Americans watching the ongoing debate over drug prices may have gotten a preview of their future recently—and not in a good way. While politicians on the left claim their efforts will bring down the cost of drugs, examples from other countries demonstrate how cost controls often result in patients not getting access to drugs at all.
In the United Kingdom, a new Alzheimer’s drug “was approved … by the country’s regulator but deemed too expensive for wide use.” While regulators found some signs of the drug’s clinical effectiveness, the National Institute for Health and Care Excellence (NICE) dubbed it not cost-effective for Britain’s National Health Service. As a result, approximately 70,000 English patients will not have access to the drug because a government board considers it too costly.
On this side of the Atlantic, some states have created their own government boards to examine drug costs, which could lead to a NICE-style regime for American patients. For instance, last year, Democrats in Minnesota passed a law, signed by Gov. Tim Walz (D-MN), creating such a board in the Gopher State.
On the plus side, the Minnesota legislation did include explicit protections for individuals with disabilities. The bill signed into law prohibits the board from using “cost-effectiveness analyses that include the cost-per-quality adjusted life year or similar measure.” The quality-adjusted life year measure has come in for justifiable criticism as discriminatory, because it treats the value of an additional year of life for someone with a disability as of less worth than an additional year of life for a “healthy” person.
The Minnesota bill requires that the board “must use results that weigh the value of all additional lifetime gained equally for all patients no matter their severity of illness, age, or pre-existing disability.” While that language protects individuals with disabilities from discrimination based on their disability status, it does not protect them—or any Minnesota resident—from being rationed access to treatment on cost grounds.
With cost-effectiveness research explicitly included in the legislative text, it stands to reason that the Minnesota board will undertake such research and use that research to restrict access to expensive drugs. After all, as Mr. Walz himself said in another context, why would they mention this research if not to put it to use by denying patients care?
Patients deserve better than getting access to care denied on cost grounds. As the mother of a daughter with cystic fibrosis, I have closely followed how NICE denied thousands of British CF patients access to an effective drug for years on cost grounds. That board has a most Orwellian acronym because government bean counters letting patients suffer for years must be one of the least NICE actions imaginable.
Ultimately, efforts like those in Minnesota and other states to use government power and engage in various forms of price-fixing will lower prices far less than they restrict access to care. There are indeed effective ways to lower drug costs, from streamlining the FDA approval process to encouraging incentives for the competition by generic drugs that can reduce prices.
However, price controls, boards of unelected bureaucrats, and arbitrary cost-effectiveness targets will only hurt the patients needing access to care most. As the mother of a special needs child, I care about that issue most—and NICE’s latest actions demonstrate how the Minnesota model will move us in the wrong direction.