US Drugs Not Consistently Aligned with Net Health Benefits


Unlike many other countries, health care reimbursements for medications in the United States are not consistently aligned with their value or net health benefits, according to a new study.

The study, published in Health Affairs, revealed that US drug prices are not always aligned with the health outcomes achieved.

Researchers from the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences used data from 1985 to 2011 to determine average lifetime quality-adjusted life-years (QALYs), which is used to measure 1 year of perfect health, and payer-related costs to calculate incremental cost-effectiveness ratios for commonly reimbursed cardiovascular drugs.

Using cost-effectiveness as a driver for coverage and reimbursement decisions can inform manufacturers as to what constitutes an acceptable cost per unit of health gained for drugs, the researchers noted.

“Solutions toward fair drug pricing include the US sending more signals about what we value in health and US decision makers being willing and able to walk away from unfair pricing,” lead author Jon Campbell, PhD, associate professor of pharmacy, said in a press release.

The findings indicated a wide spectrum of cost-effectiveness across the 30 drugs evaluated, ranging from cost-saving with increased QALYs to costlier with decreased QALYs. According to the researchers, this range suggests that drug pricing in the United States is not consistently influenced by value, or that such influence is masked by inaccessible factors, such as price discounts.

“When we purchase a medical treatment, we expect to get something in return, such as living a longer life or having fewer symptoms,” co-author Melanie Whittington, PhD, research faculty at the CU School of Pharmacy, said in the press release. “The results of our study show the amount insurance providers pay to get 1 more unit of health, such as 1 additional year of life in perfect health, varies considerably and can exceed what is considered good value in other parts of the world. This contributes to higher-priced medical treatments.”

The findings highlight the need to debate how to define and use value-based evidence to inform US coverage and reimbursement decision making, the researchers concluded.


Campbell J, Belozeroff V, Whittington MD, et al. Prices for common cardiovascular drugs in the US are not consistently aligned with value. Health Affairs. 2018.

Drug prices not always aligned with value, CU Anschutz researchers say [news release]. University of Colorado’s website. Accessed August 7, 2018.

Related Videos
Laboratory test tubes and solution with stethoscope background | Image Credit: Shutter2U -
Image credit: Andrea Izzotti
Inflation Reduction Act is shown using the text and the US flag - Image credit: Andrii |
Pharmacy Interior | Image Credit: Tyler Olson -
Male pharmacist selling medications at drugstore to a senior woman customer | Image Credit: Zamrznuti tonovi -
Pharmacist assists senior woman in buying medicine in pharmacy - Image credit: Drazen |
Pharmacy, medicine and senior woman consulting pharmacist on prescription. Healthcare, shopping and elderly female in consultation with medical worker for medication box, pills or product in store - Image credit: C Daniels/ |
Image credit: fidaolga -
Pharmacists checking inventory at hospital pharmacy- Image credit: Jacob Lund |
Young male pharmacist giving prescription medications to senior female customer in a pharmacy | Image Credit: Zamrznuti tonovi -
© 2023 MJH Life Sciences

All rights reserved.