High prescription drug prices are increasingly straining the budgets of patients, payors and healthcare systems in the United States. In this JAMA clinical review, Drs. Avorn, Kesselheim and Sarpartwari describe the origins for high drug prices and recommend policy options to help contain these rising costs. They find that per capita prescription drug spending in the United States is more than twice the average of other industrialized countries, and now comprise about 17% of total healthcare expenditures. High prices arise primarily because of government-protected monopolies. Other contributors include the fact that some physicians prescribe high cost drugs when comparable and less costly alternatives are available. Enhancing generic competition, increasing opportunities for meaningful price negotiation by governmental payers, and academic detailing were cited as realistic strategies to help contain prescription drug prices.
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