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As the U.S. grapples with rising costs for prescription medicines, the Trump administration has floated a proposal that would have Medicare use a so-called International Pricing Index as a benchmark to pay for certain drugs. Although still being crafted, the idea has, once again, focused attention on the different prices paid in the U.S. and other countries. So Suffolk University professor Marc Rodwin, who specializes in health law, has begun studying payment systems elsewhere and recently looked at France, where retail drug spending declined between 2008 and 2017, compared with rising spending in the U.S. We spoke with him about the different approaches taken by the two countries and what lessons can be learned. This is an edited version of our conversation.

Pharmalot: What prompted this and why start with France?


Rodwin: Actually, I’m looking at all of the European countries and their health technology assessments. I’m also going to publish manuscripts about the U.K. and Germany. … This is just the one that’s come out first. But Europe is particularly interesting as opposed to other parts of the world. Europe is the second-largest pharmaceutical market after the U.S. and their approach toward health technology assessments is widely studied and emulated. And so it’s viewed as a potential U.S. model because it’s based on a kind of a cost-effectiveness analysis, which we do a little bit in the U.S., or a market-oriented system that compares prices of all drugs in relation to new drugs and tries to mimic a market. So it seems there’s a lot we can learn a lot from Europe.

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