The Great American Drug Deal

Developing life-changing drugs is risky and expensive—but that’s not what makes them unaffordable. 

Drug pricing is a staple of every news cycle and political debate. And while we’ve struggled for decades to agree on solutions that serve all patients without jeopardizing the invention of new medicines, many Americans suffer because they can’t afford the drugs they need.

Do we really have to choose between affordability and innovation?

In The Great American Drug Deal, scientist and industry expert Peter Kolchinsky answers this question with a decisive No. The pharmaceutical industry’s commitment to creating new lifesaving drugs destined to become inexpensive generics can be balanced by the healthcare system’s commitment to making those drugs affordable for all patients—a Biotech Social Contract. Through deep research and compelling stories of breakthroughs and breakdowns, Kolchinsky presents solutions for striking a balance that are bold yet realistic and tackle today’s most pressing questions, including:

• Why doesn’t insurance make drugs affordable?


• How can we prevent price-jacking of older drugs?


• Why are drugs more expensive in America than elsewhere?


• How can we guarantee that all medicines eventually go generic so they are only temporarily expensive?


• What systemic failures led to the opioid crisis, and how can we prevent the next one?

The Great American Drug Deal offers clear-eyed scrutiny of all players in the industry and examines vital ideas for closing loopholes, encouraging investment, dealing with bad actors, and educating consumers. It’s time we resolve to support patients and fuel discoveries that ease suffering now and for generations to come.