Multiples of Median Income: A Tool to Call out Drugs that are High Cost and Low Value

As currently priced, many medications are harming society because they are high cost and low value, and they divert resources from interventions that could promote the health and well-being of Americans to a much greater extent. We believe that cost-effectiveness, stated as dollars per quality-adjusted life-year, is not meaningful for many Americans. By contrast, a measure indexed to household income would be far more salient. We therefore propose reporting the costs of drugs and medical devices as multiples of median income of US households. Although this simple change will leave many questions unanswered, we believe that it will contribute to ongoing efforts to increase the value of health care by bringing drug costs into perspective.