with significant clinical value, the shortcomings of our current approach are apparent.
From page 180...
... The current biopharmaceutical market displays so many market failures and distortions that marginal improvements in market functioning will be insufficient to achieve the goal of affordable drugs. Taking the view that the method for achieving patient access to affordable drugs is to redesign the regulatory framework that defines the market, we identify three specific areas where the committee's recommendations should be stronger.
From page 181...
... So long as the methods purchasing intermediaries, hospitals, and payers use to make coverage, pricing, and formulary decisions are opaque, patients and policy makers cannot know whether current arrangements provide value that outweighs the costs to patients and the health care system. The committee appropriately recommends further testing and refinement of methods for determining the "value" of drugs and using those methods in formulary design and payment policy.
From page 182...
... Yet, public resources are limited and it is more efficient to harness the power of the market to achieve these social goals. A recent National Academies of Sciences, Engineering, and Medicine study explored alternative public purchasing models for hepatitis C drugs with the goals of increased access and affordability.1 The committee appropriately recommends exploration of alternative payment models.

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