Relentless Health Value

EP494: Six Tensions of Pharmaceutical Drug Pricing, With Sarah Emond

5 snips
Dec 4, 2025
Guest
Sarah Emond
In this conversation, Sarah Emond, CEO of ICER, dives into the complexities of pharmaceutical drug pricing. She highlights six major tensions, such as the disconnect between drug prices and patient affordability. Sarah discusses the issues with rebates, emphasizing how they can distort value. The talk also covers the long-term versus short-term cost perspectives employers face. She advocates for transparent, value-based pricing models to enhance patient access and reduce healthcare costs, underscoring the need for conflict-free assessments.
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INSIGHT

Value Is Population+Time Dependent

  • Value depends on health gains versus total population cost over time.
  • GLP-1s are high-value per patient but create budget impact because many are eligible.
INSIGHT

Net Price Often Fails Patients

  • Net price and patient affordability are often disconnected due to rebates and coinsurance math.
  • A negotiated net price may not translate to lower coinsurance tied to list price.
INSIGHT

Rebates Distort Access Decisions

  • The rebate-for-formulary-placement model prioritizes discounts over true value.
  • Market dominance and rebate size often drive access decisions more than clinical benefit.
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