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.

We’ve suffered a protracted downturn in general interest in biotech. That downturn has been compounded by rising interest rates undercutting equities in general. Now we must determine 1) how much worse this downturn might be and 2) how we’ll do things differently once we reboot. Here, Peter Kolchinsky explains why he believes we’ve emerged from the downturn but must reboot biotech with more honest and efficient processes and better defend our industry’s value proposition to policymakers and the public.

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 Peer-reviewed research has made this clear again and again, but these organizations continue to insist on using outdated formulas to determine the value of drugs.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.