Policy Implementation Framework: Addressing Prescription Drug Costs Through Government Price Negotiation

Authors

  • Krupa Patel

Abstract

Prescription drug costs in the United States remain among the highest in the world, with nearly 25% of Americans unable to adhere to prescribed treatments due to affordability issues. This policy brief proposes a phased approach to government negotiation of drug prices through Medicare to enhance affordability and improve health equity. Using the policy triangle framework, the analysis incorporates stakeholder perspectives, legislative pathways, and lessons from the Veterans Health Administration, which currently pays an average of 54% less for many medications compared to Medicare. The proposed policy aims to target high-cost drugs such as insulin and cancer treatments, gradually expanding to include more categories. It outlines mechanisms for implementation, including legislative amendments to the Social Security Act and oversight by agencies like CMS and FDA. The policy also emphasizes the importance of addressing trade-offs between affordability and innovation, and ensuring inclusivity by prioritizing the needs of marginalized populations. If enacted, this policy has the potential to significantly lower drug prices, improve patient adherence, and reduce systemic healthcare costs, while maintaining a balanced environment for pharmaceutical innovation.

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Published

2025-10-30

Issue

Vol. 9 No. 5 (2025): Articles

Section

Healthcare Administration

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