The generation of innovative new products is becoming more highly concentrated in large multinational pharmaceutical firms. New drugs are generally introduced in foreign countries sooner than in the United States. The cost of introducing new chemical entities has increased. Another manifestation of supply side drug regulation is the impact on effective patent lives. Some relief has been achieved from the Waxman-Hatch Act.
Effects are more subtle than supply side, and data are less available.
3. formularies, and various efforts to increase the use of generics. In other European countries the reimbursement price is dependent on relative therapeutic benefit, cost-effectiveness, and timing of the negotiations. The values of the American people have changed so that they now expect government to intervene on their behalf. The emphasis has changed from everyone having an equal place at the starting line to having an equal place at the finish line. This has profound implications for the continuing debate on health care in the United States.