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The High Cost of Prescription Drugs in the United States: Origins and Prospects for Reform

Overview of attention for article published in JAMA: Journal of the American Medical Association, August 2016
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • One of the highest-scoring outputs from this source (#10 of 20,763)
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (99th percentile)

Mentioned by

news
132 news outlets
blogs
14 blogs
policy
1 policy source
twitter
1500 tweeters
facebook
64 Facebook pages
wikipedia
4 Wikipedia pages
googleplus
20 Google+ users
reddit
19 Redditors

Readers on

mendeley
130 Mendeley
Title
The High Cost of Prescription Drugs in the United States: Origins and Prospects for Reform
Published in
JAMA: Journal of the American Medical Association, August 2016
DOI 10.1001/jama.2016.11237
Pubmed ID
Authors

Aaron S. Kesselheim, Jerry Avorn, Ameet Sarpatwari, Kesselheim, Aaron S, Avorn, Jerry, Sarpatwari, Ameet

Abstract

The increasing cost of prescription drugs in the United States has become a source of concern for patients, prescribers, payers, and policy makers. To review the origins and effects of high drug prices in the US market and to consider policy options that could contain the cost of prescription drugs. We reviewed the peer-reviewed medical and health policy literature from January 2005 to July 2016 for articles addressing the sources of drug prices in the United States, the justifications and consequences of high prices, and possible solutions. Per capita prescription drug spending in the United States exceeds that in all other countries, largely driven by brand-name drug prices that have been increasing in recent years at rates far beyond the consumer price index. In 2013, per capita spending on prescription drugs was $858 compared with an average of $400 for 19 other industrialized nations. In the United States, prescription medications now comprise an estimated 17% of overall personal health care services. The most important factor that allows manufacturers to set high drug prices is market exclusivity, protected by monopoly rights awarded upon Food and Drug Administration approval and by patents. The availability of generic drugs after this exclusivity period is the main means of reducing prices in the United States, but access to them may be delayed by numerous business and legal strategies. The primary counterweight against excessive pricing during market exclusivity is the negotiating power of the payer, which is currently constrained by several factors, including the requirement that most government drug payment plans cover nearly all products. Another key contributor to drug spending is physician prescribing choices when comparable alternatives are available at different costs. Although prices are often justified by the high cost of drug development, there is no evidence of an association between research and development costs and prices; rather, prescription drugs are priced in the United States primarily on the basis of what the market will bear. High drug prices are the result of the approach the United States has taken to granting government-protected monopolies to drug manufacturers, combined with coverage requirements imposed on government-funded drug benefits. The most realistic short-term strategies to address high prices include enforcing more stringent requirements for the award and extension of exclusivity rights; enhancing competition by ensuring timely generic drug availability; providing greater opportunities for meaningful price negotiation by governmental payers; generating more evidence about comparative cost-effectiveness of therapeutic alternatives; and more effectively educating patients, prescribers, payers, and policy makers about these choices.

Twitter Demographics

The data shown below were collected from the profiles of 1,500 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 130 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 6 5%
Germany 1 <1%
Japan 1 <1%
Netherlands 1 <1%
Sweden 1 <1%
Unknown 120 92%

Demographic breakdown

Readers by professional status Count As %
Student > Master 28 22%
Student > Ph. D. Student 20 15%
Other 19 15%
Researcher 18 14%
Student > Bachelor 16 12%
Other 29 22%
Readers by discipline Count As %
Medicine and Dentistry 56 43%
Social Sciences 11 8%
Nursing and Health Professions 9 7%
Agricultural and Biological Sciences 9 7%
Unspecified 9 7%
Other 36 28%

Attention Score in Context

This research output has an Altmetric Attention Score of 2287. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 November 2017.
All research outputs
#250
of 8,651,065 outputs
Outputs from JAMA: Journal of the American Medical Association
#10
of 20,763 outputs
Outputs of similar age
#18
of 256,300 outputs
Outputs of similar age from JAMA: Journal of the American Medical Association
#3
of 442 outputs
Altmetric has tracked 8,651,065 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 20,763 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 38.4. This one has done particularly well, scoring higher than 99% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 256,300 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 442 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 99% of its contemporaries.