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NCD Statement on harm of using International Pricing Index for U.S. prescription drug pricing

Wednesday, August 5, 2020


Aug. 5, 2020

WASHINGTON—The National Council on Disability released the following statement:

Making prescription medicines more affordable is a proper and necessary goal for the U.S., but it is not in the best interest of Americans to import price controls from countries that use the International Pricing Index (IPI) to determine U.S. drug pricing.

Importation of the IPI in the U.S. will restrict access to prescription medications for the millions of Americans who rely on Medicare Part B due to the IPI’s reliance on quality-adjusted life years (QALYs) – a formula used to assess the value of medications by assigning a lower value to the life of a person with an illness or disability.

To date, QALYs have been deemed contrary to U.S. public policy because of the discriminatory design and impact on people with chronic illnesses and disabilities. NCD’s 2019 report on QALYs describes their consequences on people with chronic illnesses and disabilities in countries with government-run health systems that use the IPI. Where Americans enjoy broad access to the most effective and cutting-edge medications available, people in IPI countries have dramatically less access to important drugs, including denied or restricted access to the most effective drugs for cancer and other serious medical conditions.

Medicare and Medicaid have not relied on value assessments that use QALYs for prescription drugs but importing the IPI will most certainly reduce access to quality healthcare for Americans by limiting or restricting access to medications. It will also import the use of QALYs, which run counter to U.S. civil rights laws that prohibit healthcare discrimination against people with disabilities.

For the benefit of all Americans who rely on nondiscriminatory access to the most effective prescription drugs to treat their individual conditions, NCD urges the Trump administration to abandon its plan to use IPI and to examine alternatives that do not rely on QALYs or other discriminatory metrics.


An official website of the National Council on Disability