Andrew W. Mulcahy
US prices for brand-name drugs are substantially higher than those in other countries. Recent "most favored nation" proposals aim to simultaneously lower US prices through international reference pricing while increasing prices in other countries toward parity with the US. Although most favored nation policies have some merit, the challenge is for the US to establish the point at which they will have succeeded-that is, when the resulting net prices paid for brand-name drugs are "right" from a US-focused, value-oriented perspective. Without investments in US health technology assessment research, this crucial endpoint will remain difficult to define.