Book review: The Price of Global Health, 3rd edition

Drug pricing has always been a controversial topic, but as controversies go, it is one of the hottest ones in healthcare today. Readers of The Price of Global Health will get the perspective of a pharmaceutical industry manager (who is but one player in the multiperspective dynamic going on)—but the book is not a simplistic pitch for higher drug prices. Rather, it provides a valuable overview of the many factors involved in industry, insurer, provider and patient concerns—and with a global perspective that has its own high value.

The Price of Global Health is now in a third edition (previous editions were written in 2011 and 2015), and has been extensively revised. The author is Ed Schoonveld, currently managing partner of the Value and Access Practice with ZS Associates in New York. His prior experience includes stints at Lederle, Wyeth, Eli Lilly and BMS in the U.S. and Europe; he has also served as a consultant in pricing deliberations at the World Trade Organization.

After reading through the book’s sections, one gets a sense of surprise that any new drug can be commercialized at all—and not simply because of payers’ desire to get the lowest possible price. One example: it is well known (at least in the industry) that drugs for life-saving conditions are typically first tested on very sick patients (thus, are third- or fourth-line therapies, rather than the first-line therapy that might be used for a newly diagnosed patient). Most of the time, only if the drug shows efficacy at that stage can it begin the process of gradually rising (through additional trials) to becoming a first-line therapy. This arduous journey can be shut down at the earliest stages, even if the drug candidate has high potential for a less sick, newly diagnosed patient.

As detailed as the book is, it is not an instruction set for actually setting a drug price. Rather, a thorough knowledge of the information in this book is the foundation from which more focused analysis can be conducted to arrive at the pricing that provides the best chance for a successful launch and long life cycle for the drug.

A section at the end of the book details pricing and market considerations globally, for 13 nations, ranging from the US to India. With talk in Washington of an effort to adopt reference pricing for the US market, which would in turn depend on how prices are set especially in single-payer, national systems around the world, this has its own value.

The Price of Global Health: Drug Pricing Strategies to Balance Patient Access and the Funding of Innovation, E. Schoonveld; published by Routledge. an imprint of Taylor & Francis Group, an informa business. ISBN: 978-0-367-27940-0 (hbk), ISBN: 978-0-429-32071-2 (ebk)