Intended for healthcare professionals


Propaganda or the cost of innovation? Challenging the high price of new drugs

BMJ 2016; 352 doi: (Published 11 March 2016) Cite this as: BMJ 2016;352:i1284
  1. Narcyz Ghinea, doctoral researcher,
  2. Wendy Lipworth, senior research fellow,
  3. Ian Kerridge, professor
  1. Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to: N Ghinea narcyz.ghinea{at}
  • Accepted 8 February 2016

Concern is growing about the implications of rising drug prices for individuals and health systems around the world. With little transparency around the costs of drug development, Narcyz Ghinea and colleagues call for greater accountability from drug companies to ensure a fair price for new medicines

In 2014, the IMS Institute for Healthcare Informatics estimated that, by 2018, global spending on medicines would increase to almost $1.3tr (£900bn; €1.2tr), an increase of over 30% over five years.1 Forty per cent of this growth is expected to come from specialty drugs such as cancer drugs and immunosuppressants, with predictions that by 2018, such drugs will account for 50% of drug spending in the United States.2

These estimates may be conservative. For example, the IMS prediction that global spending on cancer medicines would reach $100bn by 2018 had already been passed in 2014, with almost half of this spending associated with targeted, or personalised, therapies.3 Likewise, the prediction that $100bn will be spent globally on hepatitis C drugs in the five years up to 2018 seems conservative given that the estimated cost of treating all patients with hepatitis C with sofosbuvir (currently priced at about $84 000 for a 12 week course) in the United States alone would be almost as much as the cost of all other medicines combined.4

The challenge of high drug costs also extends to rare diseases which, when combined, affect up to 10% (30 million) of Americans, 40 million Europeans, and 350 million people worldwide.5 6 Cohen and Felix identified 11 drugs for rare diseases that have been approved by the US Food and Drugs Administration (FDA) and that cost more than $225 000 per patient a year.7 Some of these drugs are not only expensive but also have high costs per quality …

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