Health Affairs March 11, 2025
Drug value assessments generally fail to account for the complexities of health care systems and thus can misinform price negotiations and lead to overly restrictive access policies.
Studies have found that conventional cost-effectiveness analyses tend to ignore broader real-world impacts and externalities that influence the use of drugs, a lesson learned during the COVID-19 pandemic. In addition, budget-impact analyses, which often accompany cost-effectiveness analyses, suffer from the same problem, sometimes wildly overestimating drug uptake because they underestimate how systems impede access.
Why It Matters
Value assessments can influence coverage policies for medications. However, the gap between projected and realized value can be profound. Cost-effectiveness analyses and budget-impact assessments that ignore real-world access barriers can themselves exacerbate barriers to access because...
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