All else being equal, people care more about outcomes that happen in the near future than about outcomes that happen later. The discount rate represents how much timing matters. We sit down with Josh Cohen, Deputy Director of the Center for the Evaluation of Value and Risk in Health (CEVR) at the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center, and Research Professor of Medicine at Tufts University School of Medicine, to learn about how changes to the discount rate can alter how we value medicines.

Generalized cost-effectiveness analysis (GCEA), a framework to comprehensively assess the societal value of innovative health technologies, will be officially debuted at the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) conference in Atlanta this week

Many people who dedicate their lives to discovering, developing, and making new, lifesaving drugs don’t understand the extent to which the drug industry has failed to communicate its value proposition to society and to inspire its customers to pay for that value. That is to say, when the public and even legislators representing our biotech innovation hubs focus on the price of a breakthrough drug without a sense of its value or how it came into being and insist that innovators should not only invent medicines but pay for them, too, that’s a self-inflicted wound. Vertex’s Trikafta, one of our industry’s greatest success stories, provides an example.

European central planners should stop trying to talk the US out of incentivizing the development of better medicines that then also help Europeans and the rest of the world. It’s one thing to argue that any one country can’t afford to pay more for new drugs. It’s another thing entirely to put new drugs in jeopardy for everybody by exporting that thinking to the one country whose market-based system has underpinned the last several decades of pharmaceutical advances.

It may surprise you to find out just how badly we’re failing to take a comprehensive approach to quantifying societal value from new innovations in medicine. The IRA’s investment in our climate future should be lauded; its treatment of medical innovation is unfortunately hobbled by its goal of lowering Medicare spending today at the expense of tomorrow’s patients – that is to say, all of us.

It’s long been assumed that as long as NICE-like cost-effectiveness analyses stay on the other side of the ocean, our US biotech ecosystem will be fine. But in recent years, toxic math has begun to make its way to US soil. Peter Kolchinsky sat down with Jayson Dallas to get his take on NICE’s tactics, their increasingly global reach, and how biopharma can fight back.

In today’s FutureCast discussion, RA’s Raj Shah, Jake Simson, Tess Cameron, and Peter Kolchinsky revisit one of our most talked-about articles: Time to Reboot Biotech. Fresh financial analysis and actionable board room advice abound.

Traditional cost-effectiveness analyses done by organizations like ICER and NICE overlook much of the value of new drugs, including factors with crucial societal impact like genericization, risk reduction, and community spillover. Peer-reviewed research has made this clear again and again, but these organizations continue to insist on using outdated formulas to determine the value of drugs. With the passage of the IRA and imminent drug pricing “negotiations” (read: price controls), it’s more important than ever to get the math that values our medicines right.