KEI has published a briefing note titled “Proposals for Reforms: Pricing, innovation and access to biomedical products,,” available as KEI Briefing Note: 2026:5. The document is 41 pages long. The text below is from the introduction:
The United States has both the world’s largest market for biomedical products and an extraordinary capacity to finance and carry out biomedical research. Yet the policies used to reward innovation often impose unnecessarily high costs on patients, taxpayers and health systems, and public investments in research are not accompanied by adequate protections for affordability and access.
Drug pricing reform is repeatedly stalled by a single argument: that lowering prices will undermine innovation. Congress does not have to choose between lower prices and biomedical innovation. Drug-pricing reforms can be combined with new and more efficient mechanisms to finance research and development (R&D) as well as improved and novel incentives and mandates for research.
This briefing note describes a set of practical reforms that Congress can consider to advance these objectives together. Some involve relatively modest changes to existing statutes and programs; others offer more transformative alternatives to the current reliance on high prices and lengthy monopolies to finance innovation. The common objective is Innovation + Access: a system that delivers both better biomedical innovation and more affordable access to its benefits.
It begins with transparency, without which every other reform is harder to design and defend, and which is important for implementation of reforms. It then works through underused and flawed safeguards already in federal law, before turning to novel approaches: a more targeted and cost-effective replacement for the Orphan Drug Tax Credit subsidy, revenue-based rather than price-based tests for excessive pricing, research mandates, access to manufacturing know-how, and a progressive path toward delinking incentives to invest in R&D from exclusivity altogether.