Rob Shaffer responds to A. Gordon Smith’s article, “The Cost of Drugs for Rare Diseases Is Threatening the U.S. Health Care System” (Harvard Business Review).
Think of a newly approved drug as you would buying a new home. With the new home comes a mortgage, taxes, insurance, and upkeep; the mortgage is often the most significant of the three, at least upfront. After the 15- or 30-year payment term, you own your house, and just have to pay taxes, insurance, and upkeep, a far less expensive monthly total. Drugs are similar: under patent protection the innovative company can charge a premium to recoup development costs and turn a profit to encourage further investment in the company. After patent expiration, cheap generics compete and drive down the price of the drug, similar to paying off your house and only having to spend on taxes, insurance, and upkeep.
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