Drug spending in the United States is at an all-time high and still rising. Studies have repeatedly shown that the U.S. pays far more for the same prescription drugs than other high- and middle-income countries. Patients in the U.S. are more likely to report that they can’t afford their medications; half of all of adults with lower incomes go without care because of cost.

This trajectory has kept prescription-drug-pricing reform on the top of to-do lists for policymakers on both sides of the aisle at the federal and state level for years. President Biden talked about the issue in his first address to Congress

The sustained attention is not a surprise. The American public has long supported drug-pricing reforms, regardless of political affiliation. The employer community also has embraced government intervention to curb drug prices.

Some fear that reduced prices will result in a lack of access to medications if manufacturers decide to pull their products from the market, but this fear appears overblown. Even in the most aggressive of policies under consideration, prices in the U.S. would still be among the highest in the world, though more in line with other countries. It seems unrealistic that pharmaceutical companies would pull their drugs from one of the largest, highest-paying, and most profitable markets in the world.

Reforming how we pay for drugs in the United States will save federal dollars, make drugs more affordable for patients, and provide an opportunity to redirect federal savings to address critical gaps in coverage, access, and affordability.