Regarding the NYT's piece on drug pricing

Reading the New York Times this morning, this piece caught my eye. I have a lot of respect for both reporters in the byline, especially their acknowledging that the way the U.S. pays for prescription drugs is complex and rife with perverse incentives.

While I understand the temptation to look outside the U.S. for answers, here are a few points that I wish had been reflected in the piece.

• The U.S. is the R&D leader of the world, and there is a complex ecosystem of investors and payors. There are large costs – and risks – with bringing a molecule from the lab to a patient, and recent NPC research suggests that most of the cost of that risk is borne by drug developers. 
• We are in a golden age of biopharmaceutical innovation. Last year, the FDA approved 55 novel drugs – the second-highest over the last 30 years. And U.S. patients typically have earlier access to newly launched products than patients in other countries with a single negotiator.
• As a percentage, what we spend on drugs compared to overall health spending in the U.S. is one of the lowest of economically-similar countries. 
• We already have price negotiation in the U.S. - currently done by commercial payers – and one need only look at the rise in formulary exclusions to dispel the myth that our health care system isn’t willing to negotiate hard.
• Don’t forget: Because of the way we pay for medicines in the U.S., there are drug shortages for medicines with prices that are too low.

Finally, central planning and price regulation don’t lead to innovation. Adopting the practices of international systems that limit patient access isn’t likely to be the answer.