Who pays for drug quality?

This study examines how pharmaceutical costs for higher quality drugs are shared between insurers and consumers. Who bears these costs has important implications for patient access to better drugs, and for differences in access to higher quality pharmaceuticals. We investigate these issues using data from two large drug product classes: non-steroidal anti-inflammatory drugs (NSAIDs) and antidepressants. We find that insurers shift the drug costs associated with higher quality onto consumers for antidepressants but share in the costs of higher quality for NSAIDs. This suggests that patients cost burden, hence access, to higher quality drugs may vary across drug product classes.