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Making Medicines Affordable: A National Imperative (2018)

Chapter: Appendix F: Disclosure of Conflicts of Interest

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Suggested Citation:"Appendix F: Disclosure of Conflicts of Interest." National Academies of Sciences, Engineering, and Medicine. 2018. Making Medicines Affordable: A National Imperative. Washington, DC: The National Academies Press. doi: 10.17226/24946.
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F

Disclosure of Conflicts of Interest

The conflict-of-interest policy of the National Academies of Sciences, Engineering, and Medicine (www.nationalacademies.org/coi) prohibits the appointment of an individual to a committee like the one that authored this Consensus Study Report if the individual has a conflict of interest that is relevant to the task to be performed. An exception to this prohibition is permitted only if the National Academies determine that the conflict is unavoidable and the conflict is promptly and publicly disclosed.

When the committee that authored this report was established a determination of whether there was a conflict of interest was made for each committee member given the individual’s circumstances and the task being undertaken by the committee. A determination that an individual has a conflict of interest is not an assessment of that individual’s actual behavior or character or ability to act objectively despite the conflicting interest.

Dr. Michael Rosenblatt was determined to have a conflict of interest because he is the chief medical officer for Flagship Pioneering and is a shareholder of Radius (of which he is a founder) and Merck & Co., Inc.

Mr. Henri Termeer was determined to have a conflict of interest because he was former chairman, president, and chief executive officer of Genzyme Corporation and also served on the boards of directors for several pharmaceutical and biotech companies.

Dr. Reed Tuckson was determined to have a conflict of interest because he is a former executive vice president and chief of medical affairs for the UnitedHealth Group.

In each case, the National Academies determined that the experience and expertise of the individual was needed for the committee to accom-

Suggested Citation:"Appendix F: Disclosure of Conflicts of Interest." National Academies of Sciences, Engineering, and Medicine. 2018. Making Medicines Affordable: A National Imperative. Washington, DC: The National Academies Press. doi: 10.17226/24946.
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plish the task for which it was established. The National Academies could not find another available individual with the equivalent experience and expertise who did not have a conflict of interest. Therefore, the National Academies concluded that the conflict was unavoidable and publicly disclosed it through the National Academies Current Projects System (www.nationalacademies.org/cp).

Suggested Citation:"Appendix F: Disclosure of Conflicts of Interest." National Academies of Sciences, Engineering, and Medicine. 2018. Making Medicines Affordable: A National Imperative. Washington, DC: The National Academies Press. doi: 10.17226/24946.
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Page 205
Suggested Citation:"Appendix F: Disclosure of Conflicts of Interest." National Academies of Sciences, Engineering, and Medicine. 2018. Making Medicines Affordable: A National Imperative. Washington, DC: The National Academies Press. doi: 10.17226/24946.
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Page 206
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Thanks to remarkable advances in modern health care attributable to science, engineering, and medicine, it is now possible to cure or manage illnesses that were long deemed untreatable. At the same time, however, the United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicines—and health care at large—more affordable for everyone has become a socioeconomic imperative.

Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual’s insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugs—coupled with the broader trends in overall health care costs—is unsustainable to society as a whole.

Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care.

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