The ethics and economics of pharmaceutical pricing

Annu Rev Pharmacol Toxicol. 2015:55:191-206. doi: 10.1146/annurev-pharmtox-010814-124649. Epub 2014 Aug 13.


The cost of drugs is a major and rapidly rising component of health-care expenditures. We survey recent literature on the ethics and economics of skyrocketing pharmaceutical prices and find that advances in economic research have increased the sharpness and focus of the ethically based calls to increase access by modifying patent protection and reducing prices. In some cases, research supports ethical arguments for broader access. Other research suggests that efforts to broaden access result in unintended consequences for innovation and the medical needs of patients. Both ethicists and economists need to be more cognizant of the real clinical settings in which physicians practice medicine with real patients. Greater cross-disciplinary interaction among economists, ethicists, and physicians can help reduce the disjunction between innovation and access and improve access and patient care. This dialogue will impact private industry and may spur new multistakeholder paradigms for drug discovery, development, and pricing.

Keywords: differential pricing; drug access; innovation; patents; prescribing; price controls; rationing.

Publication types

  • Review

MeSH terms

  • Advertising / economics
  • Advertising / ethics
  • Commerce / economics*
  • Commerce / ethics*
  • Commerce / legislation & jurisprudence
  • Diffusion of Innovation
  • Drug Costs / ethics*
  • Drug Costs / legislation & jurisprudence
  • Drug Industry / economics*
  • Drug Industry / ethics*
  • Drug Industry / legislation & jurisprudence
  • Drug and Narcotic Control / economics
  • Government Regulation
  • Health Services Accessibility / economics
  • Health Services Accessibility / ethics
  • Healthcare Disparities / economics
  • Healthcare Disparities / legislation & jurisprudence
  • Humans
  • Marketing of Health Services / economics
  • Marketing of Health Services / ethics
  • Medical Assistance / economics
  • Medical Assistance / ethics
  • Patents as Topic / ethics
  • Pharmaceutical Preparations / economics*
  • Pharmaceutical Preparations / supply & distribution
  • Physician's Role


  • Pharmaceutical Preparations