In this ‘Patti’s People’ episode, Patti Peeples of The Peeples Collaborative speaks with Lou Garrison (Professor Emeritus, The CHOICE Institute at the University of Washington) about rethinking pharmaceutical pricing beyond launch price, and why access delays, differential contribution, and global innovation incentives matter more to patient outcomes.
Questions:
00:00: Introduction
01:43 Have we misdiagnosed the central challenge in pharmaceutical policy?
04:51: Why has launch price become the dominant political narrative?
06:37: How significant is the hidden cost of delayed access to innovation, and do healthcare systems underestimate the harm caused by waiting?
15:50: You've argued for a lifecycle approach to pricing rather than a focus on launch price. What does that shift mean in practice, and why is it important for patients and healthcare systems?
22:47: Are there countries or healthcare systems that are already moving toward this broader procurement approach?
27:43: Where are the greatest opportunities to make HTA faster and more efficient without compromising decision quality?
33:10: What led you to move from differential pricing to differential contribution, and why do you see it as a better framework for global access and innovation?
34:40: How should wealthy countries think about their responsibility to support pharmaceutical innovation?
39:04: What do policies such as the IRA and MFN reveal about the challenge of balancing affordability, innovation, and patient access?
43:16 What does the hepatitis C experience teach us about evaluating the value of medical innovation over its full lifecycle rather than focusing primarily on launch price?
49:38: Rapid Fire Questions
Lou Garrison
Professor Emeritus, The CHOICE Institute at the University of Washington
Lou Garrison, PhD, is Professor Emeritus in The Comparative Health Outcomes, Policy, and Economics Institute in the School of Pharmacy at the University of Washington, where he joined the faculty in 2004. He is also a Visiting Senior Fellow at the Office of Health Economics in London following his sabbatical there in 2012–13.
Professor Garrison received a PhD in Economics from Stanford University and has more than 200 publications in peer-reviewed journals.
For the first 13 years of his career, he worked in non-profit health policy. Following this, he worked as an economist in the pharmaceutical industry for 12 years.
His research interests include national and international health policy issues related to health technology assessment, personalized medicine, benefit-risk analysis, and other topics, as well as the economic evaluation and pricing of biopharmaceuticals, diagnostics, and other technologies.
Professor Garrison was elected as ISPOR President for July 2016–June 2017. He has served as co-chair of ISPOR’s Policy Outlook Committee for Health Science Policy Council, and he is currently a leader of the ISPOR Special Interest Group on Global Access to Medical Innovation. In September 2022, he received the Avedis Donabedian Outcomes Research Lifetime Achievement Award from ISPOR.
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