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Why Some Drug Prices Should Be High

The high prices of prescription medicines in the US have prompted much public anger, compelling President Donald Trump to promise to bring those prices down. But while this is a worthwhile goal, Trump must be careful to strike the right balance between accessibility and scientific innovation.

SAN FRANCISCO – US President Donald Trump recently told the US Congress that Americans must “work to bring down the artificially high price of drugs and bring them down immediately.” He is right that, in the United States, prescription medicines are very costly – a reality that has prompted much public anger. But, in tackling this problem, Trump must be careful not to undermine scientific innovation.

The relationship between unmet medical need, innovation, and high drug prices is complex and politically fraught. For example, the 1983 introduction of the US Orphan Drug Act successfully supported the development of treatments for rare conditions. But, despite the financial incentives (like tax reductions) that the act provided to companies for research and development, the resulting treatments carry jaw-dropping price tags. And some companies gamed the system, repurposing old drugs as much more expensive orphan drugs – a practice that deepened public anger.

However justifiable some of that anger may be, the reality is that the process of discovering and developing new drugs is highly challenging and laden with risks. The aberrant processes underlying many diseases remain a mystery, and it is difficult to perform experimental medical studies that are both ethical and effective.

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