Academics must realize that studies based on correlations or incomplete data that will be misinterpreted by the media are best left unwritten.
– which shouldn’t be surprising given the term “costs” is right in the title of the paper. Unfortunately, at best the study can provide a rough estimate of what drives changes in what some patients pay out of pocket – which is important but quite a bit more limited than the claims of the paper and its press coverage.
Ultimately, net prices are the actual “price” for most insured consumers. In contrast, list prices primarily impact the spending of people who are uninsured, people whose cost sharing involves either a deductible or coinsurance , and some amount of Medicare Part D spending. This is not a trivial segment of the population, with recent estimates suggesting nearly half of Americans are in some way exposed to the list price.
The specifics of this admitted bias in the data are important. If it was simply that list prices were higher than net prices, there would not be as large a concern. But, as the authors note, the difference between list and prices varies markedly across drugs based on the competitive environment.
Lacking an ability to answer the underlying question, the authors shouldn’t have written the paper at all or at a minimum should have written a vastly more limited draft .
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