The methods many countries use to evaluate new medicines significantly underestimate the true societal benefits of innovative treatments. When high-income countries use traditional methods as a bargaining tool to deny coverage and/or secure lower prices, they free ride on the R&D investments of others and reduce patient access to novel medicines in their own countries.

America is the global leader in biomedical innovation because it has a market that values new medicines. When other countries pay less, they are free-riding on our willingness to pay for new treatments. Forcing drug manufacturers to charge the same price that these other countries mandate would backfire. Instead, policymakers should use trade negotiations to pressure other wealthy countries to pay their fair share.