Matthew Eyles

Walking the Drug-Pricing Tightrope: Fostering Innovation While Maintaining Affordability

Dan Diamond, Matthew Eyles, Dan Leonard, Mark McClellan, Seema Verma, Greg Walden, Matt Iles

Moderated by Dan Diamond, a panel comprising Seema Verma, Matt Iles, Dan Leonard, and Mark McClellan examined the unsustainability of U.S. drug spending and the urgent need for bipartisan legislation to address the "gross-to-net" price bubble and the rising cost of ultra-high therapies. While the group agreed that current payment models create perverse incentives for manufacturers of legacy drugs and antimicrobials, they diverged on solutions, with CMS advocating for private sector competition and industry representatives emphasizing the risks of government price-setting on research and development. The discussion concluded that structural reforms, including value-based arrangements and targeted regulatory changes to Medicaid Best Price rules, are essential to align reimbursement with modern cure cycles before the projected 2026 spending crisis forces administrative intervention.