1. Goal:  Lower drug cost so that they are affordable to patients

     a. US Rate of Inflation (2017-2019) = 2.14% to 1.8%

     b. CPI = 2.0%

     c. CPI (health care) = 2.8% (2019)

2. Drug Cost Transparency

     a. Transparency = cost

     b. CA SB17: WAC >= $40 with 16% inflation in prior year, or 32% inflation in last 2 years

3. How do they differ?  Are they effective?  Pros/Cons

     a. White House Plan

     b. Congressional Action

     c. Congress – Democratic Plan

4. State Plans – What are they trying to do?  Pros/Cons

     a. California

     b. New York 

5. Discount Programs

     a. GoodRx

     b. TimesRx

     c. Misc.

6. PhRMA unregulated for innovation

     a. Largest PhRMA produce 11% of leading new Rx

     b. New Rx develo9ped by universities, academic centers, NIH, hospital research groups

     c. 2/3 of new Rx developed by France, Germany, Japan, Switzerland and UK

     d. Raw materials from China, India, Israel, Brazil, South Africa, Australia

7. Transparency

     a. Shoppable vs. urgent

     b. Uwe Reinhardt – Priced Out – health care spending increases private sector > public sector

     c. Gag Order Bans (half-of-states)

     d. 8 States – PhRMA must provide reasons for reasoning for drug cost decisions

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